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Purpose:  The aim of this guideline was to find evidence on whether carrying out Doppler examinations and CTGs in low-risk cohorts of pregnant women improves outcomes., Methods:  First, a systematic search for guidelines was carried out. Identified guidelines were evaluated using the DELPHI instrument of the AWMF. Three guidelines were found to be suitable to evaluate CTG. Two DEGUM best practice guidelines were judged suitable to describe the methods. All studies on this issue were additionally analyzed using 8 PICO questions. A structured consensus of the participating professional societies was achieved using a nominal group process and a structured consensus conference moderated by an independent moderator., Recommendations:  No antepartum Doppler sonography examinations should be carried out in low-risk cohorts in the context of antenatal care. No antepartum CTG should be carried out in low-risk cohorts. NOTE:  The guideline will be published simultaneously in the official journals of both professional societies (i. e., Geburtshilfe und Frauenheilkunde for the DGGG and Ultraschall in der Medizin/European Journal of Ultrasound for the DEGUM)., Competing Interests: The conflicts of interest of all the authors are listed in the German-language long version of the guideline., (Thieme. All rights reserved.)

Worldwide, post-partum haemorrhage (PHH) remains one of the leading causes for maternal mortality. The German Society of Gynaecology and Obstetrics, the German Midwifes' Society, the German Society of Thrombosis and Haemostasis and the German Society of Anaesthesiology and Intensive Care updated the former guideline. The resulting recommendations are the results of a structured literature search and a formal consensus process and contain all aspects of PPH including diagnosis, causes, risk factors and therapy. Key aspect of the anaesthesiological and haemostatic therapies is the development of an interdisciplinary standard operating procedure containing medical options related to the bleeding's cause and severity as well as the surgical option. For suspected PPH, this guideline emphasizes clinical and laboratory-based diagnostics, as only those will enable an early identification of the bleeding's causes and the resulting causative therapy. Recommendations cover evidence-based application of uterotonics for atony as well as tranexamic acid, calcium, factor concentrates and blood products. Additionally, recommendations are given on the topics of cell salvage, controlled hypotension and restrictive transfusion triggers., (© Georg Thieme Verlag Stuttgart · New York.)

Background: Pre-eclampsia affects 2% of pregnancies. This multisystem disorder is a major cause of maternal, foetal and neonatal mortality and morbidity. Neurological manifestations of eclampsia are headache, nausea, vomiting, cortical blindness and recurrent seizures., Objective: The purpose of this study was to determine whether the neurological symptoms correlate with MR imaging findings., Results: In a patient with eclamptic seizure and another one with blindness due to pre-eclampsia, the white matter hyperintensities on T (2)-weighted MR and FLAIRsequence images could be demonstrated in the occipital region and in the basal ganglia. Within 3-5 days all neurological symptoms and radiological abnormalities had resolved., Conclusion: These cerebral lesions could be classified as posterior reversible encephalopathy syndrome (PRES) or as reversible leukoencephalopathy syndrome (PLES). Thus, MRI supports differential diagnosis regarding non pregnancy-related cerebral disease and can be helpful for therapy planning in cases of pre-eclampsia.

Background: A sufficient quality of data transfer from written patient records to electronic data processing is a precondition for a reasonable usage of perinatal data. However the quality of data transfer of the almost 200 characteristics routinely recorded at each delivery is largely unknown., Materials and Methods: The quality of data transfer of 33 characteristics in 350 randomly selected singleton deliveries of the women's clinic of the University of Marburg from 2002 and 2003 has been checked by comparing electronically recorded data with the original written documents., Results: The quality of data transfer of the tested characteristics turned out to be heterogeneous. Characteristics necessary to calculate quality indicators show a very high data quality when excluding the characteristic attendance of a paediatrician. The quality of data transfer of characteristics denoting time as well as blood gas analysis are heterogeneous. Characteristics with a low quality of data transfer are associated with ambiguous instructions, the fact that the coding obstetrician is not dealing in the first instance with the item being encoded and the characteristics are of no immediate relevance for delivery, as well as difficult application of the software., Conclusion: The quality of data transfer of the characteristics collected in perinatal surveys needs to be validated. The type and amount of data being collected should be reassessed considering improvements of data quality.

