[Microcirculation index--screening parameter for the assessment of dynamics of the terminal vascular system]. / Der Mikrozirkulationsindex--Screeningparameter zur Beurteilung der Dynamik der Endstrombahn

In this paper a new diagnostic method for the judgment of the dynamics of the terminal vascular system is presented. The microcirculation index which is to be obtained by means of the special technique of the phlebembraxis plethysmography was developed in investigations lasting several years and it was tested on persons with normal blood pressure and on hypertonics in comparison to recognized reference methods. Age-specific normal values were established and the differences found between normo- and hypertonics as well as between different decenniums were statistically ascertained. One group of hypertonics which underwent an antihypertensive long-term therapy showed a significant improvement of the microcirculation index after 8 weeks. According to the hitherto got results this index is fully suited for the utilization as screening method for serial examinations within the X-ray mass examinations and the research of cardio-criculatory diseases. It especially allows the selection of hypertonics who need treatment and through the increasing use of the multi-channel-occlusion-plethysmograph developed by the author the application in routine work for the judgment of the microcirculation and its influence by an antihypertensive therapy. For further foundation of the findings comparative methods with additional reference methods, especially electron microscopy are provided.

[Assessment of the functional capacity in arterial occlusive disease of the extremities]. / Zur Beurteilung der Leistungsfähigkeit bei arterieller Verschlusskrankheit der Extremitäten

In this paper are explained the principles essential for the judgement of the functional capacity in the arterial obturative disease of the extremities. On the basis of tables and figures the diagnostic and prognostic significance of quantitative measurements of blood supply by means of differentiated methods of occlusion plethysmography of the veins in disturbances of the peripheral arterial blood supply are demonstrated. In these cases the importance of the inclusion of all clinico-angiological findings, especially of the functional capacity of the heart and of the therapy of hypertension in the general judgment is emphasized.

[Epidemiology of venous diseases at old age (author's transl)]. / Epidemiologie der Venenerkrankungen im Alter

Venous diseases are of interest to gerontology because 1. the morbidity in connection with venous diseases in both men and women increases almost linearly with age 2. more complications, some of them fatal, must be anticipated and 3. a greater percentage of secondary and primary diseases are recorded than in younger people, which must always be included in therapeutic planning.

[Studies on the relationship between diabetes mellitus and necrobiosis lipoidica]. / Untersuchungen und Zusammenhänge zwischen Diabetes mellitus und Necrobiosis lipoidica

From 1970 to 1974 in the dermatological clinic of Leipig University in 17 women and 3 men a necrobiosis lipoidica was established. Of these patients hitherto 12 female patients with histologally ascertained diagnosis underwent a clinico-angiological follow-up examination. Apart from this metabolic disturbances were thought for. In two thirds a disturbance of the carbohypdrate metabolism, in three fourths a disturbance of the lipometabolism was found; hyperlipoproteidaemia and diabetic change of the metabolism were simultaneously present in 7 out of 12 female patients. Uric acid level of the serum and rheumatic serology were, however, rarely pathological. A disturbance of the arterial blood supply of the legs could be ascertained in three fourths of the women who underwent a control examination. In these cases 15 to 19 extremities affected with necrobiosis had a disturbance of the blood supply. The microangiopathy histologically provable in foci of necrobiosis was to be seen only in one long-term diabetic also on the eye-ground. One third of the female patients suffered from hypertension. In all cases disturbances of the carbohydrate metabolism or of the lipometabolism and/or of the local blood supply could be proved. On the basis of these findings adequate examinations are recommendable in patients with necrobiosis lipoidical with regard to therapeutic consequences.

[Diagnostic possibilities in aortic arch syndrome in ambulant care]. / Diagnostische Möglichkeiten beim Aortenbogensyndrom in der ambulanten Sprechstunde

The diagnostic possibilities in the syndrome of the aortic arch in the surgery of the outpatient department are described. The importance of the leading symptoms in the anamnesis, the pulse palpation and auscultation, the inspection and the bilateral measurement of the blood pressure is elaborated. It is referred to the value of the simple functional test. Apparative investigation methods which are also used in the outpatient department are mentioned. The exhaustion of all possibilities which are at disposal for diagnosing already the early stages of the syndrome of the aortic arch is regarded as prognostically important in order to prevent irreversible cerebral lesions by a timely induction of necessary therapeutic measures.

[Differential diagnosis of the aortic arch syndrome]. / Differentialdiagnose des Aortenbogensyndroms

With the aid of the complexes of principle signs of the pulseless disease, the cerebrovascular insufficiency and the ischaemic-brachialgiformous symptomatology the different basic diseases, which are to be taken into consideration differential-diagnostically in a large number can clearly be recognized. With the cerebrovascular insufficiency compete intracranial organic processes and reductions of the volume of the cardiac output. In the brachialgiformous ischaemic syndrome further angiopathies, neurovascular syndromes of the shoulder girdle, nervously caused pain in the arm and a series of other very different starting-points must finally be taken into consideration. By means of a good interdisciplinary cooperation a clarification can be achieved also in difficult situations.

[Assessment of the functional capacity in the patients with venous diseases]. / Beurteilung der Leistungsfähigkeit Venenkranker

Acute diseases of the veins, in most cases thromboses, cause inability to work in almost all cases; in profound phlebothromboses hospital treatment is indicated. In the chronic venous insufficiency the functional capacity can be decreased especially bey pains, inclination to swelling and changes of the skin (congestive dermatoses, ulcera). Eventual basic diseases and concomitant diseases render the judgment difficult. Experienced treatment under active collaboration of the patient may improve the functional capacity in most cases. The daily load of the patient by profession and so on, and the often changing course of chronic diseases of the veins must be taken into consideration in the estimation. On the basis of a stage-plan proposed by Kornotzki and coworders the evidence of selected phlebological methods (anamnesis, state, tourniquet-tests, measurement of the venous pressure, functional phlebography) is discussed. It is particularly referred to plethysmographic functional tests of the veins.

