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• Essure ist eine neuartige Methode zur permanenten Empfangnisverhiitung; sie wird ohne Narkose eingesetzt. • Die Essure-Mikrospirale besteht aus ciner Nickel-Titan-Legierung und Dacronfasern. • Die Essure-Mikrospirale wird unter hysteroskopischer Sicht in die Eileiter eingefuhrt und verb indert durch bindegewebigen Verschlug der Tuben eine Empfangnis. • Bei nachgewiesen orthotopem Sitz der Mikrospirale ist der Pearl-Index (noch) null.

Unter sexuellem Kindesmissbrauch (SKM) sind alle sexuellen Handlungen Erwachsener mit/an Kindern zu verstehen, nicht nur vaginale oder anale Penetrationen, wie haufig in der Offentlichkeit fehlinterpretiert.

Immer noch hort man den Satz unter Geburtshelfern „Einmal Sectio — immer Sectio!“ Wenn auch mittlerweile diese These mehrfach widerlegt ist, gehen doch die Auffassungen uber das geburtshilfliche Vorgehen bei Entbindungen nach Kaiserschnitt in der Anamnese weit auseinander.

Objective : To investigate the maturation of the paracrine system’s endothelial nitric oxide synthase (eNOS), inducible NOS (iNOS), endothelin-1 (ET-1) and adrenomedullin (AM) in human placenta during the 2nd and 3rd trimester of pregnancy. Study design : Placental tissue from 14 healthy women with normal pregnancy and from 13 patients giving birth to premature infants following premature labor was obtained. Messenger RNA expression was determined using quantitative TaqMan real-time PCR. Results : Placental eNOS/GAPDH and ET-1/GAPDH mRNA expression significantly increased as a function of gestational age ( r =0.63, P r =0.53, P =0.007, respectively). There was no change in gene expression of neither iNOS nor AM mRNA/GAPDH during gestation ( r =0.02, P =0.75 and r =0.001, P =0.99, respectively). Conclusion : There is a maturation of eNOS and ET-1 in human placenta with gestation reflecting developmental changes of important paracrine endothelial and trophoblastic regulators. AM and iNOS show no maturation during pregnancy.

Cortisol reduces the activity of the PG-inactivating enzyme 15-hydroxyprostaglandin dehydrogenase (PGDH) in human placental cells. The objective was to investigate a possible relation between 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2), converting cortisol to cortisone, and PGDH gene expression in the placenta of patients with preeclampsia. In placental tissue taken from 20 healthy women with normal pregnancy, 20 premature babies born after labor before term, and 18 neonates after preeclamptic pregnancy, 11beta-HSD2 and PGDH messenger RNA (mRNA) expression was determined using quantitative TaqMan real-time PCR and quantitative competitive PCR. When comparing matched pairs, there were 3-fold lower 11beta-HSD2/glyceraldehyde-3-phosphate dehydrogenase (11beta-HSD2/GAPDH) mRNA levels in placentas of patients with preeclampsia than in controls [0.18 +/- 0.04 relative units (RU) and 0.61 +/- 0.10 RU, P = 0.0003]. We also found a 2-fold reduction in placental PGDH/GAPDH mRNA concentrations (0.28 +/- 0.15 RU and 0.50 +/- 0.18 RU, P = 0.0003). PGDH and 11beta-HSD2 mRNA levels correlated significantly (r = 0.66, P < 0.0001). In term placenta, 11beta-HSD2/GAPDH, but not PGDH, showed a significant correlation to birth weight (r = 0.43, P = 0.01) and to placental weight (r = 0.47, P = 0.01). Results could be confirmed by competitive PCR. We conclude that, in preeclampsia, 11beta-HSD2 mRNA expression is reduced, leading to the known decrease of 11beta-HSD2 activity. By means of an autocrine or paracrine mechanism, the diminished conversion of placental cortisol may lead to reduced PGDH mRNA expression as found in the present study.