Objective: The aim of this study was to determine if aprotinin could affect postpartal fibrinolysis when given at the latest 15 min before delivery and if there is a difference between normal delivery and caesarean section. Furthermore we wanted to examine if the thrombin-antithrombin-III-complex (TAT-III) and prothrombin fragments F1 + 2 changed in the peripartal period and if prethrombotic stages could be recognized., Patients and Methods: 84 patients (15 - 44 years of age) have been examined (41 normal deliveries, 43 cesarean sections). After giving informed consent and randomization, 30 of these patients were administered 1 Mio KIE aprotinin (Trasylol(R)) at the latest 15 min before delivery (15 normal deliveries, 15 cesarean sections). The results of TAT-III, prothrombin fragments F1 + 2, factor VIII and partial thromboplastin-time (PTT) were collected shortly before and after delivery and 30 and 120 min after detachment of the placenta., Results: Normal deliveries without aprotinin showed a significant increase of TAT-III and an evident increase of prothrombin fragments F1 + 2. After administration of aprotinin this increase was significantly lower. The increase of TAT-III and prothrombin fragments F1 + 2 in patients with caesarean sections was evidently lower than in normal deliveries and was not influenced significantly by aprotinin. Factor VIII and partial thromboplastin time (PTT) showed no relevant changes in all study groups., Discussion and Conclusion: The consumption of coagulation and fibrinolysis factors induced by delivery of the child and detachment of the placenta can be reduced after administration of aprotinin given at the latest 10 - 18 min before partus. This could be used in therapy and prophylactic treatment in high-risk patients (e. g., pre-eclampsia, HELLP syndrome, etc.).

Background: Tracheostoma valves for laryngectomized patients were introduced to enable the laryngectomee after successful surgical voice restoration either by a voice prosthesis, a surgical shunt or microvascular laryngoplasty, to speak without using his fingers to close the tracheostoma. The basic principle of these aids is a mobile valve, which closes automatically at a certain air flow, directing the expired air of the lungs into the pharynx. In spite of the clear advantage of enabling a hands-free speech, the long term acceptance rate is still rather low, which is mainly caused by problems of an airtight fixation within or at the tracheostoma. Another important disadvantage of these tracheostoma valves is the necessity of removing the valve during coughing. The new tracheostoma valve "Window" (ADEVA Company, Lübeck, Germany) offers a clear improvement regarding this point. It is constructed with an additional coughing lid, which opens at a certain airflow and closes automatically after the coughing attack. After successful development and clinical testing of the new aid in 1999 and 2000, it was now the question, if the previously low acceptance rate of tracheostoma valves could be improved in the long term use by this new type of valve., Patients: Within the last 4 years 70 patients were provided with the "Window" tracheostoma valve. Patients were followed up at regular intervals in order to evaluate the function, the acceptance and the durability of the new device. Additional to the clinical examination patients had to fill in a questionnaire in order to investigate the subjective estimation by each patient himself. 15 patients did not send back their questionnaire or did not fill it in correctly, 5 patients refused clinical supervision after adjustment of the device, so finally the long term use in 50 patients could be analysed., Results: 82 % of the patients reported, that the coughing lid worked safely and opened immediately during the coughing attack. Most of the patients were satisfied with their device, but had nevertheless some proposals for a further improvement: although they cover the tracheostoma either with their clothes or a protection scarf, most of the patients would prefer a device which is smaller than the current model. Some patients reported on an insufficient stability of the plastic material, which led to a defect at the sliding mechanism of the coughing lid. The greatest problem regarding the regular use of the valve was - comparable to conventional tracheostoma valves - the occurrence of an air leakage around the tracheostoma. Although there are three different models of the "Window" tracheostoma valve available, only patients being fitted with the "standard-T-type" version could wear the device 10 hours a day or longer without any problems of air leakage., Conclusions: The "Window" tracheostoma valve with an integrated coughing lid provides further improvement in speech rehabilitation of laryngectomees. The actual rate of acceptance of 62 % for all "Window" patients (1 month daily use for at least 2 hours) is superior to other reports on the use of tracheostoma valves and probably caused by the additional comfort provided by the coughing lid. Another important factor for the long term use of tracheostoma valves is however the safe fixation of the device in or around the tracheostoma. In this point further improvement is necessary, as only the model with the fixation within the trachea (T-type) led to a satisfactory long term airtight fixation.

