Behavioural responses related to increasing core body temperature of grazing dairy cows experiencing moderate heat stress.

Exposure to direct solar radiation, high ambient temperature, lack of wind movement, coupled with own metabolic heat production, makes grazing dairy cows vulnerable to heat stress. In pastures, it would be beneficial to monitor heat stress by observable changes in behaviour. We hypothesised that grazing dairy cows exhibit behavioural changes due to increasing heat load in temperate climate. Over two consecutive summers, 38 full-time grazing Holstein dairy cows were investigated in 12 experimental periods of up to 3 consecutive days where the cows were repeatedly exposed to various levels of moderate heat load determined by the comprehensive climate index (CCI). The CCI defines the ambient climate conditions, combining air temperature, relative humidity, solar radiation and wind speed. Vaginal temperature (VT) was automatically measured as an indicator of heat stress. In addition, as a less invasive method, we investigated if reticular temperature (RET) can be indicative of heat stress on pastures. Walking activity, lying-, feeding, and ruminating durations were recorded continuously with sensors. Respiration rate (RR), proximity to and competition at the water trough, social licking, self-licking, inter-individual distance, and fly intensity were directly observed. Data were analysed in the morning (0900-1100 h) and during the hottest time of day when cows were on pasture (1230-1430 h). The VT and RET showed similar patterns in relation to the CCI, suggesting that RET can be suitable for continuous monitoring of heat stress on pastures. In the morning, the cow's VT and RET did not relevantly react to the CCI. During the period 1230-1430 h, the cow's mean VT (mean vaginal temperature (VTMEAN); range: 37.7-40.3 °C) and mean RET (mean reticular temperature; range: 37.0-41.1 °C) were positively related to the mean CCI (mean comprehensive climate index) in this period (mean ± SD: 25.9 ± 5.71 °C). For cows with greater VTMEAN, an increased mean RR and decreased durations of walking, lying, feeding, and ruminating were found. These cows were also more likely to be in proximity to the water trough and to have small inter-individual distances. Changes in these traits seem to reflect behavioural adaptations to heat stress in a temperate climate and could be used to detect the heat stress in individual dairy cows on pastures.

Antimicrobial susceptibility in E. coli and Pasteurellaceae at the beginning and at the end of the fattening process in veal calves: Comparing 'outdoor veal calf' and conventional operations.

Animal husbandry requires practical measures to limit antimicrobial resistance (AMR). Therefore, a novel management and housing concept for veal calf fattening was implemented on 19 intervention farms (IF) and evaluated regarding its effects on AMR in Escherichia (E.) coli, Pasteurella (P.) multocida and Mannheimia (M.) haemolytica in comparison with 19 conventional control farms (CF). Treatment intensity (-80%) and mortality (-50%) were significantly lower in IF than in CF, however, production parameters did not differ significantly between groups. Rectal and nasopharyngeal swabs were taken at the beginning and the end of the fattening period. Susceptibility testing by determination of the minimum inhibitory concentration was performed on 5420 isolates. The presence of AMR was described as prevalence of resistant isolates (%), by calculating the Antimicrobial Resistance Index (ARI: number of resistance of one isolate to single drugs/total number of drugs tested), by the occurrence of pansusceptible isolates (susceptible to all tested drugs, ARI=0), and by calculating the prevalence of multidrug (≥3) resistant isolates (MDR). Before slaughter, odds for carrying pansusceptible E. coli were higher in IF than in CF (+65%, p=0.022), whereas ARI was lower (-16%, p=0.003), and MDR isolates were less prevalent (-65%, p=0.001). For P. multocida, odds for carrying pansusceptible isolates were higher in IF before slaughter compared to CF (+990%, p=0.009). No differences between IF and CF were seen regarding the prevalence of pansuceptible M. haemolytica. These findings indicate that easy-to-implement measures to improve calf management can lead to a limitation of AMR in Swiss veal fattening farms.

[Evaluation of associations between barn characteristics, results of barn climate parameter measurements and health indicators in Swiss veal calf herds]. / Evaluation der Zusammenhänge zwischen Stallmerkmalen, gemessenen Stallklimaparametern und Indikatoren für Tiergesundheit in Schweizer Kälbermastbetrieben.

