Search

Dissertation, Universität Duisburg-Essen, 2019

Developing an application with high performance through the code optimization places a greater responsibility on the programmers. While most of the existing compilers attempt to automatically optimize the program code, manual techniques remain the predominant method for performing optimization. Deciding where to try to optimize code is difficult, especially for large complex applications. For manual optimization, the programmers can use his experiences in writing the code, and then he can use a software profiler in order to collect and analyze the performance data from the code. In this work, we have gathered the most experiences which can be applied to improve the style of writing programs in C language as well as we present an implementation of the manual optimization of the codes using the Intel VTune profiler. The paper includes two case studies to illustrate our optimization on the Heap Sort and Factorial functions., 16 pages

The provision of assistive devices (PAD) is a key element of care in amyotrophic lateral sclerosis (ALS). Since 2011, assistive devices (AD) have been coordinated in an internet-supported care network at university-based ALS centers in Berlin, Bochum, Hannover and Jena. The digitization of PAD processes has facilitated the evaluation of real-life ALS care.Orthotics (OT), augmentative and alternative communication (AAC), supported treadmill (ST) and powered wheelchair (PW) were the PAD groups analyzed for delivery rates (proportion of delivered AD vs. medically indicated AD), rejection by patients and payers and latency of provision of care.Between June 2011 and October 2014 a total of 1479 patients and 12,478 AD were coordinated, among which 3313 PAD were related to OT, AAC, ST or EM. The median delivery rate was 64.3 %. The mean rejection rate by patients was 9.8 % (OT 5.4 %, AAC 9.8 %, ST 10.2 % and PW 15.6 %). Marked differences were noted in the rejection rate by payers and in care provision latency: OT (16.2 %, 68 days, n = 734), AAC (30.4 %, 96 days, n = 392), ST (34.8 %, 113 days, n = 164) and PW (35.6 %, 129 days, n = 259). Analysis of rejection rates showed significant differences among insurers.Only two thirds of the medically indicated AD reached the patients. Rejection rates by patients and payers and latency of provision of care were high. The PAD can substantially vary among health insurance companies. The establishment of consented criteria for PAD and their integration into treatment regimens and guidelines are crucial tasks for the future.

Der Stickstoff und damit die Stickstofffixierung sowie die Stickstofffixierer sind für das Verhalten der Biosphäre gegenüber dem Kohlenstoff von ganz entscheidender Bedeutung. Denn neue Untersuchungen mit globalen, zeitlich und räumlich hochauflösenden Modellen der gekoppelten Kreisläufe des Kohlenstoffs und des Stickstoffs haben gezeigt, dass der Prozess der Bindung des molekularen Stickstoffs aus der Atmosphäre durch Organismen die entscheidende Rolle für die Bindung des Kohlenstoffs spielt. Somit gewann in der Wissenschaft auch das Verständnis der mit der Fixierung molekularen Stickstoffs verbundenen Prozesse und ihrer Regulation auf globaler Ebene grundlegende Bedeutung. Neben frei lebenden Mikroorganismen, die Stickstofffixierung leisten, spielen vor allem auch symbiotische Mikroorganismen zusammen mit ihren Wirtspflanzen eine entscheidende Rolle. Unter anderen zählen die Erlen und die Leguminosen zu den wichtigsten stickstofffixierden Pflanzen. In dieser Arbeit wurde die Verbreitung der Erlen sowie die Dichte der Leguminosen auf globaler Ebene modelliert. Dafür wurden zwei neue Modelle entwickelt. Das erste Modell (Alnus-Distribution-Model) sagt die Verbreitung der Erlen anhand von Klima, Boden- und Vegetationstypen vorher. Die Modellierungsstudien haben gezeigt, dass die Verbreitung der Erlen in der Nordhalbkugel der Erde nur klimaabhängig ist. Jedoch spielen die Bodentypen und die potentielle natürlichen Vegetation auf der Südhalbkugel eine große Rolle. Beim Vergleich dieser Modellergebnisse mit einer globalen Datenbank GBIF (The Global Biodiversity Information Facility) über die Verbreitung von Pflanzenarten ergaben sich einige Unterschiede, die aber vermutlich auf eine ungenügende Dokumentation in der Datenbank zurückgeführt werden können, wie ein Vergleich mit Literaturangaben belegt. Im zweiten Teil der Arbeit, der Entwicklung eines Modells zur Vorhersage der Leguminosendichte (Global Density of Legumes), wurden zur Bestimmung geeigneter Variablen zunächst Korrelationsanalysen zwischen der Leguminosendichte und sechs Klimawerten sowie neun Bodenwerten vorgenommen. Dabei wurde festgestellt, dass die Leguminosendichte im Wesentlichen durch die mittlere Jahressumme der Niederschläge bestimmt wird. Die entsprechende Funktion, die beide Größen koppelt, ist eine Maximumfunktion, die eine niedrige Leguminosendichte für geringe und für sehr hohe Niederschläge vorhersagt. Die größte Leguminosendichte mit bis zu 35 Prozent Anteil an der Gesamtbiomasse ergibt sich für eine mittlere Jahressumme der Niederschläge von rund 1 250 mm. Die Validierung der beiden Modelle hat eine verhältnismäßig gute Übereinstimmung der Modellergebnisse mit den verfügbaren Beobachtungsdaten gezeigt. Eine überraschende Feststellung war, dass es keine Korrelation zwischen den neun Bodeneigenschaften und der Leguminosendichte in den Standorten gibt.

