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Under normal physiological conditions, the supply of oxygen to the respiring tissues can be thought of as a finite series of demands within the tissues which generates the flow of oxygen from the ambient air to the oxygen consuming tissues [1]. As physical stress and the demand for oxygen as source of energy increases, provision is made for more oxygen to be transported by means of increased ventilation and recruitment of more alveoli (larger surface area for gas exchange), greater pulmonary blood flow and peripheral vasodilation in the tissues in question. Under those circumstances, the relationship of oxygen transport and oxygen consumption can be considered a straight line [2]. This is most evidently the case in exercising athletes where the need for oxygen creates the transport or delivery system to follow suit until the delivery system reaches its limits and the combustion of lactate via pyruvate ceases because of lack of oxygen, and lactic acidosis develops [3].

In three juvenile patients, one female and two males aged 14 to 21 years, there were recent deep vein thromboses of the lower limbs due to previous infrahepatic occlusion of the inferior vena cava associated with a shrunken left kidney without clinical manifestation of a nephrotic syndrome. Possible reasons and impacts of this probably congenital peculiar vascular syndrome are discussed. Radiodiagnostic management in juvenile patients with recurrent venous thromboses of the lower part of the body is explained with special respect to secondary phenomena of other retroperitoneal organs like adrenals, inner pelvis and testicles.

Pseudosarcoma is a rare malignant neoplasm composed of both carcinomatous and sarcomatous elements. It occurs most frequently in the uterus. When located in the gastrointestinal tract the lethality is almost 100% one year after the diagnosis. Clinical observations and radiological findings in a 52-year old patient with pseudosarcoma of the duodenum are presented in this report.

Basing upon 77 patients examined the lateral cysturethrography with metallic bead chain is demonstrated as a special X-ray method in the diagnostic management of the female urinary incontinence in good reference to its diagnostic value in advance. A methodic limitation to the lateral voiding cysturethrography only means lack of information about the relations of the pathophysiologically important vesico-urethral connection in "relaxed" and "straining" state. The clinical graduation of stress urinary incontinence shows no proportionality in quantity according to the angles of the vesico-urethral connection revealable by roentgenogram.

One hundred and thirty-three patients with lymph node enlargement from various causes were examined by MR tomography, using 0.5 and 1.5 Tesla. Amongst these, there were 27 patients with chronically enlarged lymph nodes and histologically confirmed sarcoidosis; these showed characteristic T1 intervals. Enlarged lymph nodes due to chronic inflammatory conditions can be differentiated from lymph nodes with malignant lymphoma, or from lymph node metastases from carcinomas. Although there are problems with the determination of relaxation times on MR tomography, this may be a valuable method for the differential diagnosis of sarcoid.

Female urinary incontinence can be visualized only insufficiently be means of static methods such as the lateral cystourethrogram. Detailed information on physiology and morphology or pathological abnormalities can be gained only by means of dynamic methods, where transvaginal or transrectal sonography could become the method of choice. The essential advantages of this method over the conventional imaging methods are discussed.

We carried out replacement of the oesophagus by transposing the stomach in 87 patients, 64 with carcinoma of the oesophagus. There is an immediate operative mortality of 20-30%, but this is followed by a relatively low morbidity, which is well demonstrated radiologically (stricture at the anastomosis, which can be mechanically dilated, about 22%; external fistula with a tendency to spontaneous closure about 25%; ectasia of the thoracic stomach, 15-25%). Average survival time is eight to ten months. There is a 24% risk of post-operative pulmonary oedema and daily chest x-rays are indicated.

A simple video densitometric method based on the indicator distribution principle in the region of interest permits the determination of the relative amount of regurgitation between the ascending aorta and the left ventricle in cases of aortic valve insufficiency. The experimental basis and early clinical measurements are described and are compared with the more conventional methods of cine angiography and radionuclide ventriculography.

The behaviour of the urethral closure pressure at rest (UCP) both before and 14 days and 3 months after radical surgery for cervical cancer was examined. The results were compared with those of other authors. In contrast to the latter we were only able to establish a constant pressure drop in patients using a transurethral catheter at the time of the first postoperative measurement. Patients using a suprapubic catheter showed non-uniform postoperative UCP-changes. This pattern was comparable to that found after simple abdominal hysterectomy, performed for other reasons, in which a transurethral catheter had been in place for a maximum of 60 h. In contrast to our predecessors we were unable to confirm a causal relationship between surgical damage to the sympathetic system and postoperative falls in pressure, except after extremely radical surgery. The cause appears to be a complex process involving wound healing problems (edema, infection, scar formation and organ position changes) and direct traumatization of the urethra (transurethral catheter).

