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Heliox is a mixture of Oxygen and Helium. The low density of Helium allows this mixture to flow in a laminar pattern where oxygen, nitrogen or air flow would be turbulent. Therefore the force necessary to move a volume of gas (e.g. Heliox) is greatly reduced in comparison to a turbulent gas flow. In a respiratory loading experiment we investigated the effects which Heliox exerts on hemodynamic as well respiratory variables. 10 volunteers were breathing spontaneously and through three different endotracheal (ET-) tubes (ID 4.0, 4.5, 5.0 mm). The subjects were switched from room air to Heliox and differences in the variables heart rate (HR), blood pressure (BP), stroke volume (SV), stroke index (SI), peripheral vascular resistance (TPRI) and left ventricular work index (LVWI) were measured. Furthermore the (PhAng) between abdomen and thorax was detected using respiratory inductance plethysmography (n=2) and the sense of dyspnoe under the different conditions was assessed by the use of a dyspnea score (DS). The means of BP, SV, SI, TPRI and LVWI did not significantly differ between the resting and the different loading conditions irrespective of the gas that was used. The variability of hemodynamic measures was significant larger during loaded vs. unloaded breathing. Heliox could significantly reduce this degree of variability. In two subjects Heliox could also significantly reduce the PhAng as well as DS. Heliox showed effects on hemodynamic as well as respiratory and subjective variables. These effects can be interpreted as a reduction of the extent of pressure variations in the intrapleural space leading to less impact on hemodynamic variables while breathing Heliox vs. room air in a resistive loading experiment. In the future the combined measurement of hemodynmic variables as well as non-invasive assessment of respiration might shed new light on cardio-respiratory interaction and effects of Heliox during airway obstruction.

The biomass of the endolithic algae Ostreobium quekettii Phyllosiphoniaceae living within skeletons of the scleractinans Mycedium elephantotus and Leptoseris fragilis averages 300 μg protein. cm-2. This represents approximately 7% of the protein of the zooxanthekie-containing tissue of M. elephantotus and approximately 38% of that of L. fragilis. Oxygen production Pmaxnet of 0. querkettii in bare skeletons of M. elephantotus averaged 0.7 μg O2.cm-2· h-1 measured in large skeletal fragments. This amount is approximately 6% of the productivity of the zooxanthellae Symbiodinium microadriaticum living in the same scleractinian species at the same depth Pmaxnet 11 μg O2· Cm-2· h-1. Light compensation of O. quekettii - within skeletons - was reached at approximately 10 and saturation at 35 40 μE·m-2· s-1. Algae within the M. elephantotus skeletons receive a maximum of 4–6% of the ambient irradiance, which is approximately 0.9 μE · m-2· s-1 approximately 0.04% surface irradiance at a depth of 88 m. In L. fragilis at a depth of 145 m, the photon flux decreases to 0.3 μE·m-2· s-1, which is less than 0.004% of surface intensity. With increasing depth, the ratio of Chl b to Chl a increased in endolithic algae colonizing L. fragilis, indicating improvement of light harvesting under low light conditions. In free-living O. quekettii cultured at irradiance levels from 0.5–60 μE·m-2· s-1, the concentrations of chlorophylls increased and that of siphonein and β-carotene decreased with decreasing photon flux.

Visual assessment, black & white image analysis and colour image analysis of the severity of powdery mildew (Sphaerotheca fuliginea) infection on leaves of cucumber (Cucumis sativus) were compared. The extent of infection with powdery mildew was expressed as the number of spores per cm2. Statistical treatment of the data showed colour image analysis to be superior to the other two methods of evaluation. Major veins, light reflections and variations in the colour of leaves can degrade the accuracy of colour image analysis somewhat. These problems are, however, surmountable. Colour image analysis qualifies as a valuable new tool for accurate, objective, reproducible and detailed quantitative assessment of disease on leaves of plants.