Das LDH-Release Assay (Lactate-dehydrogenase-Release Assay) ist ein Zytotoxizitätstest, der auf der Freisetzung von LDH aus dem Zytoplasma von Target-Zellen, die durch die zytotoxische T-Zellen (CTLs) lysiert werden, basiert. Dieser Test ist genauer, schneller, einfacher in der Handhabung und kostengünstiger als das Chromium-Release Assay, welches als Standardmethode für die Bestimmung der T-Zellzytotoxizität gilt. Ein Nachteil der LDH-Release- Methode ist aber, dass die LDH sowohl von den Target-Zellen als auch von den CTLs freigesetzt wird. Somit ist die Spezifität der gemessenen Zytotoxizität nicht gesichert. Bei einer hohen Spontanlyse bleiben die Ergebnisse fraglich. Eine hohe Spontanlyse der T-Zellen könnte durch die Verbesserung der Kulturbedingungen dieser Zellen vermieden werden. Aus diesem Grunde sollten die Kulturbedingungen von T-Zellen optimiert werden, um die Aussagekraft dieses Testes zu verbessern. Hierzu wurde in der vorliegenden Arbeit die Auswirkung unterschiedlicher Kulturbedingungen (Interleukin-2 (IL2), Interleukin-7 (IL7), Roswell Park Memorial Institut-Medium (RPMI), Iscove’s modified Dulbecco’s Media (IMDM), fetales bovines Serum (FBS), Human Serum (HS) und β-Mercaptoethanol (Merc)) auf T-Zellen geprüft. Als Quelle für T-Zellen diente das periphere Blut gesunder Spender. Mittels Dichtegradientenzentrifugation wurden T-Zellen isoliert. Nach der Kultivierung der isolierten T-Zellen in den verschiedenen untersuchten Kulturbedingungen, wurden die Vitalität, Zellzahl und Apoptose gemessen. Die besten Kulturbedingungen wurden zur Kultivierung von T-Zellen für die Untersuchung im LDH-Release Assay verwendet. Im LDH-Release-Test wurde auf die Zytotoxizität der kultivierten T-Zellen untersucht. Als Targetzellen wurden REH-Zellen oder frische bzw. kryokonservierte TEL-AML1-negative ALL-Patientenblasten eingesetzt. Als Effektorzellen dienten allogene T-Zellen, die man aus dem peripheren Blut gesunder HLA-gematchter Spender isolierte, oder autologe T-Zellen, die man aus den Blasten selbst in-vitro generierte. Die Vitalität der T-Zellen war signifikant hoch bei IL7-Medien und RPMI-Medien. Dagegen war sie signifikant niedrig bei Mercaptoethanol-Medien. Die Apoptoseraten der T-Zellen waren signifikant niedrig bei IL7-Medien und FBS-Medien. IL2 hatte eine signifikant positive Auswirkung auf die in-vitro Expansion der T-Zellen und eine positive Auswirkung (ohne Signifikanz) auf die Zytotoxizität dieser Zellen. Die Spontanlyse der CTLs in FBS-Medien war signifikant höher als in HS-Medien. Die Zytotoxizitätswerte waren signifikant hoch, wo autologe, nicht kryokonservierte Zellen verwendet wurden. Nach unseren Befunden stellen RPMI, IL2+IL7 und HS die besten Kulturbedingungen von T-Zellen dar. Darüber hinaus sollten im LDH-Freisetzungstest autologe und nicht kryokonservierte Zellen verwendet werden., The LDH release assay (Lactate dehydrogenase release assay) is a cytotoxicity assay, which is based on the release of LDH from the cytoplasm of target cells, which are lysed by the cytotoxic t-cells (CTLs). This test is more accurate, faster, easier to use and less expensive than the chromium release assay, which is considered to be the standard method for determining the t-cell cytotoxicity. A disadvantage of the LDH-release method is, however, that the LDH is released from both, the target cells and the CTLs. Thus, the specificity of the measured cytotoxicity is not assured. The results remain questionable with a high rate of sponatneous lysis of cells. A high rate of sponatneous lysis of the t-cells could be prevented through the improvement of the culture conditions of these cells. For this reason, the culture conditions of t-cells should be optimized in order to improve the reliability of this test. For this purpose, the effects of different culture conditions (interleukin 2 (IL2), interleukin 7 (IL7), Roswell Park Memorial Institute medium (RPMI), Iscove's modified Dulbecco's media (IMDM), fetal bovine serum (FBS), human serum (HS) and β-mercaptoethanol) on t-cells were tested in the present study. Peripheral blood of healthy donors was used as a source of t-cells. T-cells were isolated by differential centrifugation. The vitality, cell count and apoptosis of the isolated t-cells were measured after their cultivation in the different tested culture conditions. The best culture conditions were used for the cultivation of t-cells for the study in the LDH release assay. The LDH-release assay was used to test the cytotoxicity of the cultured t-cells. REH cells, fresh or cryopreserved TEL-AML1-negative blasts of ALL-patients were used as target cells. Allogeneic t-cells that were isolated from the peripheral blood of healthy HLA-matched donors or autologous t-cells, which were generated from the blasts themselves in vitro served as effector cells. The viability of the t-cells was significantly high in IL7 media and RPMI media. However, it was significantly low in mercaptoethanol media. The rates of apoptosis of t-cells were significantly low in IL7 media and FBS media. IL2 had a significant positive effect on the expansion of t-cells in vitro and a positive effect (no significance) on the cytotoxicity of these cells. The sponatneous lysis of CTLs in FBS media was significantly higher than in HS media. The results of the measured cytotoxicity were significantly high, where autologous non cryopreserved cells were used. According to our results, RPMI, IL2 + IL7, and HS represent the best culture conditions of t-cells. Furthermore, autologous and non cryopreserved cells should be used for the LDH release assay.

