[Definition of "chronic fatigue syndrome" (CFS)]. / Definitionen des "Chronic Fatigue Syndrome" (CFS).

The definition of "Chronic Fatigue Syndrome" (CFS) in 1988 was an attempt to establish a uniform basis for the previously heterogeneous approaches to research of this severe and inexplicable state of fatigue. At the same time, researchers wished to narrow down a pathogenetically founded disease entity a priori by specifying precise disease criteria. The empirical data gathered in accordance with the CFS definition, however, have failed to confirm the assumption that the disease entity is pathogenetically uniform. Furthermore, the originally selected criteria have proven to be impracticable ore theoretically questionable. In the period that followed, modifications that permitted a more comprehensive and yet more differentiated classification of fatigue states of unclear etiology were proposed. The new research approach avoids postulation of causal entities and puts CFS back in a category with other descriptive states of fatigue.

[Changes in the benefits spectrum of medical insurance by the development of advanced technology medicine]. / Veränderungen des Leistungsspektrums der Krankenversicherung durch die Entwicklung zur Hochleistungsmedizin.

The development of technical, diagnostic and therapeutical treatment in medicine to high-tech medicine and the survival of patients with necessity of permanent medical treatment and the development of a disadvantageous age structure of the population will need a continuous going up of costs in health maintenance. Restrictive handling of unnecessary medical treatment can only for a short time delay the going up costs, but it cannot stop this development or reverse it.

[Critical and heretical thoughts on the development of cardiology. Limits of mental and social compliance attitude of the population]. / Kritische und ketzerische Gedanken zur Entwicklung der Kardiologie. Grenzen der mentalen und sozialen Leistungsbereitschaft der Bevölkerung.

Medicine in total and cardiology seem to be in state of continuous development. However partially unproved theories and therapies at great cost of energy and money without scientific proof and cost benefit analysis for patients before uncritically and undisciplined thinking or by authorities who support status quo. Our basis of the described theories of arteriosclerosis and cholesterol the multiple uneffective studies with reduction in levels of plasmalipids must be provided. There is also a change of thinking in therapeutical doing in infarction, because conservative or invasive therapies do not change mortality rates. In Germany usual social benefits just as rehabilitation after infarction or cardiac surgery must be checked. The return of medicine to the possible and in useful means is the beginning for new theoretical development. Static behavior seems to be comfortable, but it stops the necessary changes for the future.

[The influence of the broncholytic reproterol in persons with bradycardic arrhythmia upon impulse and conduction as well as irritability of the human ventricle (author's transl)]. / Die Beeinflussung der Reizbildung und Reizleitung sowie der Irritabilität des menschlichen Ventrikels durch das Broncholytikum Reproterol bei Personen mit bradykarden Rhythmusstörungen

The new broncholytic 7-(3-[2-(3,5-dihydroxyphenyl)-2-hydroxy-ethylamino]-propyl)-theophylline (reproterol, Bronchospasmin), a beta-phenylethyl-aminoalkyl-xanthine, was investiggated in two doses (60 and 90 mug i.v.) in patients who suffered from bradycardic arrhythmia. The influence on the primary and tertiary impulses and conduction in 36 cases and on the irritability of the human ventricle in 8 cases was tested. Reproterol led to a tolerable increase in the atrial and ventricular rate as well as to a desirable acceleration of the AV conduction. Irritability was significantly increased to a lesser degree than by the administration of orciprenaline and oxyfedrine. Except for a few, but not threatening, extrasystoles, two cases with bigeminal rhythms and some cases with a thermacogenesis, no undersible side effects were noted following injection.

[Effect of nifedipine on the ventricular diastolic stimulation threshold of the human heart]. / Der Einfluss von Nifedipin auf die ventrikuläre diastolische Reizschwelle des menschlichen Herzens.

The Ca-antagonist 1,4-dihydro-2,6-dimethyl-4-(2-nitrophenyl)-3,5-pyridine dicarbonic acid dimethylester (nifedipine) does not lead to an elevation of human myocardial stimulus-threshold in contrast to another injectable Ca-antagonist verapamil. There was no increase or decrease in bradycardiac arrhythmia in this study. Therefore beta-blockers and antiarrhythmic drugs given simultaneously will not have intolerable pharmacodynamic interaction with nifedipine in bathmotropic and bradycardiac arrhythmia.

Silent ischaemia in asymptomatic 'healthy' individuals with coronary risk factors.

On the occasion of a routine medical check-up 256 out of 1100 individuals with an accumulation of coronary risk factors were screened for silent myocardial ischaemia by exercise testing and Holter monitoring. Of these individuals 5.5% had a pathological exercise test, 7.4% had ischaemia-like events on the Holter ECG, 11.3% had at least one pathological test, but only 1.6% had ischaemic signs in both ECG tests. The outcome of the ECG tests appears to be independent of the type and the total number of risk factors. To date, 13 of the 29 individuals with a positive test have undergone thallium myocardial imaging: only three individuals had signs of ischaemia. Holter monitoring and exercise ECG show comparable results in this population. The pathological ECG findings were only partly confirmed by the thallium test. The follow-up will show the prognostic significance of the ECG changes.