A semi-automatic system for the analysis of ecocardiographic tracings (author's transl)]

A semi-automatic system is described for analysis of echocardiographic traces of the left ventricle. Filtering interpolating and averaging processes are discussed and the overall accuracy evaluated. The program is able to calculate ventricular indexes (strake volume, ejection fraction, circumferential velocity of fiber shortening), continuous functions (istantaneous ventricular diameter and volume, wall thickness, velocity of cavity compression and dilation) and, correlating the echo data with pressure values, circumferential stresss and ventricular compliance. Pressure is obtained along the ejection phase only from the carotidal pulse calibrated by means of the brachial pressure values. Advantages and limits of the method are discussed.     

The influence of methoxyflurane (penthrane) on surface activity of the lung (author's transl)]

Methoxyflurane, at the moment the most potent inhalation anaesthetic, was examined in respect of its surfactant irritating properties in the rabbit. After a five hour anaesthesia with this compound there was, compared with a control group of animals which underwent only mechanical ventilation with room air for the same period, a significant decline of the compliance quotient from 2.99 to 2.55, indicating a relevant impairment of alveolar lining surfactant. A concomitant fall of arterial PaO2 from 84.8 to 71.3 mm Hg showed the resulting deterioration of respiratory function. Postanaesthetic preparations of these lungs examined using the Wilhelmy balance exhibited a significant fall of the stability index from 1.73 to 1.25, though hysteresis remained unaffected. Lung histology showed interstitial edema and patchy atelectasis, features which are found also in the early stages of post-traumatic pulmonary insufficiency. On this basis we recommend that methoxyflurane is not used in patients with impaired surfactant activity as such is found after severe traumatisation, head injury or in special preexisting pulmonary diseases. If this anesthetic is given to healthy individuals, the ventilatory pattern should include periodic sighs and prophylactic PEEP.     

The jet-wash-technique (author's transl)

For the early detection of the endometrial adenocarcinoma the Gravlee-Jet-wash-technique was used in 600 cases. The procedure is simple and requires only 2 to 3 minutes to the gynecologist. An anesthesia is not necessary. In women with stenosed os externum and in anxious patients we use an analgesia of the paracervix (PCB). The technique allows a cytologic and/or cytohistologic investigation. In 600 examined cases we found 37 endometrial adenocarcinomas. We obtained a 100 per cent accuracy in the detection of the 37 malignant lesions. Our experience up to now with the Jet-wash-technique should stimulate its wider use also for outpatients with a high risk for the endometrial adenocarcinoma.     

The influence of cardiac frequency on the hemodynamic consequences of mitral stenosis (author's transl)

In eleven patients with isolated mitral stenosis and regular sinus rhythm a right cardiac catheterization was performed and the wedged pulmonary capillary pressure recorded at rest and during electrical pacing of the right atrium at successive frequencies of 100, 120, 140, and, occasionally, 160 and 180 beats/min, while cardiac output was estimated by the Fick's principle. In all cases a significant elevation of pulmonary capillary pressure with a simultaneous reduction in cardiac output was obtained. The rise of wedged pulmonary pressure was proportional to the increment in cardiac frequency and related also to the calculated area of the mitral valve. The influence of active atrial contraction upon pulmonary pressure and cardiac output is discussed and comparisons with other studies are made. Emphasis is made on the value of atrial pacing as a diagnostic method in mitral stenosis, especially in cases in whom classical effort manoeuvres can not be applied or are insufficient to rise cardiac frequency.     

The Stepanik arteriotonograph (author's transl)

A pressure-sensitive probe, specially developed for this purpose, is built into a contact lens in such a manner that when adjusted to the patient's eye the probe registers the intraocular pressure whilst the observer compresses the eyeball and observes the arterial collapse phenomenon on the disc over the contact lens on the slit-lamp microscope. The standard deviation of a clinical measurement is 1.5 mm Hg. Derived from measurements on 65 eyes of patients without signs of vascular disorder, the correlation of the systolic and diastolic ophthalmic artery-pressure (y) to that of the ipsilateral brachial artery (x) is given by Y =0.79x-1.33 (r=0.96) and the correlation of their median pressure by Y=0.93x-17.2 (r=0.94).     

The Wyburn-Mason syndrome (author's transl)

A patient aged 39 years with Wyburn-Mason syndrome is presented. He had an apple-sized intracranial arteriovenous angioma racemosum of the left temporo-medical region, which was inoperable, as it extended to the basal ganglia. It was diagnosed by carotid angiography and by sequential brain szintigraphy. More than 50 retinal arteriovenous anastomoses were observed in the left eye, involving all quadrants and the macular region. Some of these anastomoses were only found by fluorescence angiography. Clinical signs were hemiparesis and decreased sensibility of the right side, headaches, speech disorders and right homonymous hemianopia. Vision was decreased to 0.4. By partial embolisation via the right common carotid, it was possible to reduce the size of the intracranial hemangioma.     

Animal experiments on the influence of sarbitol on the damaged internal ear (author's transl)

The influence of sorbitol was studied by recording the microphonic potentials (MP) of 10 guinea-pigs whose internal ears had been noise-damaged immediately before. Neither the rise of MP 10 sec after the start of noise exposure nor the total rise of MP showed any changes after the intraperitoneal injection of 2 ml of a 40% sorbitol solution.     

The diagnosis of IgD-Myelomatosis (author's transl)

Two patients with IgD-lambda myelomatosis are presented and the differential diagnosis is discussed. Typical features of this disease are the high incidence of Bence-Jones proteinuria, osteolytic lesions, amyloidosis and the predominance of male patients. Furthermore, an augmentation of serum IgD level to 165 mg% was observed in a 22-year-old female patient with presumed Coxsackie myocarditis. The theories in regard to IgD function are discussed.     

Dumping-prophylaxis (author's transl)

The dumping syndrome is due to a vigorous reflex distension of the jejunum, caused by the stomach violently evacuating its contents. The aim of treatment is to overcome the drastic evacuation by restoring the rhythmic peristalsis of the stomach (eukinetics). This can be achieved by a special diet. Every meal should begin with well chewed solids (pulp) and avoid all fluids. With a well organised medical staff a complete success can be achieved. Surgical measures in Dumping can be avoided.