Sterilization during puerperium (author's transl)

Sterilization of the woman during puerperium is performed immediately following delivery via a periumbilical incision during a caesaren section isthmica intraperitonealis via laparoscopy or 3--5 days following delivery by pelviscopy. The surgical procedure currently in use for ligating or severing the fallopian tubes is accompanied by extensive loss of blood. This procedure should, therefore, be replaced by the coagulation method which is safer and does not contribute to the formation of adhesions. If the abdomen has been dissected, either high frequency current or the Endo-coagulation procedure may be used to produce the destructive heat necessary to coagulate the fallopian tubes. If the abdomen has not been opened and the coagulation of the fallopian tubes must be performed via pelviscopy, the Endo-coagulation method should be used instead of the high frequency current procedure which cannot be absolutely controlled by the surgeon. The Endo-coagulation procedure works at or about the temperature of boiling water. The failure rate for this procedure is about 2--3 %0.     

Respiratory responses to tracheobronchial stimulation during sleep and wakefulness in the adult cat

The response to tracheal stimulation (50 microliters of tap water) during wakefulness, non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep was investigated in adult cats. In wakefulness, repetitive coughing occurred on 80% of the trials. In NREM and REM sleep, the most frequent response (approximately 69% and 58% of the trials, respectively) was arousal, followed by coughing. Apneas occurred following the stimulus and before arousal in 11% and 24% of the trials in NREM and REM sleep, respectively. In NREM sleep, the tracheal stimulus sometimes evoked expiratory efforts following a normal inspiratory effort (11% of the trials). These were much weaker than the expiratory efforts during coughing in wakefulness. In REM sleep, stimulation in 11% of the trials elicited increased inspiratory efforts. Although these may have been diminutive preparatory inspirations for coughing, they were much smaller than preparatory inspirations associated with coughing in wakefulness, and they were never followed by active expiratory efforts. Arousal from either NREM or REM sleep in response to tracheal stimulation was sometimes associated with an augmented breath. This response, which is common upon spontaneous arousal, may lead to deeper aspiration of the tracheal fluid. We conclude that in cats coughing requires wakefulness and that airway stimuli in sleep cause a variety of respiratory responses, some of which may be maladaptive.     

Acute leukemia as terminal stage of Hodgkin's disease (author's transl)

In a 61 year-old female patient with Hodgkin's disease treated with cytotoxic drugs and radiation therapy acute undifferentiated leukemia developed 10 years later. The possibility of a carcinogenic effect of the cytotoxic and actinic therapy is discussed. Leukemia complicating the course of Hodgkin's disease must be considered an independent disease and not a iatrogenic transformation of a preexisting lesion.     

Disorders of the ability to distinguish colors during digitalis therapy (author's transl)

31 hospitalized patients treated with beta-methyl digoxin and 34 treated with beta-acetyl digoxin were examined for color vision disturbances and compared with a control group (n = 17). The serum digoxin concentration was determined radioimmunologically. A significant correlation (p less than 0,01) was found between the severeness of the disturbances in color vision and the concentration of digoxin in the serum. The disturbances concerned different wave length regions. The lapse of time for disturbances in the distinguishing colors is being described in a case of suicidal intoxication.     

Hyporesponsiveness of the pituitary to CRH during slow wave sleep is not mimicked by systemic GHRH

During slow wave sleep (SWS) pituitary responsiveness to CRH is reduced. Since GHRH is involved in the promotion of SWS in humans and rats, it was examined whether the blunted CRH-induced ACTH and cortisol release during SWS could be mimicked by systemic GHRH. Young healthy men (n = 7) participated in 4 sleep-endocrine protocols: (A) lights off at 23.00 h, intravenous injection of 50 microgram CRH during the first SWS period; (B) lights off at 01.00 h, injection of 100 microgram GHRH at 23.00 h, followed by 50 microgram CRH at 23.30 h; (C) lights off at 01.00 h, injection of 50 microgram CRH at 23.30 h, and (D) lights off at 23.00 h, saline treatment only (= baseline condition). The sleep EEG was recorded during the lights off period and blood samples, collected every 20 min between 22.00 and 07.00 h, were assayed for GH, cortisol and ACTH. There was no significant difference in the sleep-associated GH peak between protocols. Plasma ACTH was significantly higher following CRH administration during wakefulness compared with CRH administration during SWS (protocols B and C vs. A; area under the curve (AUC) 23. 00-03.00 h: 9.6 +/- 4.8 and 7.3 +/- 2.0 vs. 6.1 +/- 1.1 ng/ml x min; p < 0.05), while there was no significant difference in plasma ACTH concentration between the baseline condition and protocol A (CRH administration during SWS). Similarly, cortisol was significantly enhanced compared with baseline following CRH during wakefulness only. CRH induced an increase in EEG activity in the sigma frequency range, both when it was administered during wakefulness and SWS, while this effect was reduced by pre-treatment with GHRH. In summary, our data suggest that (1) the blunted CRH-induced release of ACTH and cortisol during SWS is not mimicked by systemic GHRH administration, and (2) CRH enhances sigma EEG activity possibly via modulation of afferent pathways from the median eminence to the thalamus and this effect is reduced by pre-treatment with GHRH.     

Combined sleep deprivation/chlorimipramine therapy of endogenous depression (author's transl)

A sleep deprivation/chlorimipramine therapy was compared to chlorimipramine therapy in endogenous depression. In the sleep deprivation/chlorimipramine group a quick and long-lasting remission of depressive symptoms could be demonstrated. In the chlorimipramine group a marked prolonged onset of action was seen.     

Microdialysis and EEG in rats reveal cortical PGE2 changes during sleep and wakefulness

Prostaglandin (PG) E2 production was assessed in freely moving rats using the technique of microdialysis in the prefrontal cortex associated with parallel cortical EEG recordings. PGE2 concentrations were 40% higher during wakefulness than during slow wave sleep. PGE2 values varied during wakefulness with a maximal increase in the middle of the stage and a drop towards lower values before the occurrence of slow wave sleep. These variations were similar to those observed previously in the rostromedial hypothalamus, where PGE2 concentration was 2.6 times lower than that in the cortex. These data document a positive correlation between cortical EEG activation and PGE2 levels. Taken together with pharmacological data on the awakening effect of centrally administered PGE2, these observations are in favor of an involvement of PGE2 in the generation of wakefulness.     

Malignant hyperthermia during the 13th general anaesthesia (author's transl)

We report a case of malignant hyperthermia in a man of 41 years during his 13th general anaesthesia. All previous anaesthetics were quite normal. Musculoskeletal abnormalities and increased CPK-levels are to be found in some members of the patient's family. The combined use of suxamethonium and halothane might have caused the development of malignant hyperthermia. As a concept of the aetiology of the syndrome the case history indicates that it may be stress-related.     

Prostaglandin-F-levels in human plasma during late pregnancy and labour (author's transl)

The concentrations of prostaglandin F-equivalents were measured in peripheral plasma during labour at a cervical dilatation of 5 cm and at complete dilatation. After purification, extraction and chromatography the PGF-equivalents were measured radioimmunologically. The intraassay variation was 1.5%, the interassay variation 3.5%. The specificity for PGF was 96-98%. Logit/log transformation of the standardcurve yielded a sensitivity of the assay of 120 pg. At cervical dilatation of 5 cm PGF-equivalents varied between 1300 and 3200 pg/ml plasma. At complete dilatation values changed between 1200 and 5400 pg/ml. These fluctuations correlate timedepending to the uterine contractions recorded and may be interpreted as a result of uterine PGF-release.