Association between ADHD and smoking in adolescence: shared genetic, environmental and psychopathological factors.

The present study aimed to examine the extent to which the co-occurrence of ADHD and smoking in adolescents could be attributed to common genetic, environmental and psychopathological factors. Data are from an ongoing prospective study of the outcome of early risk factors. At age 15 years, 305 adolescents completed self-report questionnaires measuring tobacco consumption and deviant peer affiliations. Lifetime psychiatric diagnoses were obtained using standardized interviews. DNA was genotyped for the dopamine D4 receptor (DRD4) gene exon III polymorphism. Adolescents with a lifetime diagnosis of ADHD displayed significantly higher smoking activity than non-ADHD controls. A major component of this association could be accounted for by deviant peer affiliations and the comorbidity with oppositional-defiant and conduct disorder, while a minor part was attributable to DRD4 in males but not in females. These findings suggest that the association of ADHD with smoking relies on risk factors shared by the two behaviors.

[Early recognition of partial learning disorders]. / Früherkennung von Teilleistungsstörungen.

The long-term outcome of learning disabilities (lower school performance, higher rates of unemployment and unskilled jobs, secondary psychic disorders and juvenile delinquency) requires their early recognition even at pre-school age. The concept of learning disabilities should be adapted to the concept of specific developmental disorders (ICD-10, F80-F83). The diagnosis of specific developmental disorders at pre-school age shows many difficulties due to the drawbacks of the available psychological tests. A highly economic and reliable battery of tests is presented as an alternative, which enables us to diagnose general intelligence and specific developmental disorders. The diagnostic procedure was standardised on 657 children of four and five years of age.

[Current status of liver surgery]. / Heutiger Stand der Leberchirurgie.

Resection of subsegments, segments of lobes of the liver in anatomic borders are possible. Extensive mobilisation of the liver, operation with blood inflow interruption by a tourniquet, and apparative aids for liver dissection make this easier. Intraoperative ultrasound scanning is helpful. Early and late outcome in the management of benign and malignant tumors and metastases of the liver is described. The rupture of the liver requires well-defined therapy and determination. Packing of the liver or other operative procedures in the treatment of rupture depend on the experience of the surgeon.

[Liver surgery in the repertoire of the general surgeon]. / Leberchirurgie im Repertoire des Allgemeinchirurgen.

In 1987, 2082 operations of the liver were performed in Germany by 196 of 230 consulted surgical departments in general hospitals. Surgery for liver injuries predominates in suburban hospitals, where as planned interventions are more often performed in main clinics. Our hospital resections of 1-6 subsegments of the liver in 134 patients averaged a mortality of 4.5%. Problems of benign and malignant tumours as well as of the chronic inflammed Echinococcus cyst are mentioned. The standards of the apparative assistance is interpreted and procedures are explained.

[Surgery of malignant hepatoma of the cirrhotic liver]. / Die Chirurgie des malignen Hepatoms in der Zirrhoseleber.

The surgical approach to malignant hepatoma in cirrhotic liver has continued to be an unresolved problem. Early diagnosis, differentiated indication, and surgical techniques need further improvement, before adjuvant therapy can be discussed. All surgeons are called upon to verify experience of the past and to integrate previous findings into a study that should be helpful in overseeing larger numbers of cases.

[Indications and prognosis of preventive and simultaneous operations of the abdominal cavity]. / Indikation und Prognose prophylaktischer und simultaner Operationen in der Bauchhöhle.

The potential risk implied in prophylactic operations is just as high as that elective interventions. Indications must be subject to stringent deliminating criteria. Required are thorough elucidation and documentation as well as comprehensive substantiation. Operations of that kind may be performed even without elaborate advance planning, if indications are urgent. Simultaneous operations are accompanied by higher risk in cases of major surgery or if one of the interventions is septic. High risk factors were recordable from combined stomach and bile duct surgery, when performed simultaneously. Morbidity amounted to 13 per cent (pulmonary embolism and pneumonia) and lethality to 15 per cent. Simultaneous operations should be performed by an experienced surgeon who should be a fast worker.

[Preventive and simultaneous operations of the abdomen]. / Prophylaktische und simultane Operationen im Abdomen.

Prophylactic and elective operations have the same risk. They require detailed and extensive information of the patient and documentation thorough medical reasoning. Without preoperative planning prophylactic operations are justified in severe conditions. Simultaneous operations increase the risk in case they represent major procedures or in septic interventions. Simultaneous surgical interventions of the stomach and the biliary tract imply a high morbidity (13% pulmonary embolism and pneumonia) and a high lethality (15%). In simultaneous operations the fastest of the skilled surgeons is the one who is most successful.