Heliox is a mixture of Oxygen and Helium. The low density of Helium allows this mixture to flow in a laminar pattern where oxygen, nitrogen or air flow would be turbulent. Therefore the force necessary to move a volume of gas (e.g. Heliox) is greatly reduced in comparison to a turbulent gas flow. In a respiratory loading experiment we investigated the effects which Heliox exerts on hemodynamic as well respiratory variables. 10 volunteers were breathing spontaneously and through three different endotracheal (ET-) tubes (ID 4.0, 4.5, 5.0 mm). The subjects were switched from room air to Heliox and differences in the variables heart rate (HR), blood pressure (BP), stroke volume (SV), stroke index (SI), peripheral vascular resistance (TPRI) and left ventricular work index (LVWI) were measured. Furthermore the (PhAng) between abdomen and thorax was detected using respiratory inductance plethysmography (n=2) and the sense of dyspnoe under the different conditions was assessed by the use of a dyspnea score (DS). The means of BP, SV, SI, TPRI and LVWI did not significantly differ between the resting and the different loading conditions irrespective of the gas that was used. The variability of hemodynamic measures was significant larger during loaded vs. unloaded breathing. Heliox could significantly reduce this degree of variability. In two subjects Heliox could also significantly reduce the PhAng as well as DS. Heliox showed effects on hemodynamic as well as respiratory and subjective variables. These effects can be interpreted as a reduction of the extent of pressure variations in the intrapleural space leading to less impact on hemodynamic variables while breathing Heliox vs. room air in a resistive loading experiment. In the future the combined measurement of hemodynmic variables as well as non-invasive assessment of respiration might shed new light on cardio-respiratory interaction and effects of Heliox during airway obstruction.

Authors report on two cases of homicide and another case of suicide, all committed with captive-bolt livestock-stunners. The investigation of skull caps revealed roundish holes at the entry sites which were beveled-out in a paraboloid-like manner on the inner aspect. These defects were reproducible in test shots with various strengths of ammunition and different materials as targets.

Up to now reliable data were available on cases of lethal child neglect in the area of the Federal Republic of Germany prior to reunification (the former West Germany). In a multicenter study we therefore examined the police and court records for such cases occurring in the period from 1 January 1985 to 2 October 1990 in nearly the entire area of Federal Republic of Germany.The study center received information on 19 cases of lethal child neglect. Extrapolated to all institutes of legal medicine, this corresponds to 20 cases and thus 3.5 cases a year in the whole of West Germany in the period studied. There is to be added a dark-field which cannot be limited more precisely. However, the cases of fatal child neglect might have occurred much more seldom than fatal child abuse caused by use of physical violence. Slightly more than half the victims were younger than 1 year, the oldest one was 7 10/12 years old. Most frequently the children died of starvation and thirst. Mostly the mothers/nursing mothers killed the child alone or together with the victim's father/stepfather. In the majority of the cases there was not a close affection between parents and child. Nearly 30% female/male perpetrators suffered from chronic alcohol abuse. Only 15 (= 56%) of 27 female/male perpetrators were sentenced to imprisonment (period between 7 months on probation and 10 years). Mitigation circumstances existed for nearly half the persons sentenced to imprisonment. It is true that child neglect is a rarer crime, but the experts of legal medicine always have to indicate errors made during the external inspection of the corpse (among others failures to see indications of neglect).

No reliable data are available on cases of lethal child abuse (by active force) in the area of Federal Republic of Germany prior to reunification (the former West Germany). In a multicenter study we therefore examined the police and court records for such cases occurring in the period 1 January 1985 to 2 October 1990 in nearly the entire area of Federal Republic of Germany.The study center received information on 58 cases of lethal child abuse. Extrapolated to all institutes of legal medicine, this corresponds to 62 cases in all of West Germany in the period studied. An approximately equal number of unreported cases should be added to this figure. Including unreported cases, at least 20 cases of lethal child abuse occurred per year; thus only one in every two cases ever came to light. Almost two thirds of the victims were younger than one year old. At autopsy 59% exhibited signs of repeated abuse at autopsy. By far the most common cause of death was direct impact from a blunt object, usually to the head. Mostly, the male person to whom the victim relates most closely (father, stepfather, partner of the mother) has killed the child. Twenty-one of the 74 persons charged saw the charges against them dropped or were acquitted due to lack of evidence; 51 received sentences ranging from one year probation to life. In the remaining two cases the outcome of the trial was unknown. Signs of abuse were readily apparent at autopsy in almost all cases. The high number of unreported cases underscores the need to educate medical students and practicing physicians to be on the look-out for signs of abuse and argues for an increase in the rate of autopsy.

