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According to the German Industrial Norm DIN 6847-5 for constancy tests of linear accelerators, the measurements of the dose-monitor calibration and of the flatness of electron and photon beams for four different gantry angles are mandatory. The mounting devices developed in the Clinic for Radiation Therapy in Augsburg offer the possibility to perform all necessary constancy tests.

The clinical manifestations of odontomas in prairie dogs are described. Familiarity with this disease is important because it is common, and the signs of this disease mimic other respiratory disorders.

Equal access and participation issues are at the forefront of the current disability advocacy movement. Disabled people worldwide are demanding a change in attitudes and policies reflecting their inherent right as citizens to full participation in society. The inequalities faced by the Canadian Aboriginal community with disabilities are magnified by unique socioeconomic, political, environmental, and cultural barriers. The current rate of disability in the Canadian Aboriginal population (31%) is double the national rate. The existing system available to Aboriginal people with special needs has often resulted in an unaccountable and ineffective web of service delivery. This paper documents various aspects of the existing structure of service delivery and the potential barriers to independent living for adults with disabilities living in remote First Nations communities in Northern Manitoba, Canada. Possible advantages and drawbacks to service provision in health transfer from the federal government to First Nation control are explored.

Upon treatment with HgCl2, H-2s mice, such as B10.S, develop an activation of B lymphocytes that depends, at least partially, on activation of T helper type 2 (Th2) cells and results in increased serum levels of IgG1 and IgE, appearance of IgG autoantibodies, and development of immune glomerulonephritis and vasculitis. Results of previous studies and of experiments presented here indicate that the B cell activation and systemic autoimmune disease fail to develop in MHC-congenic B10.D2 (H-2d) and B10.BR (H-2k) mice treated with HgCl2, although B10.D2 T cells showed signs of activation by and specificity for HgCl2 comparable to those seen in strain B10.S. Here, we report that following HgCl2 injections the antibody response to sheep erythrocytes is normal in B10.S, but suppressed in B10.D2 mice. This suppression was prevented by MoAb to mouse IFN-gamma. Conversely, treatment of B10.D2 mice with murine recombinant IFN-gamma (rIFN-gamma) was able to reproduce the immunosuppression seen after HgCl2 treatment. In B10.S mice, it took administration of both rIFN-gamma and HgCl2 to suppress the anti-sheep erythrocyte response. Although rIFN-gamma diminished the increase in IgE serum levels of HgCl2-treated B10.S mice, it failed to prevent their autoantibody production and immune glomerulonephritis. These findings further strengthen the concept that B10.S mice react to HgCl2 by preferential activation of their Th2 cells producing IL-4, whereas B10.D2 mice react to HgCl2 by preferential activation of their Th1 cells, which produce IFN-gamma and thus suppress antibody responses.

Description of a 68-year-old woman with intermittent exophthalmus produced by valves in the orbital veins, which have not been described hitherto.

Osteoporosis (physiological or pathological) is to be expected in about 7 million citizens of the Federal Republic. Fracture-promoting osseous atrophy, vertebral deformities limiting movement for maintenance of stability and skeletal pains due to muscular weakness and change of posture are the symptoms which frequently lead to disability. When osteoporosis turns to a disease in this way, then sodium fluoride therapy is recommended for reossification and restabilization of the bones. Prophylactically, for reduction of osteoporosis over the age of 40, light gymnastics, regular swimming and the avoidance of noxae which decrease the blood flow are to be advised.

In vitro transofrmation of peripheral blood lymphocytes (PBL) by phytohaemagglutinin (PHA) and concanavalin A (Con A) was found to be decreased in 17 RA patients. The addition of 50 microliter RA serum or serum from normal controls exhibited an inhibitory effect on the mitogenic reactivity to Con A but not to PHA of both normal and RA patient's PBL. Allogeneic antiglobulin preparations (a-Ig) stimulated the spontaneous in vitro DNA synthesis of PBL from normal control and, to a smaller degree, also from RA patients. The simultaneous addition of a-Ig's and mitogens to PBL of normal controls and RA patients did not exhibit a significant effect on the mitogenic reactivity.