INTRODUCTION: Easy-to-use digital devices to measure climate parameters that can also be used in calf barns have become available commercially in recent years. Data collected in a prospective cohort study in 43 Swiss veal calf operations were evaluated with regard to validity of measured climate parameters, potential associations of those with barn features, and relationships between values of climate parameters and barn characteristics, respectively, with indicators of calf health. Barn parameters, such as ventilation system, access to an outdoor pen and barn size, were recorded, and temperature, air humidity, ammonia and carbone dioxide concentrations were measured at five different locations in each barn during an average of six farm visits over a year. Furthermore, continuous measurements of temperature and humidity (over a period of 72 hours each) were performed once in summer and once in winter in each farm. Whether barn parameters and measured barn climate values are associated as significant risk factors with indicators of calf health (antimicrobial use, mortality and daily weight gain) was explored with statistical methods. Values outside the optimal range were observed for all parameters measured punctually during farm visits and in all seasons. Values of temperature and humidity outside the optimal range were observed more often by continuous than by punctual measurements. Relevant correlations were observed neither among the barn climate values measured punctually nor among measured barn climate values and number of calves, barn surface, bedded surface and barn volume. High maximal group size and presence of mechanic ventilation were positively associated with high antimicrobial use, and high maximal group size and high number of fattening groups were associated with mortality >3%. Farms in lowland regions and high air volume per calf were positively associated with daily weight gain. None of the measured barn climate parameters was associated with the calf health indicators antimicrobial use, mortality and daily weight gain. Therefore, climate parameter measurements appear inadequate to predict calf health in veal fattening operations. The present results show that these (easily) measured parameters are difficult to interpret and should be considered critically.

INTRODUCTION: Des instruments de mesure digitaux faciles à l'emploi pour les paramètres climatiques, qui peuvent aussi être utilisés dans les étables, sont disponibles depuis quelque temps.Afin d'évaluer la validité des valeurs de paramètres du climat mesurées, d'éventuelles associations de ces mesures avec certaines caractéristiques des étables, et les relations des mesures de paramètres associés au climat, respectivement des spécificités des étables, avec des indicateurs de santé animale, des données récoltées dans le cadre d'une étude prospective dans 43 exploitations d'engraissement de veaux en Suisse ont été analysées. D'une part, différents paramètres des étables (tels que le système d'aération, l'accès à un enclos externe, la surface de l'étable) ont été répertoriés. D'autre part, des mesures ponctuelles de la température, de l'humidité de l'air et des concentrations d'ammoniac et de dioxide de carbone ont été effectuées à cinq endroits de chaque étable lors de visites d'exploitation (en moyenne six par ferme sur une durée d'une année). De plus, des mesures continues de la température et de l'humidité ont été conduites sur 72 heures, une fois en été et une fois en hiver, dans chaque exploitation. À l'aide de méthodes statistiques, on a évalué si les caractéristiques des étables et les valeurs de climat mesurées sont associées en tant que facteurs de risque significatifs avec les indicateurs de santé animale (usage d'antibiotiques, mortalité et gain de poids journalier). Lors des mesures ponctuelles, des valeurs en dehors des domaines optimaux ont été observées pour tous les paramètres mesurés et à chaque saison. Des valeurs en dehors des domaines optimaux pour la température et l'humidité ont été constatées plus souvent par les mesures continues que par les mesures ponctuelles. Aucune corrélation significatrice n'a été observée entre les valeurs des paramètres de climat mesurées ponctuellement ou entre les valeurs des paramètres du climat mesurées et le nombre de veaux présents dans l'étable, la surface totale de l'étable, la surface paillée ou le volume de l'étable. Les groupes comptant beaucoup de veaux et la présence d'une ventilation mécanique étaient associés positivement à un usage élevé d'antibiotiques. Les groupes comprenant beaucoup de veaux et la présence d'un grand nombre de groupes étaient associés avec un taux de mortalité supérieur à 3%. Les exploitations en zone de plaine et le volume d'air par veau étaient associés positivement avec le gain de poids journalier. Aucun des paramètres de climat mesurés ne montrait d'association avec les indicateurs de santé animale (usage des antibiotiques, mortalité et gain de poids journalier). Ils semblent donc être inadéquats pour évaluer la santé des veaux dans des exploitations d'engraissement. Nos résultats montrent que les mesures de paramètres du climat sont difficiles à interpréter et doivent être considérés de manière critique.