Questionnaires are usually used for the measurement of patient satisfaction, however, it is increasingly being recognized that the critical incident technique (CIT) also provides valuable insight.Questionnaires of the "Hamburger questionnaire on hospital stay" were distributed to 650 consecutive patients before discharge. Additionally 103 interviews were conducted in which the patients were asked to describe positive and negative incidents during their hospital stay. The results of both methods were then compared.A total of 369 patients returned the questionnaire and 103 patients participated in the interviews. The duration of a single interview was between 5 and 45 min with a mean of 12.7 min+/-10.1 min standard deviation (SD). Cronbach's alpha of the questionnaire was 0.9. A total of 424 incidents were reported, 301 of them were negative compared to 123 positive events. The questionnaires and interviews yielded partly similar and partly different results at category and subcategory levels concerning the areas of weaknesses and strengths in quality performance. The CIT was more concrete but did not give results for all aspects of quality. The CIT, but not the questionnaire, was able to detect 40/56 (71%) of the positive and 33/75 (44%) of the negative reports regarding medical performance and 25/42 (60%) of the positive and 15/51 (29.4%) of the negative reports of the performance of the nurses were revealed by the CIT and not by the questionnaires.The CIT gives valuable insights into the patient's perspective of strengths and weaknesses in hospital care, which might be overlooked by the questionnaire alone. However, the CIT is probably not suited for routine use because it is very time-consuming.