[Transcutaneous measurements of pO2 in newborns with RDS (author's transl)]. / Erfahrungen mit der transkutanen (unblutigen) pO2-Registrierung beim Atemgestörten Neugeborenen

pO2 was measured transcutaneously (commercially available Clark Electrode, Bioelectronics Roche) with two different electrode temperatures in new born infants. The correlation between paO2 (arteria radialis) and ptcO2 was bad (r= 0,74) with electrode temperature of 42 degrees C. When the electrode was heated to 44 degrees C there was a very good correlation (r= 0,969) in 80 simultaneous measurements of paO2 (umbilical arterial catheter) and ptcO2. The mean values and standard deviations of pO2 values in hypoxic, normoxic and hyperoxic states are very similar: hypoxic: paO2 34,3 "/- 7,9, ptcO2 35,2 +/- 14,0, normoxic: paO2 78,7 +/- 14,3 ptcO2 78,8 +/- 16,7, hyperoxic: paO2 141,8 +/- 37,1, ptcO2 134,4 +/- 40,8 mmHg). The specific advantage of transcutaneous measurements is the trend registration for hours. With electrodes temperatures of 44 degrees C however, there is a risk of superficial burns if the electrode is attached to the identical site for 6 hours or more.

[Transcutaneous measurements of pO2 (ptcO2) in sick newborn babies (author's transl)]. / Weitere Untersuchungen zur transkutanen pO2-Messung bei kranken Neugeborenen

PaO2 as well as transcutaneous pO2 (ptcO2) was measured simultaneously for 132 times in 34 sick newborns. PtcO2 data were obtained by the KONTRON 5300 Monitor, its electrode heated to 44 centigrades. The correlation coefficient "r" was rated at 0.98. The introduction of the ptcO2 method into routine clinical usage markedly enhanced efficiency and safety of oxygen treatment of sick newborns. However superficial burning of the skin at the measuring site might occur if the electrode is attached more than 6 hours.

[Diagnosis and therapy of choanal atresia in the new born (author's transl)]. / Zur Diagnose und Behandlung der Choanalatresie beim Neugeborenen

Report on 8 cases of congenital atresia or severe stenosis of the choanae. In 2 cases early transnasal surgery followed by canulation was necessary. One child died of pleuropneumonia and sepsis following asphyxia on the 10th day, when mouth-breathing had already been established.

[Behavior of hypertension and cardiovascular findings in hypertension within an observation period of 10 years (the Wurzen study 1961-1971)]. / Hypertonieverhalten und kardiovaskuläre Befunde bei Hypertonie in einem Beobachtungszeitraum von 10 Jahren (Wurzener Studie 1961-1971).

In concert with literary data during a mass X-ray examination in 1961 we established in 5,517 men of the district Wurzen a frequency of hypertension of 13.6% and in 1971 in the same group of test persons a frequency of hypertension of 19.4%. The percentage of the pathological cardiovascular X-ray findings was in normotonus 10.4% in 1961 and 11.2% in 1971, in hypertension 22.3% in 1961 and 27.5% in 1971. The dependence on the age of the test persons, on the degree of severity of hypertension, and particularly on the duration of the hypertension is clear. For prevention of a hypertensive heart disease the early recognition of a hypertension and an early therapy are necessary. On the basis of our studies the making of cardiovascular X-ray findings from photofluorograms is not suitable as screening test for the hypertension. The value of blood pressure controls in mass X-ray examinations must be emphasized. Important is the collection of cardiovascular X-ray findings from photofluorograms of the thorax for the establishment of a hypertensive heart disease, of not recognized vitia and age-conditioned cardiac and vascular changes. It implies an optimum use of the material collected in the mass X-ray examination.

Massive digitoxin intoxication treated with digoxin-specific antibodies in a child.

A 20-month-old girl with massive digitoxin intoxication (initial digitoxin serum level: 629 ng/ml) was successfully treated with digoxin-specific antibody fragments (Fab). She presented with moderate signs of digitalis toxicity (somnolence, bradycardia, first-degree AV block) and improved rapidly during fractional Fab administration. Free serum-digitoxin disappeared after 6 vials of Fab (480 mg), but was measurable again on days 6 and 7. This case demonstrated that digoxin-specific antibodies, despite a 30-100 times lesser affinity for digitoxin, are effective in massive digitoxin intoxications. A rebound phenomenon may occur several days later and should be taken into consideration.

[One year's experience with mechanical ventilation in newborn infants (author's transl)]. / Einjährige Erfahrungen mit der Dauerbeatmung von Neugeborenen

During the first year of newborn intensive care at the Landeskinderkrankenhaus Linz/Donau there were 80 cases of artificial ventilation, 62 of these were Low Birth Weight Infants (LBWI). 12% of all LBWI required mechanical ventilation. 53 ventilated infants suffered from severe Hyalin Membrane Syndrome (HMS). 17 survived, 18 died of intraventricular hemorrhage and 18 died of HMS. Bronchopulmonary Dysplasia was found in all patients ventilated for more than 7 days. 5 cases of pneumothorax occurred during ventilation. Good results were obtained in cases of respiratory insufficiency other than HMS (15 cases, 12 survivors. Mortality rate of LBWI delivered in Hospitals was 9.9%, whereas 34% of the LBWI delivered at home but cared for under identical conditions in the nursery died. This difference offers good evidence for the importance of the quality of the obstetrical care for the results of newborn intensive care.