[The lying and rumination behavior of healthy dairy cows housed in tie stalls is associated with bedding depth]. / Das Liege- und Wiederkauverhalten klinisch gesunder Milchkühe in Anbindehaltung ist assoziiert mit der Einstreutiefe.

INTRODUCTION: The lying and rumination behavior of dairy cows is internationally used as an animal welfare indicator. Dairy cow housing in Switzerland is subordinated to detailed legal requirements. It is particularly described that the lying area for cows must be covered with a sufficient amount of bedding. In the current study, we investigated whether bedding depth influences the lying and rumination behavior and thus, the animal welfare of healthy dairy cows housed in tie stalls. Bedding depth was categorized as ≤ 2 cm and > 2 cm. The lying and rumination behavior of 145 cows from 33 farms was recorded and analyzed considering farm effects; 105 cows were housed on ≤ 2 cm bedding, and 40 cows on > 2 cm bedding. Cows on > 2 cm bedding had on average a one hour longer daily lying time compared with cows on ≤ 2 cm bedding (mixed-effects linear regression: mean difference [cows on > 2 cm bedding - cows on ≤ 2 cm bedding] = 60,7 min/d; standard error = 28,6 min/d; p-value = 0,037). The odds of a cow to lie while ruminating were significantly higher in cows on > 2 cm bedding against cows on ≤ 2 cm bedding (mixed-effects logistic regression: Odds ratio = 1,27; CI95% [1,17-1,38]; p-value 2 cm can make a significant difference in the lying and rumination behavior of healthy dairy cows housed in tie stalls. Consequently, the animal welfare of dairy cows in tie stalls is improved by providing at least 2 cm of bedding.

INTRODUCTION: Le comportement de couchage et de rumination des vaches laitières est internationalement utilisé comme indicateur du bien-être animal. En Suisse, la détention des vaches laitières est soumise à des règles légales précises. Il est entre autre prescrit que l'aire de couchage doit être pourvue d'une litière appropriée en quantité suffisante. Dans la présente étude nous avons examiné si l'épaisseur de la litière avait une influence sur le comportement de couchage et de rumination, et ainsi aussi sur le bien-être animal, de vaches laitières saines détenues en stabulation entravée. L'épaisseur de la litière a été répartie en catégories de ≤ 2 cm respectivement de > 2 cm. Le comportement de couchage et de rumination de 145 vaches en provenance de 33 exploitations a été documenté et analysé en tenant compte de l'impact de l'exploitation: 105 vaches ont été détenues sur ≤ 2 cm de litière et 40 vaches sur > 2 cm de litière. Les vaches détenues sur > 2 cm de litière avaient en moyenne une durée de couchage journalière prolongée d'une heure (régression linéaire mixte: différence moyenne [vaches sur > 2 cm de litière ­ vaches sur ≤ 2 cm de litière] = 60,7 min/d; écart type = 28,6 min/d; Valeur p = 0,037). La probabilité que les vaches soient couchées lors de la rumination était significativement plus grande chez les vaches détenues sur > 2 cm de litière par rapport aux vaches détenues sur ≤ 2 cm de litière (régression logistique mixte: odds ratio = 1,27; CI95% [1,17­1,38]; Valeur p 2 cm est associée à des différences significatives de comportement de couchage et de rumination de vaches saines détenues en stabulation entravée. En conséquence, la mise à disposition d'un minimum de 2 cm de litière sur les zones de couchage des vaches détenues en stabulation entravée permet une amélioration quantifiable du bien-être animal.

