The influence of ossein-hydroxyapatite compound ('Ossopan') on the healing of a bone defect.

A study was undertaken in 60 adult rabbits in order to determine the effects of ossein-hydroxyapatite compound on bone healing. Standardized bony defects were produced in the distal femoral epiphyses, after which animals were randomized into four equal groups. An untreated group served as a control. One group received ossein-hydroxyapatite compound, 830 mg per day, a second group received bone mineral (ossein-hydroxyapatite compound reduced to ash, to remove organic constituents), 510 mg per day, and a third group received calcium carbonate, 650 mg per day. A series of fluorescent vital markers was administered to the animals from the 7th to the 32nd day after production of the defect. A third of the animals in each group were sacrificed 35, 56 and 84 days, respectively, after induction of the defect. Histological sections of the region of the bone defect were examined with a fluorescence microscope and resulting photomicrographs were scored with respect to degree of fluorescence, nature and degree of defect filling and structure of the newly formed bone. All three active treatment groups resulted in significantly improved mineralization as compared with the untreated control group. Treatment with ossein-hydroxyapatite compound, but not the other two active treatments, resulted in significant improvements in the pattern and quality of bone healing, particularly when assessed at 56 or 84 days after induction of the bone defect. These results indicate that ossein-hydroxyapatite compound has a beneficial effect on the process of bone healing but that this effect is lost if the organic components of the compound are destroyed or if pure calcium carbonate treatment is substituted. This strongly suggests that organic components of ossein-hydroxyapatite compound have osteogenic effects, enhancing the utilization of the mineral intake, and is consistent with previous experimental findings. It is suggested, therefore, that ossein-hydroxyapatite compound has considerable clinical potential and should be regarded as having specific, sophisticated effects on bone metabolism, rather than as a simple dietary mineral supplement.

Immunohistochemical determination of estrogen and progesterone receptor content in human breast cancer. Computer-assisted image analysis (QIC score) vs. subjective grading (IRS).

Immunohistochemistry of Estrogen Receptor (ER) and Progesterone Receptor (PR) has been performed in 687 cases of human breast cancer. The staining results have been compared by (1) computer-assisted image analysis (QIC Score) and (2) subjective grading of the cryostat sections ("German" IRS). Tumors without or with only weak ER or PR content may be distinguished by both methods from tumors with a high receptor content. The QIC Score values belonging to the intermediate IRS grades are distributed over a wide range, but no negative cases were found in these categories. It is concluded from our results that subjective grading of the slides is a simple, rapid and useful method for the determination of the tissue receptor content and must not be replaced by the expensive and time-consuming computer-assisted image analysis in daily practice.

Acute effects of 200 ppm 1,1,1-trichloroethane on the human EEG.

OBJECTIVES: Even low concentrations of organic solvents used at work may cause acute effects on the human central nervous system. We investigated the acute effects of 200 ppm 1,1,1-trichloroethane on the human EEG. METHODS: 12 healthy subjects were exposed for 4 hours to 200 ppm and to 20 ppm (control) in an exposure chamber in a cross-over design. EEG was recorded before (reference) and at the end of each exposure with eyes closed and open and during the Color Word Stress test. Spectral power was calculated by Fast Fourier transformation and related to reference values (per cent of baseline). Subjective symptoms and effects of blinding with 20 ppm 1, 1,1-trichloroethane were assessed by questionnaire. RESULTS: Blinding was not effective because of the strong smell of 1,1, 1-trichloroethane. The score for tiredness increased slightly during and after exposure to 200 ppm. In the closed eye condition, the median percentage of spectral power increased at all electrodes of the delta -band, significantly at temporo-occipital leads. In the theta-band, the percentage of the median spectral power was elevated at most of the electrodes but the parietal and some temporal ones. As to the alpha subset1-band, the percentage of the median spectral power was lower at the temporo-parieto-occipital electrodes, yielding significance at T subset4. In the alpha subset2-band, the percentage of the median spectral power was lower at all electrodes, significantly at T subset4 and T subset5. The percentage of the median spectral power of the temporo-parieto-occipital electrodes of the beta subset1 -band was lower during exposure to 200 ppm. There were no clear-cut changes in the beta subset2 -band, in the open eye condition and during the Color Word Stress test. CONCLUSION: The changes in EEG and the increased score for tiredness indicate a slight sedative effect of 200 ppm 1,1,1-trichloroethane.