Die weibliche Stresharninkontinenz wird gewohnlich der Dranginkontinenz (Urge) und der neurogenen Inkontinenz gegenubergestellt. Die Stresharninkontinenz wird durch die Urethrozystotonometrie in Ruhe und abdominaler Drucksteigerung gegenuber der Urgeinkontinenz diagnostisch abgegrenzt. Die Stresharninkontinenz kann mittels Vorlagewiegetest (Pad-Test) quantifiziert werden. Wahrend die Dranginkontinenz blasenbedingt ist, hat die Stresharninkontinenz ihre Ursache in einer Inkompetenz des urethralen Verschlusmechanismus.

Die Entwicklung der Dopplersonographie hat die Moglichkeiten der pranatalen Diagnostik erweitert. Jahrlich kommen in Deutschland ca. 7000 Neugeborene mit Herzfehlern zur Welt. Die Inzidenz angeborener Herzfehler wird mit 8 auf 1000 Lebendgeburten angegeben. Die moderne Ultraschalldiagnostik erlaubt eine Beurteilung der Entwicklung des menschlichen Herzens in utero ab dem ersten Trimenon.

17 women received 2 x 10 ml prilocaine 1% as a pudendal block sub partu. At delivery, the foetomaternal distribution ratio of the local anaesthetic was evaluated and the development of Met-Hb-concentration in the neonate was measured up to six hours post partum. The Met-Hb-concentration in the neonate was relatively low with a maximum of 1.8% after two hours, followed by a steady decline. A probable explanation for the Met-Hb-concentration could be the unexpected low foetomaternal ratio of distribution (0.5) and the increased renal elimination of the amide-type local anaesthetic in the neonate, respectively. According to these results, no contraindication for prilocaine in pudendal block is indicated.

The aim of this study was to find out which recommendations German gynecologists gave to young patients with type 1 diabetes mellitus in respect to contraception. In addition, it was asked to what extent German gynecologists/obstetricians had experience regarding counselling of young women with type 1 diabetes.A structured questionnaire containing questions about attitudes, health care beliefs and contraception in young women with type 1 diabetes was developed. 804 attendees of the Giessen Gynecological Seminar which was held in January 1997 were asked to participate in the study.Only 142 (17.7%) of the questionnaires were returned. There was no consensus in respect to contraception in young women with diabetes. 61% of the respondents referred to the micropill (0.3 mg estrogen) as the preferred contraceptive method for young women with diabetes. Condoms were regarded as second line contraceptive devices in this age and patient group. There was only very limited experience in regard to counselling and treating adolescents/young women with type 1 diabetes.Among the German gynecologists questioned there was no consensus in respect to contraception in young women with diabetes. Most importantly, there was only very limited individual experience in regard to counselling and treating adolescents/young women with type 1 diabetes among the doctors who participated in the study.A structured questionnaire containing questions about attitudes, health care beliefs and contraception in young women with Type 1 diabetes was offered to 804 gynecologists attending the Giessen Gynecological Seminar held in January 1997. Only 142 (17.7%) of the questionnaires were returned. 64.8% of the respondents were general practitioners, 42% were in private practice, 28.9% were employed at non-university clinics, and 2.1% at university clinics. 33% of the respondents did not provide any information about the number of women under their care and 19% did not treat any young patients aged 14-18 with Type I diabetes. 40% of the rest of the respondents treated 5 patients at the most with Type I diabetes. 61% of the respondents cited the micropill (0.3 mg estrogen) as the preferred and recommended contraceptive method for young patients with Type I diabetes. 25% referred to the condom as the recommended method. For young patients with type I diabetes who smoked, the most recommended method was the condom (31%) followed by the IUD (15.2%) and the very-low-dose pill. 4.2% of the physicians who decided against the very-low-dose pill for young patients with Type I diabetes cited the danger of blood vessel-related side effects and 14.6% cited inadequate safety. 35.2% of the respondents cited the danger of blood vessel related side effects and 7% inadequate safety for not recommending the low-dose pill for young patients with Type I diabetes. There was very limited individual experience in regard to counseling and treating young women with Type I diabetes among the doctors who participated in the study.