[Evaluation of a novel training course for hoof trimmers to participate in a Swiss national cattle claw health monitoring programme]. / Evaluation eines Ausbildungskonzeptes für Klauenpfleger zur Durchführung eines schweizweiten Klauengesundheitsmonitorings für Rinder.

INTRODUCTION: The main goal of the resources project «Healthy claws - the foundation for the future¼ is to establish a Swiss national claw health monitoring programme for cattle, similar to what has already been established in other countries (e. g. Finland, Sweden). So far in the course of the project, 30 claw trimmers have been trained to use a digital recording software. An appropriate training concept and information to the work environment of Swiss claw trimmers are necessary to ensure that the recorded claw health data is of good quality. The newly developed training programme for claw trimmers was evaluated using the 30 first trained claw trimmers of the project. The training consisted of group events and individual schooling sessions, during which the claw trimmers were trained to recognise, classify and digitally record foot and claw disorders according to the «ICAR claw health atlas¼. At the end of the training programme, demographic and work relevant data about the claw trimmers was collected and their abilities when using the recording software, as well as recognising and classifying foot and claw disorders using pictures or live animals, were evaluated. The demographic and work relevant data collected at the end of the training showed an ageing of the profession (43% of the participants were over 50 years old), a lack of full-time claw trimmers (23% of the claw trimmers worked 90% or 100%), a neglect of locomotion scoring during claw trimming (no locomotion scoring standing from 60% and in movement from 33% of the participants) and a broad use of the Swiss claw trimming method (90% of the claw trimmers indicate using this method). An average Cohens kappa value of 0,74, and thus an overall substantial agreement with the first author, respectively the ICAR Atlas, was achieved for the identification and classification of foot and claw disorders. It was also noted, that all the participants were capable of using the recording software in practice after their schooling. The calculation of Cohens kappa values helps to recognise claw trimmers which fall below the limiting value and therefore show an insufficient agreement. These claw trimmers can thus be excluded from the scientific evaluation or undergo further training. It was concluded that the described training concept is suitable to establish a national claw health monitoring programme.

INTRODUCTION: L'objectif principal du projet «Des onglons sains ­ de bon pied vers l'avenir¼ est la mise en place d'un programme national suisse de surveillance de la santé des onglons des bovins, similaire à ce qui a déjà été mis en place dans d'autres pays (par ex. Finlande, Suède). Jusqu'à présent, au cours du projet, 30 pareurs d'onglons ont été formés à l'utilisation d'un logiciel de documentation électronique. Un concept de formation approprié et des informations sur l'environnement de travail des pareurs suisses sont nécessaires pour garantir la bonne qualité des données enregistrées. Le programme de formation nouvellement mis au point a été évalué à l'aide des 30 premiers pareurs formés. La formation a consisté en des formations de groupe et des formations individuelles, au cours desquelles les pareurs ont été formés à reconnaître, classifier et enregistrer électroniquement les maladies des onglons selon l'«Atlas ICAR santé des onglons¼. À la fin de la formation, des données démographiques et professionnelles concernant les pareurs ont été collectées et leurs capacités à utiliser le logiciel d'enregistrement, à reconnaître et classifier les maladies des onglons à l'aide d'images ou sur des animaux vivants, ont été évaluées. Les données démographiques et professionnelles collectées à l'issue de la formation ont entre autre montré un vieillissement de la profession (43% des participants avaient plus de 50 ans), un manque d'ongleurs à temps plein (23% des ongleurs travaillent à 90% resp. 100%), une négligence de la notation de la motricité lors du parage des onglons (pas de notation de la motricité stationnaire chez de 60% et en mouvement chez33% des participants) et une large utilisation de la méthode suisse de parage des onglons (90% des ongleurs indiquent utiliser cette méthode). Une valeur moyenne du coefficient kappa de Cohens de 0,74, et donc une concordance globale avec le premier auteur, respectivement l'Atlas ICAR, a été obtenue pour l'identification et la classification des maladies des onglons. Il a également été constaté que tous les participants étaient capables après leur formation d'utiliser le logiciel d'enregistrement dans la pratique. Le calcul de valeurs kappa de Cohens permet de reconnaître les pareurs qui descendent en dessous d'une valeur limite et présentent donc une concordance insuffisante. Ces pareurs peuvent ainsi être exclus de l'évaluation scientifique ou suivre une formation complémentaire. On peut en conclure que le concept de formation décrit convient pour la mise en place d'un programme national de surveillance de la santé des onglons.

