Disseminated intravascular coagulation (D.I.C.) and fibrinolysis in patients with acute leukemia (author's transl)

Biological symptoms of D.I.C. were investigated in 43 patients with acute leukemia. Ten of them were found to be positive either at the onset or at the relapse of the disease and in some cases D.I.C. was triggered by chemotherapy. Among the ten positive cases 3 patients had an acute promyelocytic leukemia, 4 had an acute lymphoblastic leukemia, 2 a myeloblastic and 1 a monoblastic leukemia. D.I.C. was found either in patients with an hypercellular form of the disease or in patients with a normal or low white cell count. Symptoms of D.I.C. in acute leukemia must be systematically sought at the onset and during treatment by chemotherapy and treated with heparin and platelet transfusions as it is now admitted for acute promyelocytic leukemia.     

Experiences with acute moderate controlled hemodilution (author's transl)

The authors present an own method of hemodilution and experiences gained from 10 patients operated for chronic gastric or duodenal ulcer. The therapuetic results of the method show that it can be applied easely and safely in everyday surgical practice. In the patients treated with it no surgical and anaesthesiological complications could be observed during the operations as well as after them. The autors believe that the method of hemodilution for planned surgical operations will contribute to a more economical use of blood transfusions and to reduction in the occurrence of virus hepatitis.     

The problem of treating breast cancer by limited surgery (author's transl)

The value of radical mastectomy in treating cancer of the breast has been questioned by some authors. With regard to the results published and on the basis of our own experiences limited operations without or with additional radiotherapy cannot be considered to be reliable procedures at present: it is only possible to approximately equal results by a strict case selection. With special cases such as in-situ carcinoma or small well defined cancers with beginning infiltration being expected there is no real basis for the indication to limited surgery in a single case. With the increase of small prognostically favourable cancers and border-line cases due to improvement of early detection more attention should be devoted to the problem of treating breast cancer by limited operations.     

A radioreceptor assay for catecholamines. I. A study with 3H-norepinephrine (author's transl)

A radioreceptor assay for catecholamines(CA) has been established utilizing the microsomal fraction of bovine myocardium as CA receptors and 3H-norepinephrine(3H-NA) as a ligand. The bound fraction was separated from the free fraction by filtration through milipore filters. The following results were obtained: 1) The optimal amount of the microsomal fraction was 250 micrograms/tube, when 3H-NA of 12,000 c.p.m was used. The appropriate conditions for incubation were 2 hours at 37 degrees C in a pH 7.4 sucrose solution. 2) By this method, norepinephrine was detectable in the range from 5 to 100ng/tube. 3) Various compounds with catechol nucleus showed a cross-reaction in this radioreceptor assay system. 4) Alpha-adrenergic blocking agents inhibited the binding of 3H-NA, whereas beta-blocking agents were ineffective. These results suggest that the microsomal fraction of bovine myocardium contains alpha-adrenergic receptors which bind the catechol nucleus of CA.     

Applied phoniatry. I. Retarded language and speech development (author's transl)

To better understand the assessment of difficulties in verbal communication it is considered to explain language and speech development in relation to motor function. The aetiology, diagnosis, prognosis and treatment of language disorders and their common characteristics are discussed. The otolaryngologist must expect an increase in the number of such cases and should initiate prompt and adequate treatment.     

Treatment of acute myocardial infarction with sodium nitroprusside (author's transl)

In 12 patients with acute myocardial infarction, seven of whom had high and five low blood pressure measurements, sodium nitroprusside infusions were given to reduce the myocardial oxygen consumption. The dosage was between 20 and 300 mug/min. Sodium nitroprusside led to a considerable reduction of the systemic arterial pressure, while the left ventricular filling pressure was less influenced. In normotensive patients the filling pressure could often not be sufficiently lowered as a too severe reduction of arterial pressure occurred beforehand. In hypertensive patients the relationship between left ventricular filling pressure and arterial pressure was better: in all patients the arterial pressure could be lowered to normal values and the filling pressure also became normal in most cases. Angina pectoris improved markedly in all patients. These results show that sodium nitroprusside has a satisfactory effect on the haemodynamics in hypertensive infarct patients, whereas it is less suitable for the treatment of normo- or hypotensive patients.     

Aminolysis and racemization of activated esters with the use of high temperatures (author's transl)

The reactivities in aminolysis of the benzyl, phenyl, p-nitrophenyl and pentachlorophenyl esters of benzyloxycarbonylphenylalanine were ascertained at different temperatures up to 90 degrees C and the occurrence of racemization investigated. It turned out that the protective function of the benzyloxycarbonyl group in relation to the racemization was conserved, even at the high temperatures used in the peptide synthesis.     

Changes in aminophenazone metabolism with acute hepatitis in children (author's transl)

Serum half-life of aminophenazone was measured in 23 children with acute viral hepatitis and children with normal liver biopsy of matched ages. In acute hepatitis the value was 6.71 +/- 3.34, significantly longer than in the normal controls (2.79 +/- 0.53). Two hours after oral intake of the drug the serum concentration was higher in healthy children than in those with hepatitis, but the difference was not significant. Especially in children with intercurrent acute hepatic disease account must be taken of impaired metabolism during long-term drug treatment.     

Osteomyelitis, therapy and prognosis (author's transl)

The application of antibiotics at the treatment of osteomyelitis resulted in a rise of the permanent successful treatment rate. This is especially true for the acute hematogenous osteomyelitis, to a certain extent also for the chronic exogenous one, at which even today the antibiotical therapy is not as important as a surgical intervention. Under consideration of the generally accepted therapeutical principles the special importance of a much individualized treatment adjusted to the clinical picture and disease stage is pointed out. The advantages and disadvantages of an application of antibiotics at the osteomyelitis are mentioned and we try to explain the reasons for occasional therapy failures. A special chapter is devoted to the methods of filling and sterilization of the osteomyelitis bone hollows. Our own experiences with an operative combination process are reported.     

Paediatric management of acute and chronic renal insufficiency (author's transl)

Acute or chronic renal insufficiency in children is not so rare. Causes are prerenal, renal or postrenal disturbances of kidney function. The dysregulation of the homoeostatic balance of the intra- and extracellular fluid composition presents a picture of a life-threatening illness. By dietetic and medicamental correction of the disturbances uremic complications can be prevented. This conservative treatment is presented.     

Treatment of malignant melanoma (clinical stages I and II) (author's transl)

The uncorrected cumulative five-year survival rate ("actuarial method") among 195 patients with infiltrative malignant melanoma of the skin was 58% (160 cases) in clinical stage I, 26% (35 cases) in clinical stage II. In addition to clinical staging, microstaging - i.e. the histologically determined depth of invasion of the primary tumour - is of great prognostic significance. In microstages 2 and 3 with the largest vertical tumour diameter below 0.76 mm, five-year survival rate was 100% while in microstage 3 with greater vertical tumour diameter it was 66% in microstage 4 55% and microstage 5 31%. Results of treatment can be reliably interpreted only if they are divided according to microstage. Propylactic dissection of the regional lymph-nodes (dissection in clinical stage I) need not be undertaken in microstages 2 and 3 with vertical tumours diameter below 0.76 mm. Whether prophylactic dissection was done in one or two sessions has apprarently no significant influence on survival rate. A single X-radiation dose to the primary tumour of 4 000 -6000 R immediately before excision of the tumour did not significantly increase the results. The results were particularly bad when the primary tumour was removed after inadequate manipulation.