Im Zeitraum 1994/95 wurden an der Giesener Frauenklinik 195 Beckenendlagen behandelt. Ein Viertel hiervon (47/195 = 24,1%) waren Beckenendlagen vor der 36. SSW. Hier wurde grundsatzlich eine primare Sectio durchgefuhrt

The authors recently reported about the complex suicide of a former veterinarian who injected xylazine and levomethadone together with T61, which is normally used for the euthanasia of domestic and laboratory animals (1). Furthermore, various analgesics were detected in biological samples, probably taken as painkillers for an existing cancer disease. The quaternary ammonium compound mebezonium iodide, an acetylcholine inhibitor, is an active ingredient of T61, in addition to embutramide and tetracaine (2). Embutramide has narcotic properties and induces deep anesthesia and an inhibition of the respiratory center located in the brainstem. Tetracaine is a local anaesthetic substance and decreases painful reactions at injection sites. A recent report by the authors summarized cases of suicides or homicides involving the use of T61 (1). However, in most cases, embutramide, which is exclusively used in T61, was the only substance analyzed because of analytical difficulties when analyzing quarternary ammonium compounds like mebezonium. Before this report, mebezonium was only analyzed in two cases, once by thin-layer chromatography followed by ultraviolet spectrophotometry after elution from silica gel (3), and later by liquid-chromatography –mass spectrometry with quantification by a specific ion, m/z 294 (4). Because there are relatively few authentic cases reported in the literature, the distribution and concentration of all three ingredients of T61 in the body of a new case appears worthwhile to communicate. A 40-year-old male was found dead in the gateway of his home. In a garage 15 m away, opened bottles of wine, sherry and rum were found, as were a depleted 20 mL syringe, an opened pharmaceutical vial of T61 (50 mL with a rest of 5 mL) and a suicide note. Three years ago, T61 had been used for euthanasia of the Saint Bernard dog of the family and the veterinary surgeon had forgotten the rest of the drug, which was stored in the cellar. Autopsy findings The body weight was 84.1 kg and body height was 174.5 cm. No signs of external violence were observed. An injection mark was found over the back of the left hand with edema of the subcutaneous tissues. Another skin injection mark was noted on the palm of the left wrist, also with edema of the subcutaneous tissues. The subcutaneous tissues of both injection sites were dark black with discoloration. Edematous swelling of the subcutaneous tissues of the left forearm was observed, as were extreme congestion of internal organs, cerebral and pulmonary edema, acute pulmonary emphysema and advanced coronary atherosclerosis.

Psychological management of parents during a child's critical illness is a challenge to intensive care nurses because of the uncertainty that accompanies hospitalization.To explore the relationship among illness severity, family resources, and maternal uncertainty during the initial stage of a child's hospitalization in a pediatric intensive care unit for a life-threatening illness.A convenience sample of 40 mothers rated perceptions of uncertainty (using Mishel's Uncertainty of Illness Scale: Parent Child Form), family cohesion (using Olson's Family Adaptability and Cohesion Evaluation Scale), and social support (using Norbeck's Social Support Questionnaire). Illness severity was estimated with the Pediatric Risk of Mortality Scale.¿ Results showed a positive association between illness severity and maternal uncertainty and a negative association between family cohesion and maternal uncertainty. Severity of illness contributed less to maternal uncertainty than did family cohesion.Family relationship are important factors to consider when clinicians estimated the effect on parents of their child's critical illness, particularly when uncertainty over their child's outcome may lead to parental stress that can interfere with coping and child management. (American Journal of Critical Care.)

Im Jahr 1916 veroffentliche Cragin in einem Artikel den mittlerweile geflugelten Satz: Einmal Sektio, immer Sektio [3]. Damals erfolgte der Kaiserschnitt ublicherweise mittels korporalem Langsschnitt. Tatsachlich beobachtete man in dieser Zeit bei Geburten nach Kaiserschnitten haufig Uterusrupturen mit einem maternalem Blutungsschock und einer Mortalitat von 50 bis 80% fur die Mutter und eine Mortalitat von nahezu 100% fur das Kind [4].