Based on the description of the findings of four cases of self-strangulation with multiple knotting of the strangling device examined by the authors general criminological and specific forensic criteria for differential diagnosis of suicide and commission of the offence by another person are discussed. Though multiple knotting of the strangling device, caught hair and parts of clothes and concomitant injuries may also be seen in cases of suicide, they primarily justify the suspicion that the death was caused by another person. If it is one of those rare cases of self-strangulation with multiple knotting, the presence of symptoms of congestion in the head area, which may occasionally be absent in other cases of strangulation, is necessary for pathophysiological reasons.

Interstellar gas moving in elliptical streamlines is used to model the observed terminal velocities of neutral hydrogen gas in the I. and IV. galactic quadrant. The excentricity of the orbits decreases with increasing r, and they are well aligned with a position angle of 40° for r≤3 kpc indicating the existence of a bar in that region. Plotting the orbits in the galactic plane spiral‐arm‐like features are marked by orbital crowding effects. This spiral arm system is 4‐armed for 3≤r≤6 kpc, and two‐armed outside of this and it agrees reasonably well in position with the spiral structure outlined by Georgelin and Georgelin (1976). The strong peak of the galactic rotation curve found amongst others by Rohlfs and Kreitschmann (1987) near r=500 pc is seen to be caused by the alignment of the elliptical orbits and not to be a feature of the dynamics.

Nach den Allgemeinen Unfallversicherungsbedingungen § 3, III (AUB 88) liegt ein Unfall vor, wenn der Versicherte durch ein plotzlich von ausen auf seinen Korper wirkendes Ereignis (Unfallereignis) unfreiwillig eine Gesundheitsschadigung erleidet.

1) Untersucht wurde der Einflus von Saure und Lauge auf die Entwicklung der fruhen Wundreaktionen an der intakten und der mechanisch verletzten Meerschweinchenhaut. Die zellularen und fermenthistochemischen Reaktionen zeigten hierbei ein unterschiedliches Verhalten: Die Gewebsleukozytose nach mechanischer Hautverletzung wird durch chemische Einflusse weniger behindert als die reaktive Aktivitatssteigerung der Enzyme im Wundrand, welche sich durch Saure starker und durch Lauge weniger beeintrachtigt zeigte. Aktivitatsveranderungen strukturgebundener Enzyme waren nach alleiniger Saure- und Laugenwirkung in der Haut nicht nachzuweisen, sondern praktisch nur nach mechanischen Verletzungen. Die zellulare Reaktion entwickelt sich am Rande der Laugen-Nekrose starker verdichtet, bei der Saure-Nekrose breiter und mehr diffus. Charakteristische Kernveranderungen fanden sich bei der Laugenwirkung starker ausgepragt. 2) An der mechanisch unverletzten Haut fanden sich nach Saureeinwirkung signifikante Histaminuberschusse, wahrend die Serotoninfreisetzung deutlich abgeschwacht war. In der Schnitt-Saure-Gruppe ergab sich eine Verminderung des Histamingehaltes und eine signifikante Zunahme des Serotonins. Das Verhalten der sog. freien Gewebshormone nach Einwirkung chemischer Mittel auf die Meerschweinchenhaut ist zum Teil gegenlaufig. 3) Bei postmortaler Schnittverletzung und anschliesender Veratzung fand sich ein deutlicher Histaminanstieg im Wundgebiet. Bekanntlich gilt der Uberschus an freiem Histamin gegenuber der unverletzten Vergleichshaut als Vitalreaktion. Da es auch postmortal durch chemische Einflusse zu einer Entspeicherung der Mastzellen und damit zur Freisetzung von Histamin kommen kann, ist bei Hautveratzungen eine vorsichtigere Interpretation angebracht.