The importance of patient satisfaction as one indicator of quality care in the hospital is undisputed. This article discusses the findings of a survey on patient satisfaction that was conducted in patients with mainly gastrointestinal diseases. The aim was to find out whether the questionnaire is sensitive enough to discern levels of care in order to indicate which aspects of hospital care require improvement. The questionnaire comprised 63 items and measured satisfaction with 4 specific dimensions of hospital care, namely physician services, nursing care, food/accommodation and administration/organisation of daily activity, and two questions for open-ended responses. 319 questionnaires were distributed which the patients should deposit anonymously on the ward on the day of discharge. The response rate was 60.5%. 53.3% were completely filled in and could be analysed. The results show typically high levels of satisfaction with the core performances in hospital namely medical and nursing care. On the other hand the data clearly revealed detailed criticism about certain aspects of care. The four-dimensional questionnaire proved to be a useful and economically reasonable way to obtain a considerable amount of information on quality of care from the patient's perspective. The problem of losing precious information because of standardized answer categories can be met partly by providing the possibility of positive and negative remarks in open-ended questions. Despite several shortcomings of the method (i. e. social desirability) it can be used as a starting point for improvement in the clinical setting.

It was the purpose of this clinical retrospective study, which was conducted under homogeneous conditions, to find out whether there is a connection between chronic alcoholism and the consumption of narcotics. We examined a group of tumour patients who had to undergo partial laryngectomy in anaesthesia with neuroleptics. We examined 161 reports with regard to their statistical valuation. 21 patients were selected from group A in whom anaesthesia with neuroleptics had been induced with Thiopental, Droperidol and Fentanyl, and 48 patients from group B in whom anaesthesia with neuroleptics was induced with Flunitrazepam and Fentanyl. The patients of both groups were divided into three groups according to their previous alcohol history: Daily consumption of alcohol group I less than 20 ml, group II 20-100 ml, group III greater than 100 ml. Group A turned out to be too small for statistical valuation. But the mean values of Fentanyl consumption indicated dependence on the quantity of alcohol consumed. Group B was analysed statistically. In spite of the fact that there was a lack of statistical significance, the mean values for the consumption of Fentanyl (in group II higher by 7.8% and in group III higher by 16.9% than in group I) did show a dependence on alcohol abuse, the more so since signs of insufficient anaesthesia were reported by such patients only in whom severe abuse of alcohol had been established.

The clinical results of 50 patients with retinal and vitreous surgery performed in combined electrostimulating anaesthesia are reported. Premedication consisted of a barbiturate such as medomin and of atosil, ordered the evening before surgery. 1/2 hour preoperatively 1.5--2 ml thalamonal and 0.5 mg atropine were administered intramusculary. All patients were intubated and controlled respirated; stimulation starting about 5 minutes following intubation procedure. During continuous intermittent relaxation anaesthesia was maintained by a mixture of nitrous oxide/oxygen 1:1 and electrical stimulation at the dermatoms of N. trigeminus I, II and Plexus cervicalis 3 and 4. For the first time stimulation of the dermatoms during anaesthesia was done by self adhesive electrodes. So we were able to eliminate the circumstantial and not even harmless invasivity of the needle technique. The main advantages of the new method we see in a good circulatory stability and in good postoperative cooperation of the patients. Especially in old and poor risk patients the results of transcutaneous electrostimulating anaesthesia are excellent.