The study presented here was conducted for the purpose of investigating the possible relationship of masseter muscle size and activity to facial morphology. The study examined 50 adults, 25 males and 25 females, by means of electromyography, ultrasonography, and facial photography. The following results were obtained. There was considerable variation in masseter muscle activity and size both between the 2 groups and among individuals in each group. Partly there were strong differentiation's between the males and the females. The interrelationships between masseter muscle activity and size and facial morphology in both groups were generally weak, however, the links were more discernible in the women than in the men. Female subjects with thin faces and large mandibular planes had reduced masseter thickness, whereas women with a small anterior facial height index displayed when relaxed less masseter muscle activity and a smaller masseter width.

This study was designed to examine the relationships between maternal perceptions of an acutely ill child, nurse caregivers and contextual factors in a pediatric critical care unit.Subjects were mothers of 20 children who had had their first bone marrow transplant and the primary nurse of each child. The study was conducted on a bone marrow transplant unit. Variables included the acuity of the child, maternal satisfaction with nursing care, maternal vigilance as measured by the time spent at the child's bedside, nurses' attitudes toward family involvement with care, nursing experience and bone marrow transplant unit variables (census, unit acuity and staffing deficit).Positive associations were observed between the child's acuity and maternal satisfaction with nursing care, and between maternal vigilance and staffing deficit. There was an inverse relationship between maternal vigilance and length of nursing experience of the primary nurse and between positive attitudes of nurses toward family participation and years of nursing experience.These results show the complex nature of parental perceptions and involvement in the hospitalized child's care. They suggest that maternal attitudes about caregiving are associated with the child's acuity and that maternal vigilance is related to nursing and environmental factors, principally critical care experience of the primary nurse.

Unter akuter intrauteriner Asphyxie kommt es zu einer Umverteilung des Blutflusses zugunsten des Gehirns. Selbst innerhalb des Gehirns erfolgt eine Umverteilung des Blutstroms (1). Findet hierbei lediglich eine Zunahme der Flusgeschwindigkeit im kapillaren Strombett statt, oder konnen zur Steigerung der Durchblutung nicht durchblutete „Reservekapillaren” in die Zirkulation einbezogen werden? Gibt es hinsichtlich der Reservekapillaren Unterschiede in verschiedenen Gehirnregionen?

An der UFk Giesen wird im allgemeinen bei der Beckenlage (BEL) oberhalb der 36. SSW ein vaginaler Entbindungsversuch vorgenommen (2). Keirse (1991) konnte zeigen, das bei Schadellagen die Sektiorate sinkt, wenn Oxytocin verwendet wurde (1). Welchen Einflus hat der Einsatz von Oxytocin bei BEL auf die Entbindung und den Zustand des Kindes bei der Geburt?

Biometric data, i.e. the biparietal (BPD) and fronto-occipital diameter (FOD) of the skull as well as the transverse (TTD) and the longitudinal trunk diameter (LTD) were obtained in 127 cases of breech and 95 cases of vertex presentations within one week before birth. These data were compared with the birth weight measured postpartally. From these data, an optimized equation was derived for both breech and vertex presentations and compared to the equation known from the literature. The optimized equation for breech presentations requires only the biometric data of the trunk (TTD and LTD). In spite of this optimization, the quality of the foetal weight estimation of breech presentations seems to be more inaccurate in comparison to the estimation of vertex presentations. Concerning the obstetrical management the foetal weight estimation by ultrasound has to be evaluated more critically for breech presentations than for vertex presentations.

During the early part of this century, cranial trauma and asphyxia during birth were the most frequent phenomena in perinatal pathology. Atraumatic bleeding into the ventricles was regarded as an uncommon phenomenon in term pregnancies, but as early as 1919 Ylppo characterized bleedings into the ventricles as a typical sign of hemorrhage in the preterm infant. Bleeding into the subependymal matrix near the foramen of Monro (Hambleton and Wiggelsworth 1976) was often found to be accompanied by a rupture and bleeding into the lateral ventricle which then spread throughout the ventricular system (Hemsath 1934). With the general decline in perinatal mortality in the past decades, the relative importance of this type of preterm lesion has increased (Lee et al. 1980).