Background: Are obstetric doppler ultrasonographic measurements of the fetal and maternal flow parameters reproducible?, Patients and Methods: For internal quality management, doppler ultrasonographic measurements were performed on 81 patients (random screening sample) with an Acuson Sequoia Ultrasound at the Universitätsfrauenklinik Marburg. Successively two experienced investigators measured the umbilical artery, medial cerebral artery, and the uterine arteries. The correlation between the measurements of the two investigators was presented in a spread chart. In order to exclude systematic differences between the measurements, linear regression was analyzed and the distance to the abscissa was calculated. A relative divergence of more than 20% was determined as a non corresponding measurement., Results: The distance of the linear regression to the abscissa was calculated for the four vessels: umbilical artery 0.4 (95% CI; 0.124 - 0.486), medial cerebral artery 0.9 (95% CI; 0.534 - 1.264), right uterine artery 0.2 (95% CI; 0.124 - 0.305), and left uterine artery 0.2 (95% CI; 0.121 - 0.317). Concerning the four arteries, a divergence of more than 20% between the two investigators was found: umbilical artery 16%, medial cerebral artery 42%, right uterine artery 28%, and left uterine artery 37%., Conclusions: Because the interobserver variability was surprisingly high and acceptable correlation could be stated only for the umbilical artery, internal quality standards are essential. Routine use of different devices should be made after careful consideration only, especially if clinical decisions are to be based on them.

Objective: The aim of this study was to determine (a) if alpha-2-antiplasmin, plasminogen and plasminogen-activator-inhibitors (PAI 1 - 4) change in the peripartal period, (b) if these changes are explainable by the detachment of the placenta and the release of coagulation factors, and (c) if aprotinin could affect postpartal fibrinolysis when given shortly before delivery., Patients and Methods: 84 patients have been examined (41 normal deliveries, 43 cesarean sections). After informed consent and randomization, 30 of these patients were administered 1 million KIU aprotinin (Trasylol(R)) at the latest 15 minutes before delivery (15 normal deliveries, 15 cesarean sections). The results of PAI (1 - 4), alpha-2-antiplasmin and plasminogen were collected shortly before and after delivery and 30 and 120 min after detachment of the placenta., Results: Normal deliveries and cesarean sections without aprotinin showed an evident decrease of PAI (1 - 4) after delivery while alpha-2-antiplasmin and plasminogen values did not change. After administration of aprotinin the activity of PAI (1 - 4) increased slightly after labour in normal deliveries and cesarean sections and then slowly decreased later. alpha-2-Antiplasmin levels increased post partum and then decreased to the original values. Plasminogen did not change. There were no significant differences between normal deliveries and cesarean sections with regard to the three parameters studied in this work., Discussion and Conclusion: Changes in PAI (1 - 4) and alpha-2-antiplasmin after administration of aprotinin could be the result of a minimal demand on the fibrinolytic system. Finally, aprotinin can reduce the consumption of coagulation and fibrinolysis factors induced by detachment of the placenta. This could be used in therapy and prophylactic treatment in high-risk patients (e.g., pre-eclampsia, HELLP syndrome, etc.).