Es werden die Ergebnisse thromboszintigraphischer Untersuchungen bei Patienten mit cerebralen Insulten dargestellt und mit den angiographischen und klinischen Befunden verglichen. Zu negativen thromboszintigraphischen Ergebnissen kommt es bei doppelseitigen Carotisthrombosen, bei uber 1 Jahr alten kompletten Carotisverschlussen und bei Carotisthrombosen unter Marcumarbehandlung sowie wahrscheinlich auch einige Tage unmittelbar im Anschlus an eine direkte Punktion der A. carotis. Unter Berucksichtigung dieser zu erwartenden „Negativ“-Befunde fand sich unter 54 Kranken mit cerebralen Insulten nur zweimal keine Ubereinstimmung von Klinik und Szintigramm. In beiden Fallen war es zu einer Markierung der klinisch falschen Seite gekommen. Unter den Patienten mit Insulten war in 6 Fallen das Szintigramm positiv, obgleich das Angiogramm keine Auffalligkeit zeigte. In einer Vergleichsgruppe von 19 Patienten ohne einen cerebralen Insult waren in 14 Fallen Angiogramm und Szintigramm ubereinstimmend negativ, in 4 Fallen Szintigramm und Angiogramm und in 1 Fall nur das Angiogramm positiv. An Hand der vergleichenden Ergebnisse bei 20 Patienten mit transitorischen Insulten wurde die Frage diskutiert, ob es mit Hilfe der Thromboszintigraphie moglich sein konnte, angiographisch (noch) nicht fasbare thrombotische Plaques im Bereich extrakranieller Carotisabschnitte bereits zu erfassen, noch ehe sie klinisch zu bleibenden Schaden (Hirninfarkten) fuhren und zur atiologischen Differenzierung transitorischer Insulte beitragen. Die direkt an operativ entfernten Thromben der A. carotis durchgefuhrten Aktivitatsmessungen bei 4 Patienten ergaben im thrombotischen Material hohere Radioaktivitatskonzentrationen als im gleichzeitig entnommenen Venenblut. Diese ersten Ergebnisse von in vitro-Messungen sprechen dafur, das es in den thrombotischen Gefaswandveranderungen zu einer vermehrten Anreicherung von radioaktiv markiertem Fibrinogen kommt.

Es wird uber tierexperimentelle Untersuchungen berichtet, die sich unter Einbeziehung histologischer, enzymhistochemischer und biochemischer Methoden mit den fruhen Reparationsvorgangen nach Leberschnittverletzungen beschaftigen. Die reaktiven Veranderungen auf zellularer und histochemischer Ebene zeigen gegenuber den an Hautverletzungen bekannten Verlaufen z. T. erhebliche Unterschiede: 1. Die Gewebsleukozytose war fur die Bestimmung des Wundalters weniger geeignet, da die fruhzeitig nachweisbare leukozytare Reaktion sich im weiteren Verlauf nur unwesentlich anderte. Bei den kurzen Uberlebenszeiten zeigten die Leberepithelien in der Umgebung der Schnittverletzung Hypoxidosezeichen und Glykogenverlust. Andere histomorphologische Veranderungen traten erst nach 24 h auf, so die Proliferation von organspezifischen und mesenchymalen Zellen. 2. Die mit histochemischen Methoden nachweisbaren Aktivitatsveranderungen der Enzyme im Verletzungsbereich lieferten insbesondere fur die fruhe Wundphase wichtige diagnostische Parameter. 3. In den ersten 12 h fand sich eine deutliche Zunahme des Histamingehaltes im Wundgebiet, der Serotoninspiegel zeigte ein gegenlaufiges Verhalten. 4. Wir empfehlen daher, zur Schatzung des Wundalters bei Leberverletzungen enzymhistochemische Methoden mit einzubeziehen.

Aus dem ehemaligen Forstamt Bredelar, heute Forstamt Brilon, im Sauerland in Nordrhein-Westfalen werden Versuche zur Auswirkung eines starken Seitentriebverbisses an Fichte auf das Hohenwachstum der Fichte dargestellt. Die Beobachtungen erstreckten sich uber den Zeitraum von 1968 bis 1976.

Es wird in Anlehnung anBianchi undToni uber eine Clearance-Methode berichtet, die auf externenen Harnblasenaktivitatsmessungen beruht und den Harnblasenkatheter uberflussig macht. Bei dieser Modifikation des Verfahrens dient die Tracer-Substanz lediglich der Bestimmung der Dauer der Clearance-Periode. Die nierengangige inaktive Testsubstanz in den Serum- und Urinproben wird chemisch bestimmt. Dadurch entfallen die sich aus der Jodabspaltung ergebenden Probleme. Damit sind auch simultane PAH-Inulin-Clearance-Untersuchungen moglich. Vergleichende Bestimmungen des Glomerulumfiltrates an 17 Patienten ergaben eine statistisch gesicherte Ubereinstimmung mit der konventionellen Inulin-Clearance (Mittelwert der Differenzen=1,8 ml/min).