Effect of subacute occupational exposure to toluene on color vision.

The subacute effect of toluene on color vision was examined in 59 rotogravure workers exposed to toluene. Toluene and ethanol were determined in blood and color vision testing was performed on Monday before shift and on Friday after shift. The battery included the Ishihara plates, the Velhagen plates, the Standard Pseudoisochromatic Plates part 2, the Farnsworth panel D-15 test, and the Lanthony desaturated panel D-15 test. The concentrations of toluene in blood ranged from < 0.22 to 7.37 mg/l. No effect of toluene on color vision could be observed even in a subgroup of highly exposed workers. So their ability to judge colored products was not impaired.

[Epidemiological studies of P. aeruginosa infections by the typing of pyocine sensitivity (author's transl)]. / Untersuchungen zur Aufklärung epidemiologischer Zusammenhänge bei P. aeruginosa-Infektionen durch Bestimmung der Pyocin-Empfindlichkeit

A standardizing by means of determination of the pyocine sensitivity could be achieved on the basis of 200 strains of P. aeruginosa which had been isolated out of clinical material. It was analyzed semiquantitatively by using a step-scale in five parts. The identical or in a high degree corresponding strains according to the pyocine sensitivity could be registered on the example of the isolated strains of a intensive-care unit by the calculation of the Q-correlation coefficient according to the Q-technique as well as by the determination of the differences in the single reactions using a standardized measure of distance. The epidemiological connexion resulting from that is discussed.

Measurements of the volume and density of intracerebral tumors by CT following therapy.

For the interpretation of curative measures in patients with cerebral tumors CT is of increasing importance. The therapeutic effects can be demonstrated by close follow-up studies without any of the disadvantage of invasive neuroradiological methods. Our investigations of 125 patients with cerebral tumors are based on volume and density determinations. The CT studies of removed or inoperable tumors followed by radiation and/or cytostatic therapy prove that the best results follow a combination of both. In the present cases however, if CT proves postoperatively, at the end of radiation or at the beginning of the application of cytostatics that there is a residual mass, a complete remission cannot be obtained.

[Development of tuberculosis in Germany--a comparison between former West and East Germany]. / Die Tuberkuloseentwicklung in Deutschland--ein Vergleich zwischen der ehemaligen Bundesrepublik und der ehemaligen DDR.

The development of tuberculosis in both parts of Germany between 1950 and 1990 is compared. From 1950-1965 morbidity and mortality were significantly greater in the former GDR than in the FRG. Figures have somewhat increased in the FRG since 1965; a breakdown according to indigenous and alien population shows that the development of the disease among Germans has been approximately the same in both parts of Germany. For the last ten years the proportion of cases of acute infectious tuberculosis has remained almost unchanged in both the GDR and the FRG. A comparison of the development of infant tuberculosis does not disclose any influence exercised by BCT vaccination on the epidemiology.

[Intrauterine fetal weight assessment using ultrasound. A comparison of several weight assessment methods and development of a new formula for the determination of fetal weight]. / Intrauterine Gewichtsschätzung mittels Ultraschall. Ein Vergleich mehrerer Gewichtsschätzungsmethoden sowie die Entwicklung einer neuen Formel zur Bestimmung des Fetalgewichtes.