Background: The development of a new technique to evaluate the normal fetal acid-base balance in risk deliveries with pathological fetal heart rate has been seen with great expectations over the last years. The aim of this representative survey was to ask for the actual status of the fetal pulse oximetry in clinical use in German delivery rooms and to analyze hopes, expectations and system errors. PATIENTS RESPECTIVELY AND METHODS: Collecting data were done by a representative, time limited anonymous questionnaire in all German clinics who used Nellcors fetal pulse oximetry N-400 in measuring fetal arterial saturation in the years 1995 - 1999 during risk deliveries with non-reassuring fetal heart rate., Results: With 66,6 % of the departments participating a number of 54 clinics returned the questionnaires. An average of 4.5 times per month fetal pulse oximetry was used per clinic and in over 90 % of all cases the handling and fixation of the sensor was without problems. There is qualified staff in every clinic and regarding the satisfaction with this system an average note of 2.8 was assigned. Fetal pulse oximetry will be established in some years to replace fetal blood analysis and to reduce operative deliveries. Technical problems in cases of insufficient sensor fixation at the fetal head and with the re-sterilization of fetal sensors must be solved in the future., Conclusions: Fetal pulse oximetry will be incorporated as the third method of monitoring the fetus during labor.

Background: The evaluation of the birth position and its effects on maternal and fetal wellbeing has been a topic of perinatal research over the last decades. The aim of our observational study was to determine the effects of a modified and vertical maternal position on fetal oxygen saturation measured by pulse oximetry., Methods: Fetal oxygen saturation was measured by pulse oximetry in 56 labouring women randomly and successively adopting the supine position in 96.4%, the sitting position in 25.0%, the standing position in 14.3% and the prone position in 12.5%. The statistical analysis addressed the integrated 10 minutes period of SpO2 registrations before versus after adopting the modified position. Furthermore the mean values and the standard deviation (SD) for the total registration periods of different birth position was calculated., Results: While the supine position induced a reduction in oxygen saturation, sitting and prone position were favorable for fetal oxygenation as compared to horizontal position., Discussion: These findings implicate a clinical benefit of the modified birth position.

Background: In this study separation and enrichment of fetal trophoblastcells have been investigated in venous blood of pregnant women, in order to see, if this non-risk method can replace invasive methods of gaining fetal cells for antenatal diagnosis., Material and Methods: First investigation of antigen-patterns of fetal cells, placenta-tissue and leucocytes as well as of different MAb 425-concentrations in chorioncells, A-431-cells and leucocytes was done, thereafter staining of A 431-cells, staining and evidence of A 431-leucocytes mixtures (group 1: n = 11), staining of chorioncells, staining and evidence of chorioncell-leucocytes mixtures (group 2: n = 13), staining and evidence of leucocyctes of nonpregnant (group 3: n = 18) and pregnant women (group 4: n = 6). A FACScan was used. Antigen patterns of fetal cells, placenta tissue and leucocytes were tested by means of specific antibodies., Results: Almost all chorioncell-cultures have been EGF-receptor positive, whereas leucocytes were negative. For separation of trophoblastcells the EGF-receptor was the most suitable. 18 leucocyte samples of non-pregnant and 6 of pregnant women were tested. There were no significant differences either concerning staining with MAb 425 or in evidence in the MiniMACS. In pregnant women there was no sufficient number of EGF-receptor-positive cells available, in order to recognize, if these cells were of fetal origin., Conclusions: Before trophoblastcells could be used for antenatal diagnosis potential influences concerning presence time and separation of these cells should be investigated., Discussion: We did not have enough fetal cells for further cytogenetic investigations. One reason for not enough evidence of fetal cells could be a lack of capacity of the MiniMACS. There were probably none or not enough trophoblastcells in the maternal blood. Which parameters could be of influence, is not yet known.

By labeling HS 1500 with a radioactive 14C, it was proven that after oral application and under certain circumstances, low amounts of low molecular humic acids are for a short time absorbed from the gastrointestinal tract. But the biological availability of the substance is very low (less than 0.1% of the applied high doses). The plasma concentration curve assumes a first order kinetic for invasion and excretion. After oral application of 500 mg/kg b.w. HS 1500 the half life period was 1.5 hours and maximum plasma concentration was 3 micrograms/ml. The result obtained indicate that HS 1500 is toxicological riskless after oral administration. Taking into account the pharmacokinetic data, residues of the substance in animal tissues can be ruled out with high significance.