The effect of enflurane anaesthesia on the sympathoadrenal system, the hypothalamic-hypophyseal-adrenocortical system, and on the circulatory system was investigated in patients undergoing ophthalmic surgery. Blood concentrations of adrenaline, noradrenaline, ACTH, cortisol, and arterial blood pressure and heart rate were measured in 10 patients 30 min after premedication (I), 3-5 min after surgical incision (II), 20 or 45 min after surgical incision (III) and in 7 of 10 patients 10-15 min after extubation (IV). After conventional induction anaesthesia was maintained with enflurane (1.5-2.0%), combined with N2O/O2 2:1, and intermittent relaxation. Plasma adrenaline, ACTH, cortisol and heart rate increased significantly during operation, while plasma noradrenaline and blood pressure did not change significantly. Thus enflurane anaesthesia could not completely inhibit the increased activity of sympathoadrenal and hypothalamic-hypophyseal-adrenocortical system caused by surgical stress.

In spite of the great advances in anesthesia, regional anesthesia has not lost its importance. The development of new, longer-acting local anesthetics has extended its indication still more. The causes of accidents lie mostly in ignorance ofthe pharmacology of local anesthetics and their adjuvants, in faulty technical performance of the nerve blockade and last but not least in inadequate knowledge of the therapy, of the side effects and complications. The various complications of regional anesthesia are reported on and the necessary therapy dealt with.

The effects of ketamine anesthesia on the sympathoadrenal and adrenocortical system, on plasma concentrations of somatotropine and insulin and the circulatory system were investigated in eight patients undergoing strabismus surgery. Therefore blood concentrations of adrenalin, noradrenalin, ACTH, cortisol, somatotropin and insulin as well as arterial blood pressure and heart rate were measured 30 min after premedication (I), 5 min after the initial injection of ketamine (II) and in steady state during the operation (III). Plasma adrenalin and noradrenalin levels were determined fluorimetrically by a modified trihydroxyindole technic; plasma cortisol, somatrotropin and insulin were determined by radioimmunoassay. All examined parameters--except insulin--showed significant changes after induced of anesthesia and during surgery compared to the respective pre-anesthetic values.

During ophthalmic operations the effects of electrostimulation anaesthesia on metabolites, as glucose, glycerol, ketone bodies, and on blood gas and acid base parameters, were investigated in 10 patients with normal circulation and metabolism. They were compared with those of a group operated under neuroleptanesthesia. Both groups of patients were treated with muscle relaxation and controlled normoventilation by a N2O/O2 (1:1) mixture. As the determined parameters gave no evidence of significant differences between the two groups, it is concluded that electrostimulation anaesthesia and neuroleptanaesthesia produce comparable analgesia.

Needling of acupuncture points combined with mechanical or electrical stimulation is insufficient for analgesia for surgical interventions. Therefore a new concept of anesthesia was developed: Electrostimulation has been combined with induction of anesthesia, relaxation and controlled ventilation with a mixture of N2O/O2. We have used this method of anesthesia in patients undergoing retinal and vitreous surgery. Our stimulation has been done by self-adhesive electrodes placed bilaterally in the area of trigeminal nerve and cervical plexus. The aim of this study was to investigate the stress response under electrostimulation anesthesia compared with neurolept anesthesia. Therefore the plasma concentrations of adrenaline, noradrenaline, cortisol and some metabolic parameters (glucose, glycerol, NEFA, ketone bodies) as well as heart rate and arterial blood pressure were measured before, during and after surgery. The changes in the parameters under surgery showed that ESA induces a higher stress reaction than NLA. The differences between the two groups are not significant.