The condition of the fallopian tubes was assessed in 100 fertile women on whom a caesarean section had been performed and in 100 infertile women who had undergone a diagnostic laparascopy. The 100 infertile women revealed both peritubal adhesions (20% vs 2%) and fimbrial agglutinations (4% vs 0%) in a significantly higher number of cases. When the diagnostic procedure was extended to include the salpingoscopy of 20 women with periampullary and peritubal adhesions, 10% of them were found to be suffering from damage of the endosalphinx. In patients with fimbrial agglutination, the same diagnostic procedure revealed mucosal damage in 40% of the cases. The rate of damage to the endosalpinx may help to explain the relatively high rate of ectopic pregnancies (15%) following microsurgical fimbrioplasty. Thus, in cases where the patient is suffering from peritubal adhesions and fimbrial agglutinations, salpinogoscopy can be of use in deciding whether microsurgery is indicated. In those cases, where there is evidence of damage to the endosalpinx, in-vitro fertilization with intrauterine embryo transfer must be considered as the preferential method.

17 women received 2 x 10 ml prilocaine 1% as a pudendal block sub partu. At delivery, the foetomaternal distribution ratio of the local anaesthetic was evaluated and the development of Met-Hb-concentration in the neonate was measured up to six hours post partum. The Met-Hb-concentration in the neonate was relatively low with a maximum of 1.8% after two hours, followed by a steady decline. A probable explanation for the Met-Hb-concentration could be the unexpected low foetomaternal ratio of distribution (0.5) and the increased renal elimination of the amide-type local anaesthetic in the neonate, respectively. According to these results, no contraindication for prilocaine in pudendal block is indicated.

Im Bereich der Hessischen Perinatalerhebung (HEPE) wurden in den Jahren 1986–1989 ca. 85% aller Beckenendlagenkinder durch Kaiserschnitt entbunden. Von allen Kaiserschnitten bei Beckenendlagen wurden 90% (!) als primare Kaiserschnitte durchgefuhrt. Nur bei einem Viertel aller Geburten aus Beckenendlage wurde uberhaupt ein vaginaler Entbindungsversuch unternommen. Die hohe Rate an Kaiserschnitten ist die Folge einer Empfehlung von Kubli (1975), die Indikation zur Sectio bei Beckenendlage groszugiger zu stellen. Es gibt bereits eine ganze Generation von Gynakologen, die bei Vorliegen einer Beckenendlage grundsatzlich eine Sectio durchfuhrt. So ist die Zahl der vaginalen BEL-Geburten in den letzten 10 Jahren fast um die Halfte zuruckgegangen. Es ist unverkennbar, das mit dem Anstieg der Sectiofrequenz bei Beckenendlagen die Zahl der geburtstraumatischen und asphyktischen Schaden gesenkt werden konnte (Schutte et al. 1985; Svenningsen et al. 1985). Die Zeiten im Kreissaal gehoren damit der Vergangenheit an, wo die ganze Extraktion und nachfolgende komplizierte Armlosungen bei hochgeschlagenen Armen nicht selten oder die Entwicklung des Kopfes schwierig war. Die Folge dieser komplizierten geburtshilflichen Operationen war haufig ein asphykti-sches Kind mit den daraus resultierenden Zeichen der hypoxischen Hirnschadigung.

