[Basic features of diphtheria (author's transl)]. / Grundlagen der Diphtherie

The basic features of diphtheria, especially clinical aspects, differential diagnosis and therapy are set out insofar as they are important for the general practitioner. The doctor, not the bacteriologist, must make the diagnosis. Serotherapy must be begun as rapidly as possible, and in adequate dosage. The patients must be carefully watched over in the interests of early detection of possible complications. Rest in bed is required in every case for at least 3 to 4 weeks, longer if possible. Even mild "localized" forms can lead to toxic damage during the course or subsequently. In infants, diphtheria may run its course as the well-defined clinical picture of "diphtheria intoxication" of infants.

Immunologic defense in bacterial and viral meningitis in children.

The investigation of a number of parameters of nonspecific and specific defense in 13 purulent and 18 mumps meningitides gave no indication of underlying primary immunodeficiencies. Only in the acute phase of mumps meningitis did we find a temporary suppression of cellular immune reactions measured as diminished rate of incorporation of thymidine by phytohemagglutinin-stimulated peripheral blood lymphocytes.

[The unspecific reaction of inflammation in rickets due to lack of vitamin D (author's transl)]. / Die unspezifische Entzündungsreaktion bei Vitamin-D-Mangel-Rachitis

10 children (3--18 months old) with Vit. D Deficiency Rickets were investigated by Rebuck skin windows for their ability to elicit unspecific inflammation before and after therapy. Differences to a control group (13 children) were statistically significant. In the acute phase of the disease beginning of inflammation is retarded, reduction of polymorphonuclear leucocytes in favour of mononuclear cells is less then in controls, the absolute quantity of exsudation is reduced too. After therapy inflammation is intensified and accelerated, but exsudation is still different from control children qualitatively and quantitatively. These findings add new facts to the data already known on impaired defence mechanisms in rickets.

[Studies on the antimicrobial effect of vitamin D (author's transl)]. / Zur antimikrobiellen Wirkung von Vitamin D.

In in vitro studies vitamin D3 proved inhibitory on strains of Staphylococcus aureus, Streptococcus pyogenes, Klebsiella pneumoniae. Escherichia coli, and Candida albicans. In the presence of 5x10(4)-9x10(4) IU/ml vitamin D3 the organisms were killed or reacted with a marked growth inhibition.

[Principles of treatment and nursing of children with diphtheria (author's transl)]. / Grundlagen der Behandlung und Pflege diphtheriekranker Kinder.

The principles of treatment of diphtheria are discussed: in the present epidemic situation, diphtheritic children must be admitted to a pediatric hospital. The children need at least 3 to 4 weeks, to a large extent strict, bed rest. The basic concepts of the treatment of both peripheral circulatory weaknesses and of myocardial damage are communicated. Glucocorticoids have proved their value in myocarditis. Prophylactic digitalization is to be rejected. Confirmed heart failure is a binding indication for digitalization. A causal therapy for para- and metadiphtheritic paralysis does not exist. All forms must be treated with antibiotics nowadays. In croup, tracheotomy must not be delayed too long. The nursing must be left the best staff only and requires, in addition to a fundamental knowledge of the disease picture, an exceptional empathy in the particular, especially psychic, situation of the sick children.

[Symptomatology, differential diagnosis and treatment of bacterial meningitis of newborns and infants (author's transl)]. / Zur Klinik der bakteriellen Meningitis im Neugeborenen-und Säuglingsalter

Bacterial meningitis in our hospital too shows its maximal frequence with 30.5% in the first month of life, 25.2% of these cases being newborns. The frequent difficulties of diagnosis in this period of life are demonstrated. Predisposing factors and possible complications of meningitis are named. The principles of modern therapy are summarized.

Continual observation of clinical and immunological parameters, in particular of salivary IgA, in tonsillectomised children.

In 106 tonsillectomised children the following parameters were measured before and after operation: clinical parameters (length, weight, postoperative complications), haematological parameters (BSR, Hg, PCV, RBC, and WBC), and immunological parameters (IgG, IgA, IgM, and salivary IgA); in a number of children measurements were taken over a period of more than 3 years. Standard values of salivary IgA in relation to total salivary protein were determined in noninfected children of various age groups. Compared to the standard and initial values, we found some statistically significant changes in the serum immunoglobulin levels and in the salivary IgA, but no irreversible pathological decrease in the above-mentioned parameters.

[Continual observation of clinical and immunological parameters, in particular of salivary IgA, in tonsillectomised children (author's transl)]. / Verlaufsbeobachtung klinischer und immunologischer Parameter, insbesondere des Speichel-IgA, bei tonsillektomierten Kindern.