History and Clinical Findings: A 31-year-old woman with known postrheumatic mitral valve stenosis developed for the first time left heart failure in the 19th week of her fifth pregnancy. After intensive drug treatment she was in stage 3 (New York Heart Association classification). Apart from that the patient was in a good general condition and obstetrical status was according to the estimated duration of pregnancy. Auscultation revealed an apical diastolic murmur and mitral opening snap., Investigations: Echocardiography demonstrated a mitral valve opening area of 0.85 cm2 (pressure-half time method); the mean gradient was 19 mm Hg., Treatment and Course: Because of the severity of the findings a percutaneous transvenous balloon valvotomy (according to Inoue) was performed in the 27th week of pregnancy, after careful lead shielding of abdomen and pelvis. Radiological screening time was 10 min. The invasively measured transvalvar pressure gradient was reduced from 28 to 4 mm Hg, echocardiographically determined mitral opening area increased to 1.5 cm2. Delivery was induced in the 36th week of pregnancy because of third-degree renal pelvis congestion. A healthy child, weighing 2850 g was delivered vaginally., Conclusion: High-grade symptomatic mitral stenosis can, if necessary, be treated with a low-risk to mother and child by percutaneous balloon valvotomy.

Influences of the low molecular humic substance HS 1500 on parameters of organs (testis weight, epididymis weight), FSH-, and LH-levels in plasma as well as on the spermatogenesis of male rats were studied. After a daily oral application of 1000 mg/kg b.w. and 2000 mg/kg b.w., respectively over a period of 60 days (40th to 100th day of life) only 2 animals of the high dose group were observed with bilateral testicular atrophy. Despite of the two animals with testicular atrophy no significant differences between treated and control rats were observed with respect to testis morphology and spermatogenesis. There is no evidence whether the differences between the hormone levels and the testicular atrophy revealed is regarded to a HS 1500-effect or not. But otherwise a direct influence of HS 1500 can be ruled out with high certainty. Possibly because of the thin covering layer on the gastrointestinal mucous membrane formed by HS 1500, the absorption of nutritive substances is inhibited. Therefore the growth of sensitive organs like testis and epididymis, in the development period, can be decreased. Nevertheless, even after long time application the spermatogenesis is not influenced.

The influence of a low molecular synthetic humic substance (HS 1500) on pre- and postnatal development of rats was investigated. After oral application of 1000 mg/kg and 2000 mg/kg b. w. HS 1500 during the period of organogenesis (6th to 15th day p. c.) and from 16th day p. c. up to weaning neither adverse effects in the mothers nor in the fetuses were reported. The occurrence of a single malformation (gastroschisis) after application of 1000 mg/kg b. w. from day 6 to 15 of pregnancy, few ossifications of phalanges and differences in swimming behaviour are not regarded as the effect of the substance. In conclusion, the oral use of HS 1500 in the treatment of gastrointestinal diseases in animals during pregnancy is regarded to be riskless.

Reflectance pulse oximetry is a new method to monitor the fetus during labour in order to get a better assessment of the fetus's condition than by CTG interpretation alone. In this study the method is investigated with regard to its prognostic value concerning fetal outcome and complications possibly due to its application: Increased uterine bleeding, umbilical cord complications, amniotic infection syndrome. Arterial oxygen saturation was continuously recorded during labour in a total of 122 patients with a gestational age between 37 and 42 weeks and correlated to the umbilical cord-pH post partum and, if available, to intrapartum fetal blood gas analysis. 30% seems to be a threshold value below which oxygen saturation should not drop for a longer period of time. A post partum pH < 7.2 can be expected in more than 50% of the cases in which the saturation remains below this value for more than ten minutes. The application of the fetal pulse oximeter sensor did not affect maternal or fetal morbidity.