Many anesthesiologists prefer epidural anesthesia for cesarean section because of the potential risks of general anesthesia such as Mendelson's syndrome. For this indication, the local anesthetic of first choice is the long-acting substance bupivacaine. The aim of the following study was to determine maternal and neonatal plasma concentrations of bupivacaine 0.5% following epidural anesthesia for cesarean section in order to give critical statements about the systemic toxicity of the local anesthetic. MATERIALS and METHODS. Central venous blood samples were collected for bupivacaine analysis (gas chromatography) in 15 patients (Table 1) undergoing cesarean section with epidural anesthesia over a period of 60 min after injection of 14 to 23 ml bupivacaine 0.5%. Six of these patients had received the epidural anesthesia earlier to relieve labor pain. Before administering the anesthetic dose, a blood sample was taken to determine the baseline value. Immediately after cord clamping, blood sampling was done to determine bupivacaine concentrations in the umbilical artery and vein. Apgar scores and blood gases were also checked and compared with those of neonates born by cesarean section under general anesthesia. RESULTS. Ten to 15 min following epidural application of 70 to 115 mg bupivacaine (mean = 99 mg), peak plasma concentrations occurred (mean = 0.41 micrograms/ml) The maximum plasma level of 0.7 micrograms/ml bupivacaine was found in a patient who had received epidural anesthesia for pain relief during labor. In this case, the baseline bupivacaine level after several epidural injections (125 mg in 15 h) before the anesthetic dose for cesarean section was 0.2 micrograms/ml. Immediately after delivery the mean plasma bupivacaine concentrations in the umbilical vein and artery were 0.11 micrograms/ml and 0.07 micrograms/ml respectively. Apgar scores and blood gas analyses showed no significant difference between neonates born by cesarean section under regional or general anesthesia. DISCUSSION. Using bupivacaine 0.5% for epidural anesthesia for cesarean section, we found maternal and neonatal plasma concentrations of the local anesthetic far below the accepted threshold level for producing systemic toxic reactions. In contrast to others, we obtained good analgesia and sufficient motor blockade accompanied by low plasma levels. In our opinion, there is no need to use 0.75% bupivacaine, especially since peak plasma concentrations of more than 2 micrograms/ml occur shortly after its epidural administration.

Eine gegenuber der vaginalen Entbindung um das 6–8 fach hohere mutterliche Mortalitat und Morbiditat wirft die Frage auf, ob eine Sectio bei Beckenendlage in jedem Fall medizinisch zu rechtfertigen ist, zumal es fur Mutter und Kind oft risikoarmere effektive Vorgehen gibt. Klare Indikationen zur abdominalen Schnittentbindung bei BEL sind praexistente lageunabhangige Risikosituationen und Fruhgeburten, bei denen die Drehung in Schadellage noch nicht erfolgt ist. Auch ist die BEL haufig verursacht durch uterine Fehlbildungen und Myome. Eine bei BEL seltene extreme Deflexion des fetalen Kopfs fuhrt bei vaginaler Entbindung zu deutlich hoherer Mortalitat und Morbiditat. Deshalb ist hier eine Sectio angezeigt. Die Vorhersage eines fetomaternalen Misverhaltnisses als Risikofaktor fur eine vaginale BEL-Entbindung ist trotz Sonographie oft nicht moglich. Weiterhelfen kann hier die Kernspintomographie. Schwierigkeiten bei der Wahl des Entbindungsmodus ergeben sich auch aus juristischen Erwagungen: Die Sectio ist belastet mit einem hoheren Risiko fur die Mutter, die vaginale Entbindung mit einem hoheren Risiko fur das Kind. Die Wahl des Verfahrens wird zunehmend beeinflust durch die derzeitige Rechtslage zu Gunsten steigender Sectioraten bei BEL. Indikationen fur die sekundare Sectio sind der protrahierte Geburtsverlauf, das pathologische CTG und der Fusvorfall. Der operative Eingriff sollte in maximaler Tokolyse erfolgen. Das Kind wird wie bei der vaginalen Entbindung entwickelt: Herausleiten des Steises, eventuell Armlosung und Entwicklung des Kopfes. Der Versuch einer auseren Wendung sollte nach Abwagung aller Ausschluskriterien und Kontraindikationen nur in Sectiobereitschaft erfolgen.