Experiences in i.v. digital subtraction angiocardiography (DSAC) including so-called parametric imaging for morphological delineation of the right ventricle are illustrated. 32 patients with different anatomical and haemodynamic disturbances of the right ventricle were subjected to these examinations. Special emphasis is placed on pulmonary stenosis, particularly on its infundibular manifestations. For visualisation of muscular or fibrous bulging or other changes of the outflow tract of the right ventricle, analysis of the amplitudes is very suitable to produce cumulative pictures of ventricular wall motion during a cardiac cycle. Obstructive wall alterations within the infundibular part become visible even if they occur only during certain phases of the myocardial action, usually in late systole than otherwise.

The paper deals with the early clinical experience, using a new DSA installation with a specially programmed cardiological module. DSA provides very good contrast and special resolution and morphometric estimation of the ejection fraction and regional movement of the left ventricular myocardium derived from DSA. This is as good as the results of the left cardiogram. The significant advantage of DSA ist the ability to make a rapid and simple diagnosis. In addition, it is possible with densitometric methods to calculate ventricular volume curves and to provide phasic indications of the amplitude to contraction of the left ventricle. These investigations have so far proved valuable and provide new scope for the radiological evaluation of left ventricular function.

The economic policy propcsals of the Joint Economic Committee of the U.S. Congress from 19’3 through September 1978 are a mixed bag. They have not changed a great deal since those of 1971 through 1974.’ They contain excellent proposals for reform of inequities in our Federal tax system, for reduction of barriers to international trade, for floating exchange rates with a float that is clean at least in the long run, for revising the income tax so that its real burden is independent of inflation, for the use of temporary budget stimulus during depressions, for including the off-budget agencies in the Federal budget, against international agreements to put a floor under the price of gold or of oil, and against another bout of wage and/or price controls. They contain unworkable proposals intended to reduce inflation and unemployment, whose effect at best would be the continuation of our present rate of inflation with no improvement in unemployment, and at worst would be only a temporary improvement in unemployment followed by stepped-up inflation. This review of the recent economic policy proposals of the Committee is organized as follows. The remainder of this section lists the members of the Committee and some of its senior staff during the period, and describes the format of the Joint Economic Reports and the Midyear Reviews of the Economy. Section 2 discusses the Committee’s macroeconomic policy proposals. Section 3 discusses the Committee’s other economic policy proposals. Section 4 is a brief summary and conclusion. Table 1 lists the Committee membership, by house of Congress and by party, for 1975-78. It also lists, some of the senior staff members.

Neurogenic bladder dysfunction, the main cause of chronic urinary tract infections in multiple sclerosis (MS), is efficiently treated by bladder training with ultrasound control of the residual urine. However, the beneficial effects of bladder training in the hospital are often lost within a short time when the patient returns to his home. Reexamination at home of 97 MS patients with increased residual urine and/or chronic urinary tract infections showed that the group which claimed to continue bladder training at home had significantly less residual urine at home than the group which did not continue bladder training at home. The residual urine decreased from 210 ml on average to almost normal while the patients did bladder training in the hospital, but the volume nearly doubled within a short time at home. Thus, more decentralized rehabilitation by family members, volunteer personnel or local nurses is necessary. Decentralized symptomatic therapy is the most efficient treatment of MS at present. Family members. volunteers, and local nurses, however, need training. Without these improvements in decentralized rehabilitation the hospital treatment of MS is of little benefit because urinary tract infection quickly recurs at home. For efficient bladder training the patient needs feedback regarding the residual urine; this can be provided with minimum risk by ultrasound sonocystography. In those rare cases in which bladder training does not work, intermittent catheterization must be carried out by the patients or their families, volunteer personnel or a local nurse. A continuous indwelling catheter should not be used. antibiotic treatment should be applied only on the basis of a precise bacteriological diagnosis.

Consider a macroeconomic model with constant capacity, an inflation adjustment process depending on excess demand, a government budget restraint, and plausible assumptions. Steady-state equilibrium paths have constant (possibly zero) inflation rates. Stability is assured if the endogenous policy variable is money, government purchase, or the tax rate; if it is government debt instability is assured (contrary to Blinder-Solow). Exogenous increases in money or government purchases raise prices in the short and long run. An open market purchase raises prices in the short run, but if money is endogenous it reduces money and prices in the long run.

In experience of generally increasing frequency of diaphragmatic injuries, nowadays mostly caused by blunt body traumata in traffic accidents, a review is made about diagnostic and morphologic aspects outlining syndromal relations of 70 cases treated from 1950 until 1980 in the Department of Surgery of the Bonn University. Diaphragmatic tears following indirect (closed) trauma are surely more often associated with a transposition of abdominal organs (73%) than those secondary to direct (penetrating) wounds with an amount to 23%. In typical associated injuries like multiple rib fractures (29%, in relation to blunt injuries even 42%) and pelvic fractures (24% resp. 35%) diaphragmatic damage has to be investigated for if there is any doubtful abdominal or cardiorespiratory symptom. Especially in less symptomatic intervals roentgenographic methods come to use predominantly.