Accumulating evidence indicates an association between intraamniotic infection and raising concentrations of amniotic cytokines, resulting in preterm labor and preterm rupture of fetal membranes, because these cytokines are able to stimulate prostaglandin biosynthesis. Therefore the purpose of our study was to investigate if quantitative determination of Il-1 beta, Il-6, Il-8 and TNF-a in amniotic fluid may be a practicable method to diagnose intraamniotic infection. Since invasive amniocentesis doesn't allow repeated cytokine detection, in case of preterm rupture of fetal membranes, amniotic fluid also was obtained by placing a sterile gauze and cotton pad into the women's vagina, absorbing draining amniotic fluid for cytokine detection. Our results clearly indicate that Il-1 beta and TNF-a are not detectable in normal pregnancy, while Il-6 and Il-8 are produced in low, but constant levels. In contrast, in amniotic fluid of patients with intraamniotic infection high amounts of Il-6 and Il-8 were found, while Il-1 beta and TNF-a bioactivity became measurable, indicating that biosynthesis was activated. These results demonstrate, that infection associated cytokines detectable in amniotic fluid are highly sensitive markers for intraamniotic infection. In case of preterm rupture of fetal membranes recovery of amniotic fluid from a vaginal pad allows monitoring of cytokine bioactivity in daily intervals to control success of antibiotic treatment.

Congenital candida infection is a rare disease, although the incidence of candida vaginitis during pregnancy is high. We report on five cases each showing patterns considered typical for candida infection. The infective agent can cause chorioamnionitis even in the presence of intact fetal membranes. An intrauterine device (IUD) has been proved to be a risk factor for a congenital candida infection. The pathogenetic significance of contamination with candida for the fetus appears to depend largely on gestational age. A premature infant with a birth-weight less than 1500 g presented with bilateral candida endophthalmitis which was cured by intravenous Fluconazole therapy. Another premature infant weighing 800 g at birth developed a systemic candida infection. The other three more mature infants had milder symptoms, two of them presented with cutaneous candidiasis.

Using the synthetic humic acid product HS 1500 and the native product Sodium-Humate, the suitability of the HET-CAM-test to evaluate irritating effects was tested. Neither sensitizing nor irritating properties were detectable in concentrations of up to 10% in either humic acid solution. This leads us to the conclusion that both products are very mildly acting substances on mucous membranes and skin, causing no irritative effects. In order to improve the certainty of these results, it is still currently recommended to carry out the Draize-test in addition to the HET-CAM procedure (SPIELMANN, 1992). We are convinced that the HET-CAM-test can be a very useful first step in distinguishing between irritative and non irritative substances and in protecting animals from pain, even in the event that the results of both tests do not clearly correspond to each other. Taking into account the results of our experiments, a modified HET-CAM-test also seems to be useful to predict the antiphlogistic effects of chemical substances.

This paper describes results of ecotoxicological investigations concerning the effects of industrial pollutants on farm animals. By means of simultaneous experiments using dusts from lignite-filters and sedimentation-filters as well as sulfur dioxide (SO2) as stress models and by using studies on farm animals in pollutant-burden regions of eastern Germany it could be shown, that pollutants can lead to disorders of health, efficiency and behaviour, like o. g. heavy metals, and to contamination of food of animal origin. Dusts, resulting from combustion of lignite and SO2 initiate non specific effects in the organism and it is only difficult to determine their part on the decrease of productivity and metabolic disorder of farm animals in pollutant regions.

Investigations were performed to determine the hexobarbital sleeping time (HST) of a strain of Wistar rats (WIST/Lppt). Another aim of the studies was to demonstrate possibilities to use the HST as a method to get additional informations during pharmacological and toxicological experiments. The age--and sex--dependent changes in the hexobarbital sleeping time of the investigated strain of rats are in coincidence with results of other authors, using different rat strains. Additionally, the HST more or less depends on circadian and circannual rhythm. It was stated that the HST as a prescreening-method before starting investigations in detail is of great importance.