The generally accepted principles of treatment of a diabetic as a case for operation or emergency are listed and substantiated with reference to the varied pathophysiological processes. In particular the preoperative attitude of the diabetic and the special anesthesiological problems are gone into.

The principal aims of whole blood transfusion therapy are simultaneous volume substitution, raising the oxygen transport capacity and the replacement of clotting factors. The necessary control factors for volume substitution are described. It must be borne in mind that the blood undergoes changes during storage which among other things affects the ability of the blood to transport oxygen and the clotting potential. Not only the destruction of thrombocytes must be considered but also the loss of activity of the proaccelerin and the antihemophilic globulin A. For this reason for massive blood transfusions using older blood conserves it is recommended that the loss of activity be compensated by antihemophilic cryoprecipitate.

During storage banked blood show changes as far as function and concentration of their corpuscular and plasmatic ingredients are concerned. Antihaemophilic globulin (factor VIII) and pro-accelerin (factor V) in particular lose their activities so quickly that only very few activities still remain after a storage period of 3-5 days. In connection with existing primary diseases but also in trauma and shock a dilution-coagulopathy caused by insufficient supply of factors VIII and V can develop during massive transfusion, and this especially with banked blood already stored over a longer period of time. Therapy of this disturbance of coagulation consists of substituting the missing coagulation factors under heparin protection.

Plasma cortisol was determined before, during and after ophthalmological operations. These were performed under electrostimulation anaesthesia using adhesive electrodes attached to the dermatome of the site of operation. Plasma cortisol decreased after premedication and induction of anaesthesia; it increased continuously during surgery beyond the end of operation. Thirty minutes after extubation plasma cortisol decreased again.

Plasma adrenaline, noradrenaline, blood pressure and heart rate were determined in 10 normotensive and 10 hypertensive patients undergoing ophthalmic surgery under electrostimulation anaesthesia. Venous blood samples for the determination of the catecholamines by a spectrofluorometric method were taken 30 min after premedication and 45 min after surgical incision. The catecholamine concentrations showed no significant differences neither by comparing the normotensive patients with the hypertensive patients nor by comparing the values during operation with them after premedication in each group. However, in the hypertensive patients blood pressure showed a higher increase during operation than in the normotensive patients.

Five to six millions of hypertensives live in the Federal Republic of Germany. Of these, about 70% are known to be hypertensives but only 30% are consistently treated. It is therefore not surprising that hypertension is one of the most common risk factors in patients who have to be operatively treated. The commonly approved principles of hypertensive therapy are compiled in the present study and classified with reference to the multivarious pathophysiological processes. In particular, special anesthesiologic problems are dealt with in detail. Furthermore, this paper provides the basic knowledge of the artificial fall in blood pressure under anesthetic conditions.

The sympathetic suppressant properties of Thalamonal as a premedication is reported in both normotensive and hypertensive patients. The investigations were carried out in 27 patients altogether, of whom 7 were previously treated hypertensives. The plasma catecholamines noradrenaline and adrenaline, the blood pressure and heart rate were monitored before and after premedication.

After oral administration, and depending on dosage, propaphenone produces a uniform delay of the excitation conduction in the region of the atrium, ventricle and atrioventricular conduction. At a dosage of 5 or 10 mg/kg body-weight (1 or 2x 300 mg capsules) propaphenone causes an average delay of excitation conduction of + 11% or + 19% of the initial value, and of + 39% (capsule) or + 30% (sugar coated tablet) at 14 mg/kg body-weight. The maximum effect is attained 2.5 to 4 hours after administration. A prolongation of conduction times and consequently of the anti-arrhythmic efficacy, is still found eight hours after oral ingestion.