Computerized tomographic localization of insulinomas utilises the differences in radiodensity between the tumor and the adjacent pancreatic tissue. With the aid of this new technique four insulinomas have been localized preoperatively. All of the tumors had the same radiodensity. Firm, well encapsulated beta-islet-cell tumors were detected with the same ease as an insulinoma, which was soft and almost without encapsulation. The smallest tumor detected was 1.0 cm in diameter. Of the four insulinomas, localized by computer tomography of the body, only one was also detected angiographically and only two were detected sonographically.

Neither the bone-matrix theory of osteoporosis established by Albright in the 1940's nor the lack-of-calcium theory of the 1960's especially represented by Nordin, due to experimental tests and clinical results could be maintained. Here a new theory of osteoporosis is introduced, explaining osteoporosis not to be primarily a disfunction of calcium- or bone metabolism, but as a part-symptom of disfunction of the whole sustentaculum -bones, marrow, nucleus pulposus and musculation. Osteoporosis is predisposed by amyothenia respectively in activity and is initiated by reduced blood circulation of the sustentaculum. Certain relevant conclusions for prophylaxis and therapy of osteoporosis can be deduced without neglecting already the presently only effective therapy using sodium fluoride.

Based on the author's new haemodynamic biostatic theory of osteoporosis the typical symptoms of osteoporosis are demonstrated by X-ray, revised, interpreted and completed. Atrophy of trabeculae related to osteoporosis, consequences for vertebrae bodies and vertebrae column are chronologically explained. Introduction and distribution of force are discussed and the special importance of muscular system and discs to maintain supporting capacity is emphasized.

Documentation of insulinoma by computerized tomography and the diagnostic value of this new method compared with conventional radiography is discussed. The study of four cases demonstrates the capability of computer tomography to localize tumors in the pancreas.

To avoid the influence of general anaesthetics on the functions of most organ systems, the present experiments were carried out in unanaesthetized rats. Blood concentrations in the aorta, V. portae and Vv. hepaticae as well as urinary and biliary excretions of bupivacaine were studied after either intravenous or enteral administration. From the course of the aortic bupivacaine concentrations after i.v. injection the following pharmacokinetic data were derived: t1/2 = 24,7 min; k2 = 1,467 h; V = 1,492 1. Absorption of bupivacaine from the jejunum is rapid. The hepatic clearance of bupivacaine in the rat is 12 ml/kg b.w..min-1. The biliary excretion of bupivacaine in the rat is very small; therefore the enterohepatic circulation of this substance may be considered neglible.

By using three different assay methods, circulating immune complexes have been detected in 85% of sera from patients with malignant melanoma, and in 77% of sera from patients with breast cancer. These methods were a C1q-binding assay, a double-antibody conglutinin-binding ELISA, and a polyethylene glycol 6000 precipitation technique followed by quantitative determination of immunoglobulins in the redissolved precipitate. Detection rates of circulating immune complexes using any one of these methods separately ranged from 33% to 56%, indicating the presence of different types of circulating immune complexes in cancer patients' sera. The combined use of the three methods mentioned resulted in an increased diagnostic sensitivity and a doubling of the predictive value. However, tests for circulating immune complexes cannot be considered as useful parameters for early diagnosis of cancer, since the comparatively low incidence of malignancies in the population at large, together with the presence of circulating immune complexes in other, nonmalignant, diseases of considerable prevalence, appears to preclude effective application of any nonspecific method for early diagnosis of cancer in general.

In this prospective study 613 patients on whom a total of 783 spinal anaesthetics had been performed, all for urological operations, were questioned and examined. Subjective complaints occured in 102 cases (13%) and were found to be more frequent amongst the female patients. 23 cases (2.9%) developed a typical post-spinal headache, this being more likely to occur if the patient was a woman, was young, and if a 22-Gauge needle was used. The headache usually began on getting up on the day of operation or the first post-operative day, and rarely lasted longer than four days. The pathophysiological changes indicate that the headache is caused by a fall in CSF pressure. The therapy and various methods of preventing this complication are discussed, and the other potential neurological symptoms and signs mentioned.