Es wurden bei 35 Probanden extrakranielle Carotisthrombosen mit intravenos injiziertem 113m-Indium-Fibrinogen markiert und szintigraphisch nachgewiesen. Davon besasen 10 Verschlusse und 7 Stenosen der A. carotis interna; in 18 Fallen waren die extrakraniellen Carotiden bds. angiographisch unauffallig. 14mal war das Computerszintigramm in der Gruppe der Stenosen und Verschlusse positiv, 3mal negativ. Negative Szintigramme fanden sich 2mal bei beidseitigen Thrombosen und bei einem mindestens 3 Jahre alten Verschlus. Unterschiede zwischen Stenosen und Verschlussen ergaben sich im Szintigramm nicht. In der Kontrollgruppe waren 13 Szintigramme negativ und 5 positiv. Die 5 positiven Befunde betrafen 1 Vertebralisstenose und 4 gleichseitige intrakranielle Thrombosen (Syphon und A. cerebri media). Der Methode kann fur die Vorfelddiagnostik extrakranieller Carotisthrombosen Bedeutung zukommen, weil sie eine gezieltere Anwendung der Angiographie gestattet.

ZusammenfassungDie Ergebnisse von 57 Testen an Normalpersonen und Kranken zur Prüfung der Resorptionsfähigkeit des Vitamin B12 im Intestinum lassen es als berechtigt erscheinen, neben der Messung der Harnaktivität auch die Serumaktivitätskonzentration 8 Std. nach Aktivitätsgabe zu bestimmen. Der Aussagewert des Schilling- Testes wird dadurch wesentlich verbessert. Ein Wert unter ca. 0,3% der applizierten Dosis spricht nach unseren Untersuchungen für eine gestörte Resorption.

The rates of incoporation in vivo of 131Iododeoxyuridine (mIUdR) into the tumour and into 10 organs of tumour-bearing rats was investigated after partial synchronization with hydroxyurea (HU). The rate of DNA synthesis was reduced to 5% of the normal value over aperiod of 8.5 h by six successive injections of HU (50 mg/kg body weight). Commencing 1.5 h after the last HU injection, groups of 6 animals were injected with 131IUdR at intervals of 0.5 h. The animals were killed 48 h after this treatment and 131IUdR activity in the individual organs and in the tumour was determined. The results showed that the maximal uptake of 131IUdR after partial synchronization varied from organ to organ (not increased: brain, blood; increased by a factor of 1.5-1.8 duodenum, liver, spleen; increased by a factor of 2.1-2.5 lung, tumour, muscle, bone; increased by a factor of 3.6-4.5 stomach, kidney). Moreover, the time to reach maximal incorporation after HU treatment is different according to the tissue under investigation. The use of 131IUdR as a tumour-localizing agent in scintigraphy of tumour-bearing rats previously injected with HU showed that this method of partial synchronization clearly facilitates the detection of tumours in the lung area.

ZusammenfassungFür eine sichere Differenzierung zwischen extra- und intrahepatischem Verschlußikterus besteht großes klinisches Interesse. Mit den klinisch zur Verfügung stehenden Methoden ist diese Differentialdiagnose häufig nicht möglich. Auch angiographische Untersuchungen der Leberarterien und der Venen des Pfortader-systems können zur Frühdiagnostik nichts beitragen. Dagegen erscheinen funk-tionsszintigraphische Untersuchungen für eine Differenzierung des Verschlußikterus im Frühstadium geeignet.

First clinical results of patients with diseases of the lungs. The previous experiences on patients with diseases of the lungs reveal that the regional function diagnostics of the lungs may be extended and improved by functional scintigraphic radiospirometry. Because of the determination of regional lung volumes restrictive lung diseases can be differentiated and analysed more exactly than it has been possible before by the examinations of perfusion and ventilation alone. A further advance of the determination of lung volume is that the question of functional operability can be cleared up exactly. In our opinion the routine use of the functional scintigraphic radiospirometry is justified. A contraindication for this kind of examination should only be pregnancy.

In order to elucidate the contradictory findings in cases of suicide or homicide with firearms, firing tests were performed with various weapons shot at textile samples, block gelatine, animal and human skin, and pigs' heads. Ricochets were produced at different angles of incidence and bullets were shot through various materials introduced between the target and muzzle. The morphology and emission spectrum analyses of the entry holes were investigated, and the projectiles were collected and inspected. The morphological and chemical alterations observed at the entry holes were classified and discussed.