Carbon monoxide - beyond toxicity?

Carbon monoxide (CO) intoxication is one of the most frequent causes of accidental poisoning, mechanistically related to the inhibition of oxygen transport following blockage of the oxygen binding site of hemoglobin. However, it has become evident that CO is also a gaseous signaling molecule like nitric oxide and capable to trigger cellular stress responses in complex organisms. Endogenously, CO is synthesized upon degradation of heme by heme oxygenases (HOs) of which two enzymatically active isoenzymes are known in mammals; the stress-inducible HO-1 and the constitutively expressed HO-2. Among other pathways, HO-1 expression is stimulated by the Nrf2/Keap1 system which senses electrophilic compounds including alkylating agents and reactive oxygen species (ROS) such as superoxide or hydrogen peroxide. In context with ROS, HO-1 expression has been associated with antioxidant defense related to the heme-metabolite redox pair biliverdin/bilirubin. Studies on CO signaling were facilitated by the introduction of so called "CO releasing molecules" (CORMs), which allow for the controlled release of the compound in biological systems. Obviously, major biological targets of CO comprise intracellular heme-proteins such as cytochrome c oxidase of the respiratory chain, cytochrome P450-dependent monooxygenases (CYPs), or NADPH oxidases. From toxicological studies it is known that exposure to high amounts of CO provokes an inhibition of mitochondrial respiration and increased generation of ROS. In contrast, biological response to low amounts of CO comprises moderate mitochondrial uncoupling (proton leakage) due to the activation of channels including phosphate carrier (PiC), adenine nucleotide translocase (ANT) or large-conductance Ca2+-activated K+ channels (BKCa). Uncoupling of mitochondrial respiration from ATP production is accompanied by a loss of mitochondrial membrane potential - a key sensor and regulator of mitochondrial quality control and mitophagy. Inhibitory effects of CO on mitochondrial respiration are compensated by an increased glycolysis. However, on a short term, utilization of glucose is shifted to the pentose phosphate pathway, to provide NADPH for detoxification. It is notable that endogenous CO production is associated with the physiological response against exogenous electrophilic insult like Nrf2-dependent expression of phase II enzymes or glutathione synthesis. In contrast phase I enzymes such as CYPs which usually generate more electrophiles are inhibited by CO. Together with direct and indirect transient effects on energy metabolism and mitochondrial quality control CO may be an important regulator in cellular stress response.

Inbreeding-related trade-offs in stress resistance in the ant Formica exsecta.

Inbred individuals and populations are predicted to suffer from inbreeding depression, especially in times of stress. Under natural conditions, organisms are exposed to more than one stressor at any one time, highlighting the importance of stress resistance traits. We studied how inbreeding- and immunity-related traits are correlated under different dietary conditions in the ant Formica exsecta. Its natural diet varies in the amount and nature of plant secondary compounds and the level of free radicals, all of which require detoxification to maintain organismal homeostasis. We found that inbreeding decreased general antibacterial activity under dietary stress, suggesting inbreeding-related physiological trade-offs.

[Laparoscopy in the management of endometrial cancer]. / Place de la laparoscopie dans le traitement du cancer de l'endomètre.

Recent advance in laparoscopy have changed the surgical approach of endometrial cancer patients. The Swissendos Center, Fribourg, in collaboration with AGO (Groupe de travail pour la gynécologie oncologique) and AGE (groupe de travail pour la gynécologie endoscopique) have established a consensus based on the available evidence for the use of laparoscopy in the management of patients with endometrial cancer The main objective was to define Swiss clinical practice guidelines appropriate to the country and consistent with the needs of the physicians.

[Practice guidelines: conservative treatment of fibroids]. / Traitement conservateur des fibromes: recommandations pour la pratique.