Licht- und elektronenmikroskopisch werden an 132 Wistar-Ratten die morphologischen Reaktionen auf Implantation von hamostyptisch wirksamem, nativem Kollagen-Vlies in die Subcutis und auf eine blutende Leberwunde untersucht. In der Subcutis vermittelt das Einwandern von Mikround Makrophagen eine problemlose Resorption des Kollagens. Eine bindegewebige Organisation der Implantationszone erfolgt vom 5. bis 15. Tag p.o. Uberschiesendes Bindegewebe ist nach 25 Tagen, Fremdkorpergranulome sind nach 50-100 Tagen p.o. abgebaut. Die besonderen Merkmale der Applikation auf die blutende Leberwunde sind rasche Blutstillung, Mesothelisierung des Vlieses gegenuber der Bauchhohle nach 1 Tag, Resorption und Organisation ohne Bildung von Verwachsungen bis zum 10. Tag p.o. Die Ausheilung erfolgt in Form einer flachen Verdickung der Leberkapsel und vereinzelten restlichen Fremdkorpergranulomen nach 100 Tagen.

To evaluate right ventricular function following mitral valve replacement, we studied 84 patients with isolated mitral valve disease with the use of first-pass radionuclide angiography before, 1 week after, and up to 1 year after operation. The right ventricular ejection fraction for the entire group improved from 29% ± 11% to 43% ± 10% (p

The general management of cases of backache is outlined, stress being placed on an exhaustive diagnostic study. A detailed technic for injection of heavy oil anesthetics is given.

Slovak literature has never achieved such prominence as some other western Slavic literatures, but it is an interesting topic for academic research. Until the era of Romanticism, literature in Slovakia is not represented by the verse romance and lyrics of courtly love which are characteristic of the mediaeval literatures of the West. The aristocracy was assimilated with Hungarians, and the use of Latin for literary purposes remained predominant not only among the Catholics but also among some Protestants until the end of the eighteenth century. Humanism found an early entry into Slovakia through the University of Bratislava (Academia Istropolitana, founded in 1465) and through students and professors studying or teaching abroad (Bologna, Padua, Prague, Cracow). It did not, however, give any meaningful impulse to literary production in verse or prose except in homiletic writings. The second university on Slovak territory, Trnava, founded in 1635, gave a strong impetus to cultural life, both in Latin and in Slovak, but activities were mostly restricted to religion, history, geography, mathematics, and jurisprudence, and only occasionally ventured into poetry and drama.

The author has devised an apparatus for resuscitation and immediate management of the newborn infant which has the following advantages: (1) It concentrates all resuscitation and immediate management facilities for the newborn in a compact, portable and relatively inexpensive apparatus. (2) It enables the obstetrician with little or no assistance to manage the newborn infant and to resuscitate it without a break in sterile technic so that he can administer at the same time to the mother if necessary.

Zu den schwierigsten Aufgaben in der Geburtshilfe gehort heute immer noch, eine Frau von einem Kind zu entbinden, das sich in Beckenendlage befindet. Bei sehr konservativer Geburtsleitung sind Mortalitat und Morbiditat der Kinder extrem erhoht (Doring u. Sousa Gerbert 1988; Manzke 1981; Wulf 1981).

Commercial preparations of human "Lyodura soft" were implanted into the subcutaneous connective tissue of 40 Wistar rats. After survival times from 7 days up to 1 year the samples were examined by light microscopy. An initial reaction of mononuclear cells, activated fibroblasts, and some giant cells of foreign body type in the surrounding connective tissue is followed by the development of a fibrous capsule rarefied by cells around the implant in the time up to 3 months. After 6 months and more clearly after one year the capsule is reduced or even completely vanished. The implant remains then integrated in the subcutaneous connective tissue almost without residual reactions or signs of resorption.

A light and electron microscopic study was made on the resorption of native collagen fleece following its subcutaneous implantation or its application on a bleeding liver surface in 132 Wistar rats. Resorption of collagen began with the immigration of micro- and macrophages. Organisation of subcutaneous connective tissue was seen from day 5 p.o. to day 15 p.o. The excessive connective tissue was removed after 25 days and foreign body granulomas were eliminated after 50 to 100 days. Typical characteristics of application of the collagen fleece on bleeding liver surface are: Rapid hemostasis, mesothelisation of collagen towards the peritoneum after 1 day, resorption and organisation without adhesion after 10 days. The final heeling leads to a smooth thickening of the liver capsula with a few residual granulomas after 100 days.