Lasionen der Coronararterien werden bei Stichverletzungen des Herzens nur selten beobachtet. Ein 35jahriger Mann war 40h nach penetrierender Verletzung in den linken Vorhof trotz operativer Versorgung der Herzstichwunde im cardiogenen Schock verstorben. Die Obduktion erbrachte eine komplette Durchtrennung des Ramus circumflexus der linken Kranzarterie bei ausgepragtem Rechtsversorgungstyp. Histologische Untersuchungen zeigten einen antero-lateralen Infarkt mit typischen Kontraktionsbandern, diese waren besonders deutlich im Bereich der traumatisch bedingten Nekrose des Atriums ausgebildet. Die pathomorphologischen Veranderungen werden auch im Rahmen einer Catecholamin-Cardiomyopathie (sog. Epinephrin-Myocarditis) diskutiert.

It could be demonstrated by own investigations that ENU-tumors (brain-tumors induced with Ethyl-Nitroso-Urea) are better for clinical questions than the usual transplantation tumors. In this experimental study the temporal and quantitative condition of accumulation of 64Cu-Dimethylglyoxim and 59Fe-Acetyl-Acetone was investigated in rats with ENU-tumors compared with 99mTc-Pertnetate and and 67Ga-Citrate to answer the questions wether 64Cu-Dimethylglyoxim and 59Fe-Acetyl-Acetone are qualified for brain scanning. 64Cu-Dimethylglyoxim and 59Fe-Acetyl-Acetone show like 99mTc-Pertechnetate and 67Ga-Citrate certain affinity to the tumor. At the same time they accumulate in healthy tissues, too. The kinetice of the single radiopharmaceuticals is different. The rates of accumulation of 64Cu-Dimethylglyoxim after 24 hours and of 59Fe-Acetyl Acetone after 4 hours correspond to the rates of accumulation of 99mTc-Pertechnetate after 1 hour. Opposite to this rates of accumulation of 67Ga-Citrate are, because of the high accumulation in the bone, distinctly worse. There are 3 consequences: 1. Brain scintigraphical investigations should not be made with 67Ga-Citrate. 2. Brain scans with 64Cu-Dimethylglyoxim and 59Fe-Acetyl-Acetone will give no better results than scans with 99mTc-Pertechnetate. 3. Further investigations with 64Cu-Dimethylglyoxim and 59Fe-Acetyl-Acetone are not indicated.

Im September 1983 erhielten wir einen staatsanwaltschaftlichen Gutachtenauftrag u. a. zu folgender Frage: „Sind die Mittel Vesparax und Temgesic, insbesondere Temgesic, im Korper auch langere Zeit nach dem Tode nachweisbar, so das eine Exhumierung Erfolg verspricht?“

485 women underwent induced abortion by the vacuum aspiration method. 231 underwent the operation with diazepam narcosis and paracervical blockade as an outpatient procedure, 203 were hospitalized and underwent the operation under full anesthesia, and 51 patients comprised a "risk group", and were not included in the analysis. There were no significant differences in the incidence of complications and side effects. Genital infections were the most common complication, occurring in 6.9% of the outpatient group and 5.9% of the hospitalized group. The outpatient technique can be recommended as a safe procedure for the performance of abortions.

A foreign worker died after a compressed air injury. The insufflation of high pressure air into the anus caused multiple ruptures in the part anterior of the dilated sigmoid and colon descending. For the reconstruction of the case it was necessary to know the minimum distance between the nozzle and the gluteal region. Experimental work has shown that clothing does offer protection against the high pressure air and colon perforations can only be expected if there is a small distance between the jet of the compressed air and the anal region.

A 44 year old male alcoholic was throttled by his wife. The visible white furrow after strangulation was massaged with unguentum; afterwards, the corpse was transported with a scooter by the sons of the victim into a lake. Here, the man was found 24 hours later without any external signs of strangulation. Experimentally produced strangulation furrows (at lower legs of human deceased and at neck of shaved and deeply narcotized guinea-pigs) disappeared when exposed to water or treated with ointments.

Radioiodine therapy and surgical enucleation as a functionally legitimate operation are adequate methods of treatment for the autonomous adenoma of the thyroid. With reference to a series of our own patients, the making of the indication, the operation technique and the carrying out of radioiodine therapy are commented on. The aim of the operation is the enucleation of the autonomous adenoma without traumatizing the healthy thyroid tissue and without ligature of the polar vessels. The aim of radioiodine therapy is the selective destruction of the adenoma. The indication for the operation should certainly be made more liberally to perform the low-risk enucleation.

