Actions of carbocromen of toxic effects of digitalis (author's transl)

Experiments an anaesthetized dogs, rabbits and guinea pigs show that with clinically relevant doses of 3-(2-diethyl-aminoethyl)-4-methyl-7-(carbethoxy-methoxy)-2-oxo-1,2-chromene-hydrochloride (carbocromen, Intensain?) the LD100 of digoxin (+50%) and ouabain (+60%) considerably increase. The positive inotropic effect of digoxin is not influenced by carbocromen. The appearance of arrhythmias is significantly delayed, the coupling between atrial and ventricular activity continues for a longer time. Besides effects on myocardial metabolism a membrane effect of carbocromen could be responsible for the improvement of the therapeutic range of digoxin and ouabain.     

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.     

Hemodynamic interaction of propranolol and digitalis in patients with arterial hypertension (author's transl)

Central hemodynamics at rest and during supine ergometer exercise have been studied in 12 hypertensive subjects and three healthy persons before and 20 min after 5 mg of intravenous propranolol. Cardiac output (CO) decreased by 19% at rest (p less than 0.001) and by 15% during exercise (p less than 0.001). Pulmonary capillary wedge pressure (PCP) during exercise rose after beta-blockade by 56% to 28 mm Hg (p less than 0.001); a similar increase could be observed in pulmonary artery pressure (PAP) and right atrial mean pressure (RAM). Brachial artery mean pressure at rest did not change significantly; during exercise this value was 6% below the pretreatment level (p less than 0.001). In order to evaluate the influence of digitalis on beta-blocker induced hemodynamic changes, measurements were repeated 30 min after administration of 0.6 mg beta-Methyldigoxin intravenously. After addition of digitalis, average PCP during exercise was significantly lower than after beta-blockade alone (22.8 mm Hg, p less than 0.001). Likewise, PAP and RAM after digitalis were lower than after propranolol alone. CO did not change following digitalis administration. These findings indicate that digitalis partially counteracts the elevation of filling pressures induced by beta-blocking agents but leaves CO unchanged.     

Radiation therapy in renal adenocarcinoma (author's transl)

Sole irradiation treatment for renal carcinoma or its metastases has to be regarded as only a palliative therapy, whereas postoperative radiation therapy brings about a distinct diminution of the frequency of local recurrences, and, at least in advanced tumor stages, an improvement of the 5-year survival rate. Long-term preirradiation (ca 3000 rd TD within 3 weeks, and operation after another three weeks) or short-term pre-irradiation (ca 1200 to 2000 rd TD within 2 or 4 days, and operation the next day) are tolerated well and do involve no disturbances of the wound healing. Surgical treatment is not complicated by short-term irradiation, but often is easier following long-term irradiation; beyond this, the latter may just render possible a radical extirpation of the renal tumor. It appears from first results that decrease of distant spread and improvement of recovery rates in advanced tumor stages may be within reach, particularly in connection with post-operative irradiation.     

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.     

DTIC in the therapy of solid tumours (author's transl)

From 1975 to 1977 42 patients with advanced solid tumours were treated with imidazole-carboxamide (DTIC). It was applied in 18 cases as monotherapy: in the remaining patients it was administered in combination with other cytostatic agents. Tumour remission was recorded in 4/22 patients with melanoma, 2/2 with Kaposi sarcoma and 2/7 with soft tissue sarcoma. No change in tumour behaviour was recorded in 6/22 melanomas, 2/7 soft tissue sarcomas, 1/7 head and neck tumours and 1/1 thymoma. Side effects of DTIC monotherapy were comparably low. The optimum dosage and frequency of DTIC therapy have not yet been established. Combinations with other cytostatic agents are still being tested.     

Experiments of electro-acupuncture-analgesia during delivery (author's transl)

We report about 20 patients who underwent electroacupuncture therapy during delivery with intent to reduce labor pains. Acupuncture steel needles situated in the thoracal, lumbal, sacral region and in the region above the symphysis were stimulated by a rectangular impulse current. A good effect for the reduction of labor pains could be observed in 5 cases, a moderate one in 6 cases. An absolute analgetic effect could not be achieved in any case, and in 9 cases no analgetic effect of acupuncture therapy on labor pains was visible. Acupuncture had no influence on labor or fetal heart rate, monitored by cardiotocography.     

Longterm potassium therapy in angina pectoris (author's transl)

The effect of a two month potassium therapy on maximum performance was systematically investigated in 12 patients with overt angina pectoris. The patients received 40 mEq potassium daily by mouth. The average maximum performance increased by 85% after 8 weeks' administration of potassium. The rise in the performance curve fell after 6 weeks to attain a steady state after 8 weeks. In particular it must be emphasized that the heart rate was reduced under maximum capacity in spite of considerable increase in performance. Furthermore, a comparison of heart rates after 8 weeks' potassium administration showed that in each case for the same level of performance the heart rate was 15% less than before potassium. The results of the investigation support longterm therapy with potassium in angina pectoris.