At the Department of Gynaecology and Obstetrics of the University of Mainz, the foetal weights were estimated in 196 foetuses between 24 and 42 weeks of gestation. All estimates were based on sonographic determination 0-6 days prior to delivery. In a prospective study the equations of Hansmann, Schillinger et al., Campbell and Wilkin, Warsof et al., Shepard et al., Higginbottom et al., Thurnau et al. and an own unpublished formula of Merz were compared. In addition, with the aid of computer analysis, a new equation for predicting foetal weight was evolved from the data measured in this study. This formula should be valid for all weight groups. In 25.5% of the newborn the actual birth weights ranged from 610 to 2499 g, in 42.9% from 2500 to 3499 g and in 31.6% from 3500 to 4520 g. On comparing the individual equations for the entire study group, the most reliable formulas for estimating foetal weights were found to be those of Shepard et al. (72.4%), Hansmann (61.2%) and Merz (61.2%). In the very low birth-weight range less than 2500 g the formula of Shepard et al. proved to be the most reliable for estimating foetal weight with 72%. In the group between 2500 and 3499 g reliability in estimating foetal weight was over 60% with the equations of Shepard et al. (72.6%), Hansmann (67.9%) and Merz (61.9%). In the birth-weight group of 3500 to 4520 g the most reliable formula for predicting foetal weight was found to be that of Schillinger et al. (91.9%), Hansmann (83.9%), Shepard et al. (72.6%) and Merz (69.4%). The formula which was derived from own data was as follows: W (g) = -3200.40479 + 157.07186 AC (cm) + 15.90391 (BPD)2 (cm). With this formula we obtained 71.4% reliability in predicting foetal weight with a mean absolute weight difference of 221 g for the complete study group. Are of validity for this formula could be defined as follows: BPD 7.0-10.5 cm AC 21.8-36.5 cm (all measurements from outer to outer margin).

Relation of elastosis to biochemical and immunohistochemical steroid receptor findings, Ki-67 and epidermal growth factor receptor (EGFR) immunostaining in invasive ductal breast cancer.

We studied 1073 cases of invasive ductal breast cancer, NOS for their elastic content (DEL, ductal+periductal elastosis; TEL, tumour elastosis) and compared the findings with the results of biochemical and immunohistochemical steroid hormone receptor examination. Tumours of patients up to 50 years of age and older were examined separately. In a number of tumours elastosis was also examined in relation to Ki-67 and epidermal growth factor receptor (EGFR) immunostaining. Sensitivity and specificity of DEL and TEL for predicting the receptor, Ki-67 and EGFR findings were estimated. Sensitivity of DEL and TEL for oestrogen and progesterone receptors is dependent on the degree of tumour differentiation and the degree of elastosis, increasing from DEL 1 degree and TEL 1 degree to DEL 3 degrees and TEL 3 degrees. It was more evident in grade 1 (G1) and G2 than in G3 carcinomas. Elastosis is a useful predictor of positive receptor findings particularly in G1 and G2 tumours with moderate and high-grade elastosis. It is a similarly useful predictor of negative receptor values in G3 carcinomas. The predictive value of DEL and TEL for the results of Ki-67 and EGFR immunostaining gradually decreases with increasing elastosis, consistent with the assumption that Ki-67 and EGFR identify the degree of tumour proliferation and invasion, while elastosis correlates with the degree of differentiation of breast cancer. Elastosis is a poor predictor of Ki-67 and EGFR findings in any individual breast cancer. Moderate and high-grade elastosis points to positive steroid hormone receptor assays in G1 and G2 carcinomas. In contrast, the lack of elastosis in G3 carcinomas may indicate a negative receptor assay. Both findings have a high degree of reliability.

[Modified cryopreservation of parathyroid gland tissue. Evaluation and comparison in an animal experiment]. / Modifizierte Kältekonservierung von Nebenschilddrüsengewebe. Prüfung und Vergleich im Tierexperiment.