Digital subtraction angiography, using a time interval difference mode in relation to a suitable mask, provides a means of showing the myocardium in every phase of the cardiac cycle. The endo- and peri-cardial contours and the thickness of the myocardium in both ventricles can be demonstrated accurately. Artifacts are usually due to displacements of the heart or to tachycardia.

One hundred and thirty examinations with oral gastrografin were performed in 110 patients with obstructive symptoms, who did not require immediate operation. They consisted of 49 patients with mechanical ileus, eighteen patients with paralytic ileus and 63 patients with incomplete mechanical ileus. All patients with complete mechanical and three patients with paralytic ileus were investigated surgically and treated in this way. Small bowel transit time longer than five hours provides considerable certainty of complete mechanical ileus. The method has been tried for four years; it makes few demands on the patient and has practically no contra-indications, except for deranged electrolyte balance. In children, the amount of contrast medium should be limited and it should be diluted or an isotonic contrast medium should be used. The method provides definite differentiation between mechanical and functional obstruction. In patients with adhesions and recurrent incomplete obstruction, further laparotomies may be avoided in this way.

One hundred and thirty-six patients with various cardiac abnormalities that had been diagnosed by standard methods, were examined by I-V DSA; images of the left and right ventricles during a representative cardiac cycle were submitted to amplitude and phase analysis, using a Fourier transformation. Temporal differentiation of ventricular function was derived from the best available right anterior oblique projection; the amplitude of cardiac movement of abnormal areas in the myocardium were obtained from a grey scale or colour coding at a fixed point. Comparison with a control group of 35 individuals showed the following pathological findings: hypokinetic segments (33 cases) showed delay, dyskinesias (20 cases) showed complete separation of maximal phases, frequently with a double peak in the phase histogram; disturbances of cardiac rhythm (14 cases) showed atypical localisation of initiation of contraction: in Wolfe-Parkinson-White syndrome this is basal-anterior, in left bundle branch block and VVI stimulation it is apical inferior; in hypertrophic obstructive cardiomyopathy (eight cases) it is postero-basal inferior with high, narrow peaks on the phase histogram. Differential phase analysis on I-V DSA enables one to define cardiac contraction in a simple manner.

Das geburtshilfliche Kollektiv des Jahres 1971 der Erlanger Universitats-Frauenklinik (n=1752) wurde auf die Haufigkeit von latent und manifest diabetischen Stoffwechselstorungen sowie auf die Haufigkeit von uberschweren Kindern untersucht. Ubergewichtigkeit, familiare Diabetesbelastung werden ebenso wie die Wahl des Geburtstermins, des Geburtsmodus, Behandlung der Stoffwechselstorung zueinander in Beziehung gebracht wie Apgarbenotung, perinatale mutterliche und kindliche Mortalitat und Glucosetoleranzstorungen im Wochenbett. Bei 147 uberschweren Neugeborenen (8,48%) betrug die kindliche Mortalitat 0%. 44,25% der Mutter (n=45) hatten eine pathologische Glucosetoleranz im Sinne eines latenten Diabetes mellitus. Die kindliche sowie die mutterliche Mortalitat bei manifest diabetischen Schwangeren (n=9; 0,51%) betrug jeweils 0%. Eine Gruppe klinisch erkannter und betreuter Schwangerer mit verminderter Glucosetoleranz (n=106; 6,05%) wies eine perinatale kindliche Mortalitat von 1,89% (n=2) auf. Sie wurde einer Gruppe klinisch nicht behandelter latent diabetischer Schwangerer gegenubergestellt mit einer perinatalen kindlichen Mortalitat von 5,35%. In beiden Gruppen betrug die mutterliche Mortalitat ebenfalls 0%. Der latente Diabetes bei Schwangeren wurden ausschlieslich diatetisch behandelt. Die Wahl des Geburtstermins wurde individuell getroffen entsprechend der Ostriolausscheidung im 24 Std-Sammelurin, der diabetischen Stoffwechsellage und geburtshilflichen Komplikationen. Bei 7 der 9 manifest diabetischen Schwangeren wurde die Geburt vor dem errechneten Geburtstermin beendet. Der fruheste Termin war die 37. Schwangerschaftswoche. 30,2% der klinisch erkannten und betreuten Schwangeren mit latentem Diabetes mellitus wurden vor dem errechneten Geburtstermin, 45,3% am errechneten Geburtstermin und 24,5% in der 41. Schwangerschaftswoche entbunden. Die Sectiohaufigkeit bei latent diabetischen Schwangeren betrug 15%, die bei manifest diabetischen Schwangeren 33%. Bei 56 Schwangeren, die erst bei Wehenbeginn oder nach Blasensprung stationar kamen, wurde innerhalb der ersten 72 Std post partum eine pathologische Glucosetoleranz-festgestellt. Diese Gruppe wies mit 5,35% die hochste perinatale kindliche Mortalitatsrate auf.