The influence of the pesticide Sodium-2,2-dichlorpropionate (Na-DCP; Dalapon) was investigated on dairy cows concerning of its effect on ability and health condition. The investigations were carried out in practice using several parameters (feeding, efficiency, haematological and clinicochemical parameters, tests of the slaughtered organisms including their patho-histological examination). The arising of residues was controlled in milk, organs and tissue as well. The pesticide was daily applied orally with the feedstuff in 3 different dosages (2.5, 10, 30 mg/kg b. w./d). Feedstuff consumption, results of milk production and milk quality were not influenced by Na-DCP. The presented results can not verify with safety the insignificant alterations of some clinicochemical parameters (Creatinine, Bilirubin). Direct after the deposit of Dalapon in all samples of milk, organs and tissue residues of this pesticide could be observed. The maximum tolerable residue levels for animal in the ex-GDR were exceeded under these conditions.

Bioavailability of iron (II) bounded as a chelate to macromolecular humic acids was investigated in two different concentrations using retention rates of 59Fe in piglets (age: 24 h). Investigations period was from 3 hrs. to 21 days following application. 21 days after a single oral application of the humic-acid-iron-complexes, 25% of the total Fe was detected in the animal, distributed in the erythrocytes (80%), muscles and bones (8% respectively) and liver (4%). For the first time in veterinary medicine these results enable a combined therapy of enteric and iron-deficiency syndrome by using only one drug. Recommendation for dosing is provided.

Higher yield and performance in plant and animal production will depend on reinforced use of pesticides, particularly alkyl phosphate esters and insecticidal carbamates. Prenatal toxic action of the pesticides used today may be detrimental to human and animal health. Prenatal-toxicological tests, using parathion-methyl, were conducted on the basis of known but modified experimental methods. The vulnerability of a rat strain was tested by applying to it teratogenic model substances (trypan blue and cyclophosphamide). Several oral applications of parathion-methyl (3 ppm) during the sensitive phases of germ formation and growth (fifth to ninth and eleventh to fifteenth or eleventh to nineteenth days from conception) were followed by clear embryotoxic effects, such as retardation and increased resorption. The average number of resorption sites grew from nine in the control group to 20 in the experimental group. Postnatal malformations were not observed.

Oral administration of three doses of Carbaryl at 200 or 350 mg/kg body weight to pregnant female rats at various stages of fetal development had only slight teratogenic activity. Three doses of Carbaryl at 350 mg/kg given during the late embryonic or early fetal stages of pregnancy delayed fetal development; in the pre-embryonic stage it produced increased mortality of fertilized ova and increased the degree of retardation of individual fetuses. Similar results were produced by six doses at 200 mg/kg given on alternate days between the 5th and 15th days of embryonic development. It was concluded that the effects of Carbaryl on intrauterine development in rats were related to dosage.

The at present usual nuclear-medical methods in diagnostics and control of the course of the vesico-uretero-renal reflux are discussed. The semiquantitatively evaluated ING or the side-separated isotope clearance and the function scintigraphy are important parameters for therapeutic decisions in the basic diagnosis and the control of the course of the vesico-uretero-renal reflux.

Humic acids derive from a class of natural substances in humic substances. The chemical properties of certain defined humic acid products enable their application in diseases of the digestive system of mammals when combined with metabolic disorders, especially in rearing age. The simple administration (via feed), their exceptional safety and the absence of side effects (e. g. allergy, resistance) as well as no residue formation in animal derived products allow a broad application of these substances in veterinary medicine, even when regarding ecotoxicological aspects.

The results of interposition plastic operations of the small intestine are presented which were performed in 8 patients. The control period comprises 4 to 23 years. The relatively complicationless postoperative course confirms an efficient technique, by means of which the functionless ureter may be bridged over. The function of the kidneys remains compensated and this the technique fulfils the main criterion of an operative technique conserving the organ.

The results of the treatment of 194 patients with non-seminomas were analyzed and statistically registered. The therapeutic approach is described and the cumulative probability of survival is compared according to the stages. For the total number of these tumours a cumulative 5-year-survival probability of 68.6% was calculated. In detail it reaches from 100% in clinical stage I to 39.7% in clinical stage III. The decisive change of the prognosis is between the clinical stages IIb and IIc. An adjuvant cytostatic therapy should, if performed, be aggressive. Relapses in the clinical stage I are possible and call for a critical valuation of the primary stage. A retarded cytostatic polychemotherapy should be performed only under certain conditions.