The present paper reports a comparative study on circulatory conditions of patients who underwent both electro-stimulation- and neurolept anaesthesia. Investigations were carried out in 20 patients who had operations on the retina or vitreous body, either under neurolept or electro-stimulation anaesthesia, and who had to undergo a second of those, so that both types of anaesthesia were administered in each patient. 50% of the patients were showing polymorbidity which is often observed in elderly persons; 5 of the cases were patients suffering from hypertonia which had previously been treated unsatisfactory. As measure for judging the circulatory conditions under either anaesthetic method, the plain measurable values of systolic and diastolic pressure and heart rate were registered. A statistical evaluation of the anaesthetic records was carried out with special consideration of circulatory stability and each method of anaesthesia in the individual group of patients. Concerning circulatory changes, significant variations on 1%- level were found.

We determined in two groups of patients with normal circulation and metabolism during operations on the retina and vitreous body the concentration of plasma catecholamines. The intensity of stress was compared between electrostimulation anaesthesia and neuroleptanaesthesia. Venous blood was sampled 1) before premedication, 2) 30' after premedication, 3) at the start of surgery, 4) 45' after the start of surgery, 5) 30' after extubation. Plasma catecholamines (adrenaline and noradrenaline) were determined using a modified trihydroxyindol-spectrofluoremetric method (combined "Batch-technique"). There was no relevant difference between the two techniques of anaesthesia when using the concentrations of plasmacatecholamines as an indicator of stress resulting from operation and anaesthesia.

The effect of electrostimulation anaesthesia was studied in 23 patients undergoing ophthalmic surgery. Intraocular pressure (IOP) was measured 30 minutes after premedication (I), immediately after intubation (II), after the start of stimulation and relaxation (III) and after the establishment of full relaxation and achievement of full stimulation (IV). After intubation IOP increased from 16.4 +/- 3.3 mm Hg to 19.4 +/- 5.6 mm Hg (p less than 0.05), but decreased at reading IV statistically significantly compared with reading I to 12.7 +/- 2.8 mm Hg. To investigate the effect of electrostimulation alone on IOP, we performed tonometry on 10 control persons, in whom we observed a rise in IOP which can be attributed to current induced contractions of the extraocular muscles. The results demonstrate that there is a direct relation between electrostimulation and extraocular muscles, and we find it essential to relax the patients sufficiently to avoid hazards of IOP elevation.

The psychological effects on cortisol, human growth hormone (HGH), free fatty acids and lactate were investigated in 10 healthy students using a one hour television game. To insure that only the psychological aspects of the game were being measured, hematocrit, creatininkinase, CK-MB and myoglobin were used as controls. The game began 60 minutes after venapuncture of a lower arm vein with an indwelling catheter. Blood samples were taken 30 and 60 minutes after venapuncture, at intervals of 20 minutes during the game and 30, 60 and 120 minutes after the end of the game. After an initial rise, plasma cortisol levels sank steadily and significantly (alpha = 1%). The HGH level initially fell, but as the game progressed, rose and remained at a high level for a considerable period after the game had ended. These variations however were not statistically significant. The three free fatty acids under investigations, myristinic acid (C14), palmitic acid (C16), and stearic acid (C18), all showed similar levels over the course of the experiment. During the first 20 minutes of the play, free fatty acid levels rose, with stearic acid levels rising the most (52%). The free fatty acid levels then sank as the game progressed, with the palmitinic acid level showing a significant decline (alpha = 1%). The other parameters remained relatively constant during the experiment, with the exception of the CK-MB level, which showed severe, hard-to-interpret variations.

The antiarrhythmic effect of Propafenon administered orally in single doses of 600 resp. 900 mg (X = 10,2 Mg/kg/ bodyweight) was examined in 20 patients with chronic and stabile extrasystoles of either ventricular or supraventricular origin. In 18 patients the ectopic beats could be completely eliminated, 2 patients did not respond to antiarrhythmic therapy. The antiarrhythmic effect begins 30 minutes after administration of the drug and has its maximum 3 hours after application with a duration of more than 8 hours in most patients. Propafenon is an effective drug for oral therapy of ectopic cardiac arrhythmias.