Consequences for sun protection factors when solar simulator spectra deviate from the spectrum of the sun.

Synopsis The sun protection factor (SPF) of two products, one with an expected SPF of 4 and another with an expected SPF of 15 were determined, using two solar simulators: Multiport Solar UV Simulator (xenon, Solar Light, Philadelphia, PA, USA), and Supersun 5000 (metal halide, Mutzhas, Munich, Germany). The mean SPFs using the Multiport were: 4.8 for the low SPF product and 19.4 for the high SPF one. The results using the Supersun were lower: 2.6 for the low SPF product and 7.2 for the high SPF one. Relative emission spectra of the two sources were recorded using a fluorescence spectrophotometer in bioluminescence mode. Efficacy spectra were calculated and compared with the corresponding spectrum of natural sunlight. It was evident that the spectral power of the xenon source is too high in the UVB, leading to overestimation of SPFs, whereas the Supersun irradiator emits too much in the UVA, resulting in too low SPFs. Heat effects and photodegradation of UV filters are discussed as further possible reasons for the discrepancies between the experimentally determined SPFs. Our results confirm a recent publication about theoretical SPFs, calculated with emission spectra of a xenon source and spectra of the sun at different elevation angles, where the authors provide evidence that in natural sunlight the contribution of UVA to total UV radiation is twice as high as in a xenon source. This may contribute to an understanding of why sunscreens tested according to the FDA method (xenon sources) often yield higher SPFs than those obtained from European testing procedures.

[Attempted suicide by intake of pholedrine]. / Suizidversuch durch Einnahme von Pholedrin.

It is reported on an attempted suicide of a 21-year old female patient with a lethal dose of 60 to 80 tablets pholedrine longo. A pulmonary oedema could be observed in the patient. This was accompanied by hypotensive crises of blood pressure, which compelled us to use dopamin. Under therapy a stabilization of the behaviour of the patient could be achieved. Pathological liver values were diagnosed. The findings got were discussed and compared with the data of former publications.

[The problem of ventricular flutter and fibrillation]. / Zur Problematik des Kammerflatterns und -flimmerns.

Ventricular flutter evokes quick, haemodynamically little effective ventricular contractions. The still existing minimal circulation does not maintain the vital functions. Ventricular fibrillation is tantamount to the acute standstill of the cardiac circulation. If they are not treated, these malignant disturbances of the rhythm nearly always lead to death. Reentry processes or foci with rapid formation of impulses are discussed as responsible electrophysiological mechanisms. Warning arrhythmias are significant for the evocation of ventricular flutter and fibrillation. But the concept of the warning arrhythmias has no unrestricted validity. Thus also late involving ventricular extrasystoles can evoke ventricular fibrillation. Disturbances of intraventricular conduction are also significant for the development of ventricular fibrillation. In our own patients there were no disturbances of conduction only in 13.1% of the cases with ventricular fibrillation. Etiologically are of concern: acute myocardial infarction, chronic myocarditis, chronic ischaemic heart disease, current accidents, advanced stages of vitia and cardiomyopathies. Frequently ventricular fibrillation appears as paroxysmal form (paroxysmal uncoordinated ventricular tachycardia, "torsades de pointe") due to inhomogeneous repolarisation (prolongation of the QTU-time). Therapeutically only the immediate electro-shock therapy has a chance of success in ventricular flutter or fibrillation. Among our patients out of 61 patients with ventricular flutter and fibrillation 26 could be dismissed.

[Liver rupture after prolonged use of contraceptive]. / Leberruptur nach mehrjähriger hormonaler Kontrazeption.

Since several years benign liver tumours have been observed as complication of a long-term intake of hormonal contraceptives. Apart from a clinical unconspicuousness uncharacteristic complaints of the epigastrium up to the picture of the acute abdomen due to rupture of the tumour rich in vessels may be appear. A preoperative diagnosis is only rarely successful, and only the laparotomy brings the final diagnostic clarification.

[Technic of venous access for infusion therapy and parenteral nutrition]. / Zur Frage der Technik des venösen Zuganaes für die Infusionstherapie und parenterale Ernährung.

The creation of a secure venous access is the basis of the infusion therapy and the parenteral nutrition. As ways of access are suited above all the subclavian vein, the internal jugular vein and the basilic vein. Taking into consideration the contraindications and the exact performance of the various methods early complications such as punctures of the arteries, pneumothorax, rupture of the catheter and extended haematomata may be reduced to a minimum. Abnormal positions are avoided by control of the position by means of endo-ECG via steel mandrin. As late complications are observed infections at the place of puncture, unclear, partly septic temperatures and clinically manifest thromboses. Own experiences with 3,282 central venous catheters (2,057 subclavian catheters, 63 catheter into the internal jugular vein and 1,162 central catheters with access via arm veins) are taken into consideration.

[Infusion- and microcatheterization technics at an internal medicine intensive care unit]. / Infusions- und Mikrokathetertechnik auf einer internistischen Intensivstation

It is reported on the infusion, stimulation and microcatheter technique in an internal intensive therapy ward. From July 1st 1970 to November 11th 1974 were altogether laid 1,642 superior cavacatheters, 1,057 times by puncture of the subclavian vein and 585 times through the brachial veins. Compared with the usual infusion techniques the advantages of the cava-catheter technique consist in the fact that a constant venous approach is existing and that solutions of a high percentage and medicaments may be infused relatively undangerously. Apart from this the cava-catheter gives the possibility to carry out continuous measurements of the central venous pressure and guarantees the taking of blood samples at any time. The phlebitides or thromboses, respectively, which are regularly appearing in flexules lying longer than 40 hours are avoided in most cases. Taking into consideration the contraindications and the exact performance of the various methods especially early complications such as puncture of the arteries, pneumothorax, detachment of the catheter, extended haematomas and wrong positions of the catheter may be reduced to a minimum. As late complications distinct infections in the place of puncture, unclear, partly septic temperatures and clinically manifest thromboses were observed. In these cases the cava-catheters should be removed. The temporary electrostimulation through electrode catheters plays an important part in the emergency medicine and the mastering of the various methods of the cava-catherization is taken for granted. During the period of report altogether 423 stimulation catheters were laid. The cardiac microcatheterization should be reserved for more special cases.