In 106 tonsillectomised children the following parameters were measured before and after operation: clinical parameters (length, weight, postoperative complications), haematological parameters (BSR, Hg, PVC, RBC and WBC), and immunological parameters (IgG, IgA, IgM and salivary IgA); in a number of children measurements were taken over a period of more than three years. Standard values of salivary IgA in relation to total salivary protein were determined in non-infected children of various age groups. Compared with the standard and initial values we found some statistically significant changes in the serum immunglobulin levels and in the salivary IgA, but no irreversible pathological decrease in the above-mentioned parameters.

[Influence of nutrition on the cellular defence mechanism (phagocytosis) of preterm and underweight babies during the first six weeks of life (author's transl)]. / Einfluss der Ernährung auf die zelluläre Infektabwehr (Phagocytose) von Früh- und Mangelgeburten in den ersten sechs Lebenswochen.

The phagocytic and NBT reduction indices of 94 preterm and underweight babies, divided into 7 groups and two weight classes, were observed over a period of six weeks while they were observed over a period of six weeks while they were given four commercial baby foods (Humana 0, Meb, Multival, Pomil). In all groups the mean values of both parameters were always within the standard range with only slight differences. In all test subjects, phagocytic activity decreased continuously during the first five weeks, and NBT reducing capacity during the first six weeks. Correlations could not be established between phagocytic or NBT reduction rate and birth weight or gestational age. As compared with the other groups there was a distinct lowering of the phagocytic indices in both Meb groups, which we think is nutrition-dependent and can be interpreted as the result of interaction between nutrition and immunological parameters.

Antibacterial activity of GO 10213, a nitroimidazole derivative.

Compound GO 10213, a 5-nitroimidazole substituted at the 2 position, is more active against aerobic, microaerophilic, and anaerobic bacteria than metronidazole. The MICs for Salmonella typhimurium (2 to 128 micrograms/ml), Campylobacter spp. (0.06 to 16 micrograms/ml) and Bacteroides spp. (0.03 to 0.25 micrograms/ml) are definitely lower than those of metronidazole. Niridazole, a 5-nitrothiazole, is still more active.

[Histiocytosis X--a retrospective analysis of 40 cases with localized or disseminated disease]. / Histiocytosis X--retrospektive Analyse von 40 Fällen mit lokalisierter oder disseminierter Erkrankung.

A retrospective analysis of 40 cases with histiocytosis X was undertaken to find out the course of primarily localized disease, and the prognosis of children with initially disseminated disease. Bone lesions recurred in nine of 23 children with localized histiocytosis X. In eleven cases other organ manifestations occurred as well; in four cases without bone relapse. After an observation period of 1-14 3/12 years, nine of 22 children in remission suffer from long-term sequelae like diabetes insipidus, convulsion, extrahypothalamic CNS-disease, orthopedic disability, growth retardation, dystrophia adiposogenitalis , and chronic headache. Four of 17 children with disseminated histiocytosis X died. Our results and others from the literature indicate various risk factors to be prognostically significant. 1) age less than 2 years 2) involvement of spleen and/or lung 3) elevated Lahey-score 4) dysfunction of the hematopoietic system, liver, and/or lung 5) histologic feature resembling malignant type 6) no response to therapy 7) severely affected general health. These factors can be evaluated initially. Considering our own experiences and some risk factors we suggest the definition of four risk groups: 1.) localized histiocytosis X of bone, lymph nodes or skin; 2.) disseminated histiocytosis X with benign histologic type and Lahey-score of one or two; 3.) Lahey-score of 3-8; 4.) disseminated histiocytosis X with dysfunction of certain organ systems and/or malignant histology.

[Glaucoma operation in the case of an infant with hemophilia A (author's transl)]. / Glaukom-Operation bei hämophilem Säugling

This composition gives an account of the coagulative physiological problems and therapy in the course of glaucoma operation in the case of an eight month old infant with hemophilia A.

Morphological and morphometric studies of the skeletal muscles of rachitic rats.

The question of "myopathia rachitica" was pursued in a disease progress study using rachitic rats. The length of the study was 18 weeks. During this time a discrete dystrophic myopathy formed. The morphometric examination showed muscle fibre diameters 8--24 mu less than those of healthy control rats in correlation with the degree of rachitis. The absence of fiber growth in the C fibres was conspicuous. The question of the relation of these findings to the inactivity, osteomalacia and changes in metabolism in rachitis was discussed. The myopathic changes can not be solely interpreted as a result of inactivity, but the cause of myopathia rachitica remains unclear.

On the influence of age on immunity in Down's syndrome.

In 23 subjects of different ages with Down's syndrome a number of parameters of non-specific defense of humoral and cellular immunity were investigated. While in all age groups complement factors C3, C4 and C5 as well as phagocytosis and NBT indices were in the normal range, a dysgammaglobulinaemia increasing with age with a hyperglobulinaemia of the IgG, IgA and IgD types was found, sparing immunoglobulins IgM and IgE. In addition the transformation capacity of peripheral blood lymphocytes decreased with age. This is understood as the consequence of premature aging of the thymus-dependent immune system.