By "camera-cinematography" of the heart, we mean an isotope method which permits detailed observation of cardiac mechanics without the use of a catheter. All that is necessary is an intravenous injection of 10 to 15 mCi 99mTc human serum albumen followed after ten minutes by a five to ten minute period of observation with a scintilation camera. At this time the isotope has become distributed in the blood. Variations in the precordial impulses correspond with intra-cardiac changes of blood volume during a cardiac cycle. Analysis of the R-wave provides adequate information of cyclical volume changes in limited portions of the heart. This is achieved by a monitor with a pseudo-3-dimensional display; contraction and relaxation of the myocardium can be shown for any chosen longitudinal or horizontal diameter of the heart. Our programme allows simultaneous presentation of the movement of any point on the myocardium as a time-activity curve. The method is recommended as an addition to chest radiography, heart screening or cardiac kymography before carrying out cardiac catheterisation.

The diagnostic accuracy of CT in cases of lumbar disk prolapse was investigated on the basis of a group of 158 of our own patients who were divided into three separate groups. CT findings were compared on the one hand with myelograms and on the other with results of surgery. Simultaneously performed myelographic and CT examinations produced different diagnostic findings in 7 out of 80 lumbar disks (approx. 9%). These deviating findings ranged from gradual differences (in 3 cases) to completely contradictory findings (in 4 cases). In 31 patients who underwent surgery, approximately the same amount of false-positive and false-negative findings were obtained in preoperative diagnosis using CT as with myelography. The overall accuracy calculated for non-invasive computerized tomography was 93.7%, while for myelography it was 90.7%. Out of a further 91 patients in whom myelography was not performed and whose condition was checked surgically, the diagnosis had been established correctly by CT in 88. This represents a degree of accuracy of 96%. The vertical and lateral location of the disk prolapses as determined by CT corresponded with findings at surgery in every case. It is concluded from the results of these investigations that CT should be given absolute priority over myelography in the diagnosis of lumbar disk prolapse and that if there is a correlation between clinical history, neurological deficiency symptoms, and CT findings, myelography is unnecessary, even for surgery. Only if there are discrepancies between the findings myelography is indicated as a supplementary examination. CT and myelography are examination methods which complement, rather than complete with one another.

1) The influence of acids and bases on the development of the early wound reactions in the intact and the mechanically injured skin of guinea pigs was investigated. The cellular and the enzymohistochemical reactions showed to be different: the tissue leucocytosis after mechanical trauma is less restrained by chemical effects than the reactive increase of enzymic activity in the border of wounds, which proved to be affected by acids more than by bases. Changes in activity of structure bound enzymes could not be demonstrated in the skin after mere action of acids and bases, but only after mechanical trauma. The cellular reaction is in the border of the base necrosis more compact, in case of the acid necrosis broader and more diffuse. Characteristic changes in the nucleus were preferentially found after basic reaction. 2) In the mechanically unhurt skin a significant excess of histamine was found after the action of acids, while the liberation of serotonin was distinctly decreased. After incision and addition of acid the histamine level was decreased and the serotonin concentration significantly increased. After exposition of guinea pig skin to chemicals, the concentrations of the so-called tissue hormones showed a contrary course. 3) After postmortal incision and following cauterization a distinct increase of histamine was found in the wound area. Generally the excess of free histamine in comparison to the unhurt skin is considered to be a vital reaction. But because degranulation of mast cells and liberation of histamine can also be caused by chemical influence in the postmortal period, a critical interpretation in cases of skin exposition to acids or bases is necessary.

Case report about a myocardial infarction following stab wound of the left atrium including a complete severance of the left coronary artery: An athletic 35-year-old man suffered a latero-medial stab wound of the thorax. The knife had penetrated the left lung and the atrium of the hypertrophic left heart. Postoperatively, the patient developed a heart infarction; 40 h after trauma he died. The postmortem revealed traumatic necrosis of the left atrium, an intraoperatively undiscovered complete severance of the ramus circumflexus arteriae coronariae sinistrae and an antero-lateral ischemic cardionecrosis of the left ventricle. The location of the infarction could be explained by an extreme right preponderance of the coronary blood supply. Traumatic and ischemic myocardial necrosis differed distinctly in the amount of contraction bands. Other causes for such morphological changes like catecholamine-cardiomyopathy (so-called epinephrine myocarditis) or heart operations are discussed.