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Background: On 2009-04-01 the Association of Statutory Health Insurance Physicians Westfalia-Lippe and health insurance organizations made an agreement to implement palliative home care for terminally ill patients. Based on this agreement, family doctors and palliativecardoctorscooperate,supported by coordinators., Method: 12 and 36 months after coming into effect of the agreement a questionnaire was sent to the regional palliative care networks to collect data about supply structure, number of patients and their place of death., Results: In the year 2011 85,410 people died in Westfalia-Lippe, 9.0% of them were included in palliative care structures. 69.5% of the included patients died at home, 9.9% in hospital (in 2010: 68.7% at home, 14.7% in hospital). A correlation between the population density or the number of included patients per palliative networkcould not be detected., Conclusion: Low-threshold access to palliative care networks(bothfamilydoctorand patientcancontact the palliative care team at any time) improves ambulant palliative care. Non-bureaucratic change from general home palliative care (German abbreviation: AAPV) to specialized home palliative care (SAPV) has proven successful in Westfalia-Lippe. Well-trained and experienced coordinators guarantee multidisciplinary and multiprofessional working of palliative care teams. In order to enhance palliative care in Westfalia-Lippe, data for quality assurance should be defined, periodically collected and evaluated in the future.

The influence of the unspecific stress factors at the distribution of the lymphocyte subpopulations in spleen and thymus was investigated in skin transplantation model of the mouse after operation. The parameters total lymphocyte content, electrophoretic distribution pattern, activity and isoenzyme pattern of the LDH were compared in allogenic, syngenic, and sham transplanted mice with untreated control animals. Stress reactions were observed in the electrophoretic distribution pattern of the spleen cells as an increase of the quickly moving fraction (S-fraction) still on the 14th day after transplantation. Such reactions as an increase of the S-fraction were provable in the thymus cells on the 3rd and 7th day. The influence of the operation stress was further shown in a changed isoenzyme pattern of the thymus cells LDH. The relative portions of the LDH 1 and LDH 2 were reduced still 10 days after transplantation with an increase of the LDH 5.