The anaesthesia outpatient clinic can be a new concept of preanaesthetic preparation and treatment. Related to the figures of 1977, a report is given about our 2-years experience. Patients from the usual outpatient clinics, like gynecology, urology, ENT, who are expected to be operated upon are immediately sent to the anaesthesia outpatient clinic for preanaesthetic check up. After the overall state of the patient has been examined, the original outpatient clinic and/or the family doctor are given information about the patients condition, and probably proposals for a preanaesthetic treatment are made. In 1977, 15% of all anaesthetized patients were checked as outpatients, another 40% were only examined after entering the hospital, whereas as few as 17% were not checked in the anaesthesic outpatient clinic. In patients, checked as outpatients, the period between the first day of hospitalisation and operation was evidently shorter than in patients, having been hospitalized at the time of preanaesthetic examination. This gives the opportunity to save money and beds. Furthermore, the anaesthesia outpatient clinic improves the organisation and efficiency of surgery, urology, gynecology etc., improves the relationship between patients and anaesthetists, decreases the risk of anaesthesia and operation, saves personnel and gives a qualified additional background for the purposes of graduation and student training.

A method is described enabling blood concentrations and urinary and biliary excretion of bupivacaine to be estimated in unanaesthetized rats. After enteral application of bupivacaine, the urine volumes of 40 rats are collected, cleared off and analysed by gas chromatography. 5 fractions are obtained, of which the structures are identified by mass spectrometry and nuclear magnetic resonance. The following five metabolites could be identified: (1) Desbutyl-bupivacaine, (2) 3'-Hydroxy-bupivacaine, (3) N-Butylpipecolyl-2-amide, (4, 5) mono-hydroxylated isomeres on the piperidine ring.

In addition to the well-known rheumatoid factors or antiglobulins belonging to different immunoglobulin classes, a new type of antiglobulin has been found in serum and synovial fluid from patients with rheumatoid arthritis. 15/20 sera and 6/6 synovial fluids contained serologically active material with a molecular weight of approximately 95.000 Daltons. Using chromatographic and affinity chromatographic methods as well as specific precipitation techniques, the (Fab')2 character of these antiglobulins could be ascertained. These antiglobulins may arise through enzymatic degradation of IgG or monomeric IgM antiglobulins, or may be the product of partial intracellular degradation of phagocytosed immune complexes with subsequent extrusion of such material. An in vitro blocking effect of (Fab')2 type antiglobulins on SCMC or ADCC reactions was not found.

Antisera raised against idiotypic determinants of myeloma proteins and macroglobulins have been used to differentiate peripheral blood lymphocytes populations from individual patients. I.D.-positive lymphocytes not resembling plasma cells have been regularly found in peripheral blood in these diseases. This lymphocyte population is heterogeneous with respect to non-tumor-specific surface markers, such as SRBC-, Fc- and C-receptors. Tumor specific idiotypic determinants will thus allow a more correct recognition of the total tumor cell compartment in these diseases.

According to a theory of the authors both senile osteoporosis and pathologic osteoporoses (rheumatic, in diabetes, bronchial asthma, pulmonary emphysema, portal hypertension and Cushing's disease) are due to disturbances of the circulation of the blood in bone. Every type of stasis in the sinusoids, be it due to reduced arterial supply or venous stasis or to a reduction of extravascular fluid-pressure will provoke an increase in osteoclastic activity and thus osteoporosis.

The effect of hypophysectomy and of a successive treatment with LTH and STH on growth and weight gain was investigated in pigeons, 2-6 weeks of age. LTH stimulates as well as STH the growth retarded by hypophysectomy. Either hormone not only prevents the decrease of body weight caused by hypophysectomy but even produces an evident increase. The growth: weight-ratio approximates better to the value of normally developed animals in case of LTH-treatment than in case of STH-treatment.