[Examples for asbestos-related findings in HRCT - criteria for the assessment of causal relationships in surveillance programmes and medical expert opinion]. / Beispiele asbestfaserstaubbedingter Veränderungen im HRCT - Anhaltspunkte für die Kausalzuordnung bei Vorsorgeuntersuchungen und bei der gutachterlichen Beurteilung.

The increasing use of high-resolution computed tomography in formerly asbestos-exposed workers requires valid diagnostic criteria for the findings which have to be reported as suspicious for being asbestos-related in surveillance programmes and for the assessment of causal relationships between former asbestos exposure and findings in computed tomography. The present article gives examples for asbestos-related findings in HR-CT and discusses the specificity of parenchymal and pleural changes due to asbestos fibres.

Photon emission at molecular resolution induced by a scanning tunneling microscope.

The tip-surface region of a scanning tunneling microscope (STM) emits light when the energy of the tunneling electrons is sufficient to excite luminescent processes. These processes provide access to dynamic aspects of the local electronic structure that are not directly amenable to conventional STM experiments. From monolayer films of carbon-60 fullerenes on gold(110) surfaces, intense emission is observed when the STM tip is placed above an individual molecule. The diameter of this emission spot associated with carbon-60 is approximately 4 angstroms. These results demonstrate the highest spatial resolution of light emission to date with a scanning probe technique.

[Digital radiography in chest imaging of occupational and environmental lung diseases]. / Digitale Radiografie in der Untersuchung von arbeits- und umweltbedingten Lungen- und Pleuraerkrankungen.

The classification of pneumoconiosis according to ILO standard - comparing a X-ray of the lung with ILO radiographs - is well established in Germany. The extension of digital imaging is a challenging task in occupational medicine as well as in pneumology. Technical requirements are not known sufficiently and the necessary equipment is not well distributed. This paper describes the current position on recording, assessment and documentation of digital imaging of the lung and pleura.

[Recommendations for reporting benign asbestos-related findings in chest X-ray and CT to the accident insurances]. / Anzeigekriterien asbestfaserstaubbedingter Erkrankungen gemäss BK-Nr. 4103 BKV.

Asbestos-related diseases still play an important role in occupational medicine. The detection of benign asbestos-related diseases is one condition for the compensation of asbestos-related lung cancer in Germany. Due to the increasing use of computed tomography, asbestos-related diseases are more frequently detected in the early stages. The present article proposes recommendations for the findings which have to be reported as suspicious for being asbestos-related based on a) chest X-rays and b) computed tomography using the International Classification System for Occupational and Environmental Respiratory Diseases (ICOERD).

Melting of two-dimensional adatom superlattices stabilized by long-range electronic interactions.

The melting transition of Ce adatom superlattices stabilized by long-range substrate-mediated electronic interactions on Cu(111) and Ag(111) noble metal surfaces has been investigated by low-temperature scanning tunneling microscopy, density functional theory calculations, and kinetic Monte Carlo simulations. Intriguingly, owing to the interaction between Ce adatoms and substrate, these superlattices undergo two-dimensional melting to a liquid without transition through the hexatic phase. The crucial parameters for this direct solid to liquid transition are identified.

[Experiences with a standardized acetylcholine test in occupational medicine]. / Erfahrungen mit einem standardisierten Azetylcholintest in der Arbeitsmedizin.

This review deals with methodological features and the corresponding argumentation of a screening test for non-specific bronchial provocation with acetylcholine as it was standardized in the eastern part of Germany. This test has shown its suitability, whereby it has to be mentioned critically that the low provocation dose detects only higher grades of hyperreactivity. On the other hand the relevance of the test could be proved especially in occupational health follow-up studies.

[Epidemiological studies on the occurrence of lung diseases in welders]. / Epidemiologische Untersuchungen zur Häufigkeit von Lungenkrankheiten bei Schweissern.

A cross sectional study in electric arc welders revealed significant higher prevalences of simple chronic bronchitis and of nodular opacities in thorax x-rays in spite of exposure below MAC in most cases. Spirometry, flow-volume-curves and bronchial challenges with acetylcholine showed no substantial functional deterioration in comparison with controls. But there are weak dose-response-relations between symptoms as well as lung function data on the one hand and duration of exposure as well as welding fume concentration on the other hand.

[Efficacy and safety of topical 0.05% diflorasone diacetate (florone) cream/ointment in patients with acute/chronic dermatitis]. / Wirksamkeit und Sicherheit von topisch angewandter 0,05prozentiger Diflorasone-Diazetat-(Florone)-Creme/