[Gastrectomies in the elderly as curative and palliative operations (author's transl)]. / Die Gastrektomie beim alten Menschen als Kurativ- und Palliativoperation.

Out of 422 patients operated on for gastric carcinoma from 1970-1980, 152 were older than 70 years. We performed a total resection of the stomach on 145 patients: 63 were 60-69 years old, with a 14% mortality; 36 were 70-79 years old, with a 25% mortality. In curative gastrectomies, the mortality was 8% in patients in their seventies (4 cases out of 48) and 12% in their eighties (3 cases of 25). In additional resection of neighbouring organs (liver, colon, and pancreas) mortality was only increased to 17% in the seventh decade and 20% in the eighth. Therefore, radical surgery for carcinoma of the stomach in form of a gastrectomy is justified even in older people, as there is a curative chance. In palliative gastrectomies the mortality has been too high: 33% (5 out of 15) in the seventh decade and 58% (7 out of 12) over the seventh decade. Palliative gastrectomies are only justified in older people if there are special indications.

Antiphytoviral activity of 2,4 dioxo hexahydro triazine.

Three treatments with 2,4 dioxo hexahydro triazine (DHT) significantly reduced the concentration of potato virus X (PVX) in systemically infected tobacco plants. In hypersensitive plants DHT caused a reduction in the number of local lesions produced by PVX. In systemic and hypersensitive hosts, treatment with DHT resulted in a more or less marked reduction in the concentration of, and in the number of local lesions caused by, potato virus Y (PVY), potato virus A (PVA), tobacco mosaic virus (TMV), and cucumber mosaic virus (CMV). Three days after treatment with DHT the incorporation of 32P into TMV RNA was significantly reduced, while that into host RNA was less affected.

[Audiological findings in cases of acoustic neuromas, cerebellopontine angle and brain tumors (author's transl)]. / Audiologische Befunde bei Akustikusneurinomen, Kleinhirnbrückenwinkeltumoren and höher gelegenen Hirntumoren.

The study contributes to improve, audiological diagnostics of central auditory path lesions and attempts, through the comparison of audiological and neurosurgical findings of 15 patients, to refer certain auditory lesions caused by cerebral tumors to topodiagnostically characteristic audiological symptoms. The audiological findings obtained through 7 generally accepted test methods from 6 patients with an acusticus neurinoma indicate a labyrinthine but not a central symptomatic picture while 4 patients with a pontine-angle tumor present a chiefly central hearing defect which, as regards the constellation of findings, clearly differs from the central hearing defect of 3 patients with a pontine tumor. Two patients with tumors in the lateral ventricle area merely show, from the audiological point of view, a lack of contralateral dichotic discrimination.

[Dioxohexahydrotriazine, a new synthetic antiphytoviral compound (author's transl)]. / Dioxohexahydrotriazin, eine neue vollsynthetische antiphytovirale Verbindung.

This paper reports the first results of studies made to determine the antiviral activity of dioxo hexahydro triazine, a newly developed antiphytoviral compound. After treatment with dioxo hexahydro triazine, the concentration of helical potato virus X in leaves of Nicotiana tabacum "Samsun" was found to be considerably reduced in both the serological test and local lesion test conducted on Nicotiana glutinosa at temperatures of 14 degrees C +/- 3 degrees C. In secondarily infected leaves, the reduction of the concentration of potato virus X in the range of from 1 mol/l to 10(-3) mol/l was so that it was no longer possible for viruses to be detected serologically. In vitro, however, dioxo hexahydro triazine, which was added to the inoculum, did not produce a significant change in the activity of the virion of potato virus X. Therefore, it is reasonable to assume that dioxo hexahydro triazine tends to affect replication steps of viruses. The use of dioxo hexahydro triazine also had the effect of greatly and highly significantly reducing the concentration of the isodiametric cucumber mosaic virus.

[Surgical procedure in acute variceal hemorrhage (author's transl)]. / 18. Chirurgisches Vorgehen bei der akuten Varicenblutung

The author recommends various general rules to be observed in the surgical treatment of acute variceal hemorrhage: 1. attempts to arrest the hemorrhage by conservative means are always justified in the case of variceal bleeding, but should be comprehensive, and both patient and staff should first be prepared for surgery in case it should become necessary: 2. if when the GI tract is free of blood the indications for surgery are found to be present, a shunt should be constructed at once (Crile's stage A); 3. if hemorrhage starts again after carefully monitored release of the ballons of the Sengstaken-Blakemore tube, conservative measures should be carefully applied again at once. If an experienced endoscopist is available, paravariceal sclerosing injections should be given at this point. Otherwise a shunt operation is indicated (Crile's stage B). In patients in whom liver tolerance is poor (Crile's stage C), transhoracic dissection of the esophageal varices is indicated as the only possible, definitive treatment.