[Gaze-fixation tonometry or tonography in endocrine ophthalmopathy]. / Blickrichtungstonometrie oder -tonographie bei endokriner Ophthalmopathie.

In patients with Graves' ophthalmopathy there is often a rise in intraocular pressure (dIOP) in changing from straight-ahead gaze to upgaze. If dIOP is measured using the applanation tonometer of the slitlamp, mistakes occur in pressure recording. In order to check these mistakes the authors compared tonometric with tonographic records of dIOP in 90 eyes of 45 patients. It was found that tonographic values were twice as high as tonometric values. Therefore, tonography furnishes more information about the activity of Graves' disease than tonometry; the errors of measurement associated with tonometry are also avoided.

[Significance of fundus evaluation in the staging of hypertensive disease compared to electrocardiography and renal circulation]. / Bedeutung der Fundus-Beurteilung bei der Stadieneinteilung der Hochdruck-Krankheit im Vergleich zum Elektrokardiogramm und zur Nierendurchblutung.

In order to determine the relevance of ophthalmoscopic findings in cases of hypertension as compared to electrocardiographic abnormalities and disorders of the renal function, the authors examined 728 patients admitted to the German diagnostic Clinic (Wiesbaden) with hypertension over a period of 2 years. In all cases blood pressure was measured twice, and ophthalmoscopy, electrocardiography, a chest X-ray, and a laboratory checkup were performed. The effective renal plasma flow was measured in 100 cases using the 131 iodine-Hippuran clearance method. The results revealed that ophthalmoscopy is the most reliable method for classifying early and more advanced stages of hypertension, as compared to ECG and measurement of the effective renal plasma flow.

[The pattern of regional disorders of wall motion in primary dilated cardiomyopathy]. / Muster der regionalen Wandbewegungsstörung bei primärer dilatativer Kardiomyopathie.

Regional left ventricular wall motion was measured in 41 patients with dilated cardiomyopathy (DCM) and 30 healthy normal controls. Global and regional left ventricular function was noninvasively determined by radionuclide angiography (RNA). The amplitudes and phases of the first Fourier coefficient of the regional time-activity curves were used to measure regional wall motion. The normal left ventricle has its strongest contractions in the apical and distal antero-septal regions. In contrast, the left ventricle of patients with DCM contracts the least in these segments. These regional wall motion impairments are parallel to the reduced global left ventricular function. Since such a typical pattern of reduced wall motion can already be demonstrated in patients with mild DCM, determination of regional left ventricular wall motion can help to improve the early detection of DCM.

[Sonographic determination of spleen size and spleen weight]. / Sonographische Milzgrössenbestimmung und Milzgewichtsschätzung.

This report deals with the results of post-mortem sonographic examination of the spleen of 36 patients. The goal of the study was to gain direct information on the precision of the sonographic organometric method we use. It becomes evident that - depending on the position of the spleen in the dome of the diaphragm - the real length of the organ is underestimated when it is measured as the direct line between the two poles. For this reason the length should be taken as the (curved) median line obtained when performing a longitudinal section of the spleen at sonography. Under these conditions there is a good correlation of the sonographic and anatomic data obtained by autopsy. The mean deviation is maximally 7 mm. For the approximate calculation of the organ weight from the sonographically obtained data the simple ellipsoid formula is sufficient. In order to obtain a normogram for sonographic weight estimation a larger statistical sample is necessary.

[Exercise ECG as a screening test in the early diagnosis of coronary heart disease. Result of a trial study (author's transl)]. / Das Belastungs-Elektrokardiogramm bei Screening-Untersuchungen zur Früherkennung der koronaren Herzkrankheit. Ergebnisse einer Modellaktion.

1500 men (aged 30-55 years) volunteered in a trial of early recognition of cardiovascular disease. History and clinical as well as biochemical data were obtained and compared with results of exercise ECGs. In the group as a whole abnormal ECGs were obtained in 6.2%, in a subgroup of those without exercise-dependent pain in the thorax, without hypertension and noraml resting ECG it was 3.8%, while in the presence of one or several of these risk factors it was as high as 17.8%. It is concluded that in any screening programme it is not reasonable to perform exercise ECGs in asymptomatic persons without risk factors, because in this group there is likely to be only a small percentage of abnormal findings and the number of false-positive ones is higher than that or correct positive ones. In connection with the known risk factors and risk indicators it would be best to define the risk group and, using selective indications, to go step-by-step from exercise ECG to additional invasive diagnostic measures such as coronary angiography.

[Applanation tonometry within medical diagnostic "check-up" programs (author's transl)]. / Applanationstonometrie im Rahmen medizinischdiagnostischer Untersuchungsprogramme.

Within medical diagnostic "check-up" programs intraocular pressure measurements by applanation tonometry from 8899 patients (5924 men, 66.6%; 2975 women, 33.4%) were statistically evaluated. The frequency of each i.o. pressure show no Gaussian distribution but is skewed to the right with marked excess to higher values of i.o. pressure. Correlation of mean i.o. pressure with age shows (starting in the group of the 20-24 years old to the 75-79 years old persons) a rather linear progression of i.o. pressure. The mean value of i.o. pressure (n = 17,798 eyes) was x = 16.25 mm Hg, the standard deviation +/- 3.45, the standard deviation of the mean +/- 0.03 mm Hg. In men in 2.18% in women in 1.81% higher i.o. pressure than 21 mm Hg was found. I.o. pressure higher than 24 mm Hg have 0.66% of the men and 0.58% of the women. Patients forty years old and elder showing in 4.92% of the men and 4.88% of the women higher i.o. pressure than 21 mm Hg. In patients fifty-five years old and elder in 5.75% of the men and respectively in 6.69% of the women i.o. pressure higher than 21 mm Hg was found. Incidences of elevated i.o. pressure from patients over forty years old in ten years steps are presented. In 103 patients with unilaterally i.o. pressure higher than 24 mm Hg 12% presents manifest diabetes mellitus. The usefullness of applanation tonometry as a practicable screening method for early glaucoma detection within medical diagnostic "check-up" programs is outlined. Advantages of data-aquisition and -processing systems to continue those studies are emphasized.