The conservative treatment of uterine fibroids is essentially based on symptomatology and patient's choice of treatment. The gynaecologist must develop a clear therapeutic protocol based on clinical examination, available test results and consideration of patient preference. The therapeutic options include close surveillance, hormonal treatments, conservative operative endoscopy and arterial embolization.

The utility of panoramic radiography in temporomandibular joint assessment.

OBJECTIVES: Panoramic radiography was used to determine (1) intrarater and inter-rater reliability in assessing temporomandibular joint (TMJ) condylar morphology; (2) alteration in condylar shape in patients with temporomandibular disorders (TMD) and controls when matched by age, gender, and state of dentition; and (3) prevalence of condylar abnormalities in individuals with and without TMD. METHODS: One hundred panoramic radiographs were randomly selected from a hospital clinic (45 TMD and 55 non-TMD patients). The images were cropped to include only the temporomandibular apparatus and were independently evaluated by three examiners without knowledge of the patient's clinical status. Multiple statistical tests were performed to evaluate the accumulated data. RESULTS: Intrarater reliability demonstrated substantial agreement, while inter-rater reliability was fair. There was no difference in condylar morphology between patient groups, but mild condylar change was prevalent in all age groups, regardless of TMD status. CONCLUSIONS: Morphological condylar abnormalities are present on panoramic images in all adult age ranges, regardless of status of the dentition or presence of TMD. Condylar shape alone is not an indicator of TMD, and minor condylar discrepancies may have no significance in TMD.

[The Fribourg canton hospital: Bertigny II, an indispensable evolution]. / L'hôpital cantonal de Fribourg: Bertigny II, une évolution indispensable.

The Hôpital cantonal of Fribourg was built in 1971. During the past 30 years, his development has been rapid, due to the evolution of the medicine and in order to respond to the increasing needs of the population. The local population has accepted in 1996 the project called Bertigny II. The new building is an extension of the actual hospital and will be inaugurated in November this year. The emergency unit, the intensive care unit and medical services will take place in this new building.

[Lesional pulmonary edema associated with tocolysis by hexoprenaline sulfate]. / Oedème pulmonaire lésionnel associé à une tocolyse par le sulfate d'hexoprénaline.

We report the case of a 24-year-old white female in need of tocolysis during the 25th week of pregnancy with i.v. hexoprenaline, while suffering from a discrete influenza-like syndrome with nasal discharge and sinusitis. A few hours later fulminant acute adult respiratory distress syndrome (ARDS) developed. ARDS is a rare (0.5-5%) but feared complication of tocolysis with beta-2 mimetic agents and magnesium sulfate. Its physiopathology is obscure, but iatrogenic hyperhydration and lesions of the alveolar-capillary membrane are suspected. In this case both factors were involved, but lesions of the alveolar-capillary membrane were predominant. A direct toxic effect of beta-2 mimetic agents on the alveolar-capillary membrane has not been demonstrated and other factors favoring pulmonary edema during tocolysis with beta-2 mimetic agents, especially infections, are discussed.

Long-term results of varicocelectomy.

Between 1983 and 1985, 257 infertile men were examined for any present varicocele by means of the Doppler sonography, telethermography and palpation. Based on these findings, the spermiogram and the infertility history, high ligation of the spermatic vein was indicated in 89 patients with varicocele and a median duration of infertility of 36 months (6-88 months). Postoperative sperm examinations have shown a significant improvement in sperm count and morphology, but not in motility. The most significant drop was observed in germ cell concentration from 1.68 to 1.06 mio/ml (p less than 0.025 Wilcoxon signed rank sum test). The follow-up examination 6 years after the beginning of the study has shown that only 56 out of the 89 patients underwent surgery, whereas 33 patients refrained from it. Pregnancy rates were 42% (23 out of 55, 1 patient lost to follow-up) in the operated group and 45% (14 out of 31, 2 patients lost to follow-up) in the nonoperated group. The comparison of the two graphs showing pregnancy incidence clearly demonstrates that pregnancies in the nonoperated group occur earlier than in the operated group; it has to be noted, however, that several patients only refrained from being operated on because pregnancy had occurred before surgery was planned. On the one hand, our study confirms other authors' results, i.e. that pregnancy rates in the nonoperated group are relatively high despite present varicocele. On the other hand, the operated group achieved practically the same high pregnancy rate when monitored over a longer period of time.(ABSTRACT TRUNCATED AT 250 WORDS)

[Interruption of pregnancy in Switzerland 1982-1986]. / Schwangerschaftsabbruch in der Schweiz 1982 bis 1986.