A modified cryopreservation technique for parathyroid tissue was investigated in an animal model. The modified technique was compared with a previously described method [10, 11] using a programmed freezer and also with other simplified cryopreservation techniques [1, 8]. Total parathyroidectomy was performed in 90 Sprague-Dawley rats, which were allocated to 7 groups. Group I had no autotransplantation (n = 10) and group II underwent immediate autotransplantation of one parathyroid gland (n = 17). In the other five groups of rats the parathyroids were cryopreserved and one gland was reimplanted after 10 days' storage in liquid nitrogen (LN) at -196 degrees C. The following techniques for cryopreservation of the parathyroid glands were used. Group III: immediate placement in LN, n = 7; group IV: immediate placement in a freezer at -20 degrees C, transfer to LN after 2 h, n = 12; group V: immediate placement in a freezer at -80 degrees C, transfer to LN after 2 h, n = 13, group VI: manually controlled freezing initially at a rate of 1 degree C/min to -25 degrees C, and subsequently at 10 degrees C/min to -70 degrees C before transfer to LN [8], n = 19, group VII: programmed freezing at a controlled rate of 1 degree C/min to -80 degrees C prior to transfer to LN [10, 11], n = 12. Serum calcium concentrations were determined over a period of 60 days. Furthermore, the individual difference in the calcium concentration was assessed for each rat on the basis of the calcium levels recorded preoperatively and at day 60.(ABSTRACT TRUNCATED AT 250 WORDS)

[Incidence of hospitalizations and operations for ulcer disease 1970-1981]. / Hospitalisations- und Operationsfrequenz wegen Ulkuskrankheit 1970-1981.

Since 1970 there has been a slight reduction, since 1977 a marked one, in the number of admissions for peptic ulcer at the two medical and the surgical clinics of the University of Mainz. This trend was interrupted by a peak from 1975-77, due to an increase of overall admissions at that time, after vagotomy procedures had been started at the surgical clinic. The reduction in admissions only related to uncomplicated ulcer and the admissions to the surgical clinic. Admissions for ulcer complications and to the medical clinics remained unchanged. The reduction in the number of operations for uncomplicated duodenal ulcer was 62%, for uncomplicated gastric ulcer 60%. Operative mortality rate for the former was 1.6%, for the latter 1.86%, while it was 10-25% for ulcer complications.

CT-analyses of cerebral tumors under steroid therapy.

In order to determine, by CT density and volume measurements, the influence of steroid therapy on cerebral tumors, on their perifocal edema and on the uninvolved cerebral tissue, CT follow-up studies of 37 patients were analysed. In general a decrease of tumor density is to be seen within the first 10 days of therapy. Under continuous steroid application absorption coefficients then increase again, so that no cortisone effect on the tumor remains. The tumor size does not alter: in particular at no time is growth retardation detectable under cortisone therapy. Intensity and extension of the perifocal edema decrease in two stages. From this delayed course we conclude the cytotoxic component of the tumor edema to be more extensive than supposed. Deviations appear dependent on tumor histology, which should lead to individualized steroid application.

[A screening procedure for determining tetanus antibody concentrations in blood products]. / Screeningverfahren zur Bestimmung von Tetanus-Antikörperkonzentrationen in Blutprodukten.

The application of antibodies to tetanus toxin is necessary for prevention of postoperative tetanus in patients at risk, e.g. in emergency surgery. However, intravenous preparations with sufficiently rapid distribution throughout the body are not available. This could only be achieved via the blood products (whole blood unit, fresh frozen plasma, thrombocyte concentrate) transfused in such cases. For semiquantitative determination of antibody concentration in blood products, an ELISA assay was developed, which can be used as a screening method for selection of sera with high titers. The assay is quick and easy to perform so that large numbers of sera can be tested within a short time.

Acute effects on the human EEG after an external exposure to 200 ppm methanol.

