Morphological classification of oral leukoplakia (author's transl)

656 cases of oral leukoplakia were analysed according to macroscopic aspects, microscopic growth patterns and histologicalcytological differentiation, and the relationship to cancer of the oral cavity was studied. Homogeneous and speckled leukoplakia can be distinguished macroscopically, while flat (70%), papillary-endophytic (22%) and papillomatous-exophytic (8%) types can be distinguished by their growth pattern. Histological-cytological characteristics consist of epithelial hyperplasia (hyperkeratosis with ortho- or parakeratosis; akanthosis) and epithelial dysplasia (dyskeratosis, basal-cell hyperplasia, loss of polar arrangement of the basal cells, cell polymorphism, increased mitosis rate). No or little dysplasia was demonstrated in 74% of leukoplakias, moderate in 17% and marked in 6%. Carcinoma-in-situ, defined as high-grade dysplasia with additional loss of epithelial layering, was found in 3%. Precancerous leukoplakia (in almost 10% of cases, counting high-grade dysplasias and carcinoma-in-situ) must be delineated as a special group. Numerous correlations were found between dysplastic leukoplakias and oral cavity cancer as regards localisation, age and sex distribution. In the various leukoplakia forms there was an increased incidence of marked stroma reactions and of Candida colonisation with increased degrees of dysplasia.     

Gold drainage as a glaucoma operation (author's transl)

A glaucoma operation is described in which a piece of gold leaf 0.05 mm thick, 1.5 mm wide and 4 mm long is laid into a trepanation opening or into an anterior chamber angle incision after preparation of a scleral flap. The tendency of rejecting of large gold leaves was considerable. A diverticulum of the anterior chamber formed round all gold leaves through the scarred walls of which a reasonable regulation of pressure by drainage of the aqueous was apparently not possible. A real wick or drainage effect was not seen in any case.     

Misdiagnosis of intraocular iron foreign bodies (author's transl)

Out of 393 intraocular foreign bodies (1961-1975) 361 were magnetically removed and 32 non-magnetically (copper 7,brass,2,lead 5, glass 10, stone 3, wood 4 and plastic 1).60% of the foreign bodies were caused by hammer and chisel injuries.73 foreign bodies were diagnosed too late, in 71 cases no x-ray was made. The incidence of complications (infection, siderosis, retinal detachment was considerably increased where the foreign bodies were removed late. From the 73 foreign bodies (18.5%) the patient did not consult a doctor in 37 cases because of "insignificance". 4 times the family doctor was consulted, who treated the patient symptomatically. In 4 cases occurring in the weekend no eye-specialist could be ostensibly found. In 26 cases the ophthalmologist performed no x-ray control, and small foreign bodies were twice described as "x-ray plate artefacts" from the roentgen specialist. It must be an absolute rule in the eye-doctor's practice that every injury received while working with metals necessitates an x-ray control!     

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.     

The voice as a mirror of personality (author's transl)

The philosopher and astrologer Scotus, who was famous for his translations from Greek and Arabic into Latin wrote a handbook of physiognomy for Emperor Friedrich II about 1228 A.D. In this volume based particularly on Arabic sources is a chapter on the voice. It contains numerous details that suposedly enable recognition of certain personality traits by voice characteristics. In the present such concepts are familiar, but that it was of practical relevance 750 years ago may justify closer inspection of Scotus and his work.     

Serum concentrations of pancuronium in anuric patients (author's transl)

After a single intravenous dose of 6 mg serum concentrations of pancuronium were measured in 6 anuric patients by means of the bromophenol blue colorimetric method at 1, 5, 45 min and 3 h. After 45 min and 3 h there was a retention of 1.7 and 4 times the control values respectively. The prolongation of pancuronium induced muscular paralysis which has been demonstrated by other authors now can definitely be related to elevated serum concentrations of the active drug. The termination of muscle relaxation in anuric patients is considered merely to be due to redistribution of the drug from the motor end plates to non specific structures. Prolonged neuromuscular blockade may occur in as much as the redistribution mechanism is overloaded by inadequate doses.     

Isoprodiane therapy for previously untreated cavitating pulmonary tuberculosis (author's transl)

Isoprodiane (a combination of isoniazid, prothionamide and dapsone) was given to 22 persons with open cavitating pulmonary tuberculosis. None of them had been treated before. Microscopic and cultural sputum conversion occurred within an average of 5 and 11 weeks respectively. Treatment was discontinued in five patients: as a safety measure, despite sputum conversion, on account of the extent of the process and the general condition of the patient (one case); because of side-effects (two cases, one of whom was hypersensitive to isoniazid); because the patients failed to continue with the treatment (two cases). The early results were very promising; the long-term results cannot yet be assessed. The therapy did not materially affect the haemoglobin levels.     

Flat curves of oral glucose tolerance tests (author's transl)

Patients are often referred to diabetologists on account of a flat curve of oral glucose tolerance test. This abnormality, however, is virtually never associated with a serious metabolic disorder and in any case, it never points to a disease that cannot be diagnosed by questioning or by straightforward clinical examination, nor confirmed by a more specific laboratory test. The curve may be flat for technical reasons (e.g. rejection of the glucose administered, timing of blood withdrawals and assays), for physiological reasons (differences between venous and arteriolo-capillary blood), or for pathological reasons (interaction with drugs, pituitary, thyroid or adrenal insufficiency, digestive malabsorption) but it never implies organic hypoglycaemia nor diabetes mellitus.     

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.