Official statistics available for the 5-year period considered in this paper reveal a general trend: decrease in the number of terminations, in absolute terms, both in women non-resident and in women resident in Switzerland. Amongst the latter, figures show a relative decrease in the 15 to 44-year age group and in relation to birth rate. Attitudes in 'liberal cantons' concerning termination of pregnancy are clearly justified. Efforts to ensure more widespread use of modern contraceptive methods must be continued (in conjunction with AIDS prevention).

[From isolation to opening: the evolution of the practice of medicine in the canton of Jura. I. The economic and social framework]. / De l'isolement à l'ouverture: l'évolution de la pratique médicale dans le canton du Jura. I. Le cadre économique et social.

Conditions for life from nowadays are compared to those reigning during the first half of this century in the canton Jura, a rural area with some manufactures. Roads were poorly developed and unsafe, hygiene was rudimentary, social security virtually inexistent and perinatal and children's mortality frightfully high. Birth, life and death took place at ones home at candle-light and without assistance. These past conditions are revived to elucidate the enormous medical developments over the past 50 years.

[From isolation to opening: the evolution of the practice of medicine in the canton of Jura. II. Medicine in the past]. / De l'isolement à l'ouverture: l'évolution de la pratique médicale dans le canton du Jura. II. La médecine d'antan.

Medical practise between 1920 and 1940 was exerted by family physicians basing on clinics. Patients seldom came to the doctors office. Home calls were the rule. This often implied long journeys, sometimes by foot or on skis. Therapy was extremely simple. Surgery was exercised under precarious conditions. The characters of some physicians were quite original. Friendly relations to large families treated by the same doctor sometimes for generations characterize these two decades barely 50 years back.

[From isolation to opening: the evolution of the practice of medicine in the canton of Jura. III. Great changes over the last 50 years]. / De l'isolement à l'ouverture: l'évolution de la pratique médicale dans le canton du Jura. III. Les grands changements des 50 dernières années.

The past 50 years are characterized by rapid improvements in medical practise in the canton Jura. A new generation of well trained family physicians and specialists, a leap in development of obstetric care and the construction of two modern hospitals have revolutionized treatment facilities for this region and have resulted in a marked reduction of perinatal mortality for mother and child. The history of the hospital of Porrentruy is reviewed in particular, an institution with a tradition of 500 years. Public health developments over the past 30 years have closed the gap to regions more privileged by access and development.

[Special weight percentile curves for twins]. / Spezielle Gewichts-Perzentilenkurven für Zwillinge.

Based on the birthweights of our data collection on 562 twins between 1970 and 1984 at the Universitäts-Frauenklinik Basle, we have worked out a special percentile curve for twins. Presented are the 10, 50 and 90-percentile curve for boys and girls. The data were calculated with 95% confidence-limits and the curves were equalized by computer. The new curves have the same form as those for single infants, but are shifted down by about 500 g. This can be explained by an intra-uterine growth-retardation, normally with twins, caused by lack of space confirms the necessity of separate percentile curves for twins.

Impaired DNA-repair synthesis in lymphocytes of breast cancer patients.

UV-C light induced DNA-repair synthesis was studied in unstimulated lymphocytes of 41 female patients (aged 33-83 years) with invasive breast cancer and of 27 healthy women (aged 37-68 years). As a parameter for the determination of the DNA-repair synthesis the incorporation of [3H] thymidine was taken in the presence of 2 mM hydroxyurea (HU). The [3H] thymidine incorporation levels were reduced in 20 of the 41 patients and in only 3 of the 27 controls. This difference between the two groups was significant. An impaired DNA-repair synthesis might be involved in the etiology of breast cancer in some patients.