OBJECTIVES: Even low concentrations of organic solvents may cause acute effects on the human central nervous system. The German MAK (threshold limit value) of methanol is 200 ppm. The aim of this study was to investigate whether acute exposure to 200 ppm methanol causes adverse effects, measured by EEG, and moreover, whether it is possible to differentiate between sedative and excitatory effects with this method. METHODS: Twelve healthy subjects were exposed for 4 h to 200 ppm and to 20 ppm (control) in an exposure chamber in a cross-over design. The EEG was recorded before (reference) and at the end of each exposure with, the subject's eyes closed and opened and during a choice reaction test (color word stress test). Spectral power was calculated by fast Fourier transformation. Subjective symptoms and effects of blinding with 20 ppm methanol were assessed by questionnaires. RESULTS: The study was a single-blind one. During subjects' exposure to 200 ppm, their scores for prenarcotic and irritating symptoms were not different from controls. In the closed-eye condition of subjects, the spectral power of the theta-band and of some electrodes of the delta-band was significantly less at the end of exposure to 200 ppm, than that of controls. In the open-eye condition and during the color word stress test no significant changes were found. CONCLUSION: The changes in the theta-band suggest a slight excitatory effect of 200 ppm methanol. The effect was weak, as scores of acute symptoms did not change. With respect to our results, it is not necessary for the MAK value to be decreased.

[Stomach emptying after stomach resection with and without retention of duodenal passage]. / Magenentleerung nach Magenresektion mit und ohne erhaltene Duodenalpassage.

On domestic pigs 2/3 gastrectomies with retention and elimination of the duodenal passage were carried out. Postprandial gastric emptying was measured scintigraphically for 4 h and compared with a control group (laparotomy only). For the semi-solid, 99mTc-labeled test meal delayed gastric emptying after elimination of the duodenal passage by Roux reconstruction could not be shown. There was no difference in gastric emptying between B-I and Roux-en-Y partial gastrectomy. Also alteration of the length of the jejunum loop from 40 to 20 cm after Roux-en-Y reconstruction had no influence on gastric emptying. Roux reconstruction (40 cm loop) in combination with truncal vagotomy led to a non-uniform gastric emptying, but there was a statistically proven acceleration compared with B-I resection. After 240 min the mean residual intragastric activity of the control group (n = 5) was 47.8%, 78.9% after B-I resection (n = 5), 59% after Roux reconstruction with 40 cm jejunal loop (n = 5), 38.1% after Roux reconstruction with 20 cm jejunal loop (n = 5) and 20.9% after Roux-en-Y (40 cm loop) with truncal vagotomy (n = 4).

[Effect of oral administration of enoximone on cardiac performance, arterial circulation at rest and on the vasoconstrictor effect of local noradrenaline infusions into the human hand vein]. / Einfluss von oral verabreichtem Enoximon auf Herzleistung, arterielle Ruhedurchblutung und auf die vasokonstriktorische Wirkung von lokalen Noradrenalininfusionen in die menschliche Handvene.

Cardiac and peripheral vascular effects of enoximone were investigated in a placebo-controlled, crossover, double-blind trial in 10 healthy volunteers. Electromechanical systole (QS2c) revealed direct positive inotropic effects and venous occlusion plethysmography of the calf arterial blood flow before and 1, 2, 3, and 4 h following 3 mg/kg of enoximone orally. Norepinephrine (7-640 ng/min) dose-response curves of a superficial human hand vein were measured, and enoximone and enoximone-sulfoxide plasma concentrations were determined at the same time points. Peak effects on all measurements were observed at 1 h and coincided with peak plasma concentrations: QS2c shortened by 36 +/- 13 ms (mean +/- SD; p less than 0.01 compared to placebo); arterial blood flow increased from 2.10 +/- 0.58 to 4.32 +/- 1.26 ml 100 ml-1 min-1 (mean +/- SD; p less than 0.01 compared to placebo); norepinephrine dose-response curves shifted to the right (p less than 0.01 with 20-320 ng/min compared to baseline), i.e., to achieve the same vasoconstriction as before enoximone a 3-to-5-times higher dose of norepinephrine was needed. In addition to its positive inotropic effects, enoximone exerts peripheral arterial dilation and diminishes the venous vasoconstriction induced by norepinephrine. The combination of these pharmacological properties could be responsible for the beneficial effects of enoximone in heart failure.

[Attention diversion in tinnitus therapy. Comparison of the effects of different treatment methods]. / Aufmerksamkeitslenkung in der Tinnitustherapie. Vergleich von Effekten unterschiedlicher Behandlungsmethoden.

BACKGROUND: Diversion or distraction of auditory attention is a core principle of tinnitus retraining therapy as introduced by P. Jastreboff and J. Hazell. The aim of this study was to evaluate the effectiveness of a different form of attention diversion in tinnitus therapy. METHODS AND PATIENTS: In a prospective and randomized study, 40 patients suffering from chronic tinnitus were assigned to two different groups, A or B. All patients received appropriate counselling and were instructed in relaxation training. Patients in group A learned to distract attention away from the tinnitus by using sound or music. White noise generators or hearing aids were applied in this group. Patients in group B were instructed to direct their attention away from the tinnitus using imagination that was facilitated by the use of light and warmth stimuli as distracters. Different standardized questionnaires were used for an evaluation of therapy effectiveness. RESULTS: In both groups, patients were significantly less annoyed and disabled by their tinnitus immediately after therapy and after 6 months. Tinnitus annoyance still proved to be reduced 1 year after the end of the therapy. There were no significant differences in the effects of each treatment. CONCLUSIONS: Attention diversion is an important method for decreasing tinnitus-related distress. Patients should be instructed to use not only auditory but also visual and thermal sensations in order to distract attention away from their tinnitus.

[Regional chemotherapy of liver metastases of colorectal carcinoma using implanted gas pressure pumps. Results of a prospective phase II study]. / Regionale Chemotherapie bei Lebermetastasen kolorektaler Karzinome mit implantierbaren Gasdruckpumpen. Ergebnisse einer prospektiven Phase-II-Studie.

22 patients with liver metastases of colorectal carcinomas were given floxuridine infusions into the hepatic artery using a totally implantable pump system (Infusaid, model 400). The course of the disease was compared to that of 22 untreated controls matched for age, sex, extent of metastatic disease and performance status. No therapy-related mortality was observed in the treatment group, morbidity was 37%. Response rate was 77% based on CEA decrease by more than 33% after 6 months, and 64% related to a more than 50% reduction in metastasis size. Median survival time was 10 months in the control group as compared to 26 months in the therapy group; the one-year survival rate was 37.5% and 88%, respectively.

Ultrasound studies of the effect of trospium chloride on gall-bladder kinetics.

In a randomized double-blind study the effects of increasing doses of trospium chloride (Spasmo-lyt, CAS 10405-02-4), 0.2, 0.5, 1.0, and 1.5 mg i.v., on gall-bladder contractility were compared among themselves and against placebo and n-butylscopolamine bromide (20 mg i.v.) by an intraindividual 5-fold crossover technique. Gall-bladder volumes after drug-induced contraction (fat stimulus with sodium iopodate) were measured by ultrasound scanning conducted by a single examiner. Serial measurements, carried out in 6 female subjects without any evidence of gall-bladder disease, demonstrated a dose-dependent trend of inhibition of gall-bladder motility produced by trospium chloride. In the maximal doses employed (1.0 and 1.5 mg i.v.) trospium chloride effected almost total inhibition of motility. The response to n-butylscopolamine bromide tested in a nonblind comparison, showed a dose-effect ratio of roughly 40:1 between trospium chloride and n-butylscopolamine bromide given intravenously. This work confirms that ultrasound measurement of gall-bladder volume is a suitable pharmacodynamic model for testing the dose-effect relationships of antispasmodic agents.