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A complex medical field such as Child and Adolescent Psychiatry can only meet the expanding problems of quality management by multi-disciplinary cooperation. The quality control circle is the central element of the quality control process and of further advances to quality management. In a critical experience-report the concepts, practical issues and further questions of a continuing quality management conference at a University hospital are outlined. It concentrates on practical and process-oriented problems that concern the integration of quality management in practice and research.

The case of a female premature (1410 g/46 cm) with severe respiratory distress syndrome is presented, which after initial improvement of the hyaline membrane disease developed the typical clinical findings of a persistent ductus arteriosus with severe congestive heart failure. As pharmacologic treatment failed to improve the condition, after a heart catheterisation the surgical ligation of the persistent ductus was necessary. The frequence of occurence, the symptomatology and the indication for surgical treatment of the persistent ductus arteriosus following respiratory distress syndrome in the premature infant are discussed.

The increasing number of Aids cases raises questions as to the risks to which young people are exposed. The present study attempts to illustrate the psychological development of sexuality during puberty. Taking development-psychological and depth-psychological aspects into account, the author attempts to throw light on the development of the ego and the instinctual and defensive behavior of young people. These intrapsychic constellations and social norms have a major influence on young people's sexual behavior.

This complication normally arises between the 5th and 10th weeks of treatment and is most commonly seen in middle-aged and elderly women. The risk is estimated to be between 0.04% and 2%, depending on the type of medication and the method of assessment. The present report describes a 16-year-old boy who developed agranulocytosis after 4 weeks of treatment with perazine. The problem was complicated by acute toxoplasmosis. After perazine was discontinued the neutrophils recovered within 5 days; the boy did develop fever, but the infectious disease had a mild course. This case report once again confirms the importance of regular blood control during the early phases of treatment with psychopharmacological agents.

Utilizing a literature survey we reviewed dates of the intellectual and psychosocial developmental milestones of children suffering from mucoviscidosis. We analyzed the intellectual abilities and social behavior of these children in school as well as their position in the family. The sickness of the child leads to considerable difficulties in intrafamilial communication. The way the patient, the siblings and the parents cope with the sickness is reviewed. We find a changing in self-image of the child as well as changing in self-confidence of the parents, who often react with depression and withdrawal.

A prospective study on oral feeding was started in 75 low birth weights (below 2500 g) with adapted milk. Early feeding was given in two groups with different feeding volume and caloric intake. The infants were grouped alternately. Both groups were comparable concerning birth weight, gestational age, and intrauterine growth. Due to partially different variances, covariate correction was applied to analysis of the data. The high caloric group had excellent weight gain, the maximum weight loss was less, and birth weight was regained earlier than in the control group. Blood sugar and serum protein were similar in both groups. Mean serum bilirubin levels were lower in the group with high caloric intake, but differences failed to be significant. Early high caloric feeding was well tolerated and is preferable to parenteral nutrition in low birth weights.

The effect of phenolic steroids with low estrogenic activity on the serum lipids was studied in male rats. The phospholipid and free fatty acid concentration of the animals increased significantly after the treatment with estrogens, hydroxylated or methoxylated in C-2, C-3 and C-4 positions. The concentrations of fatty acid esters were lowered, and there was a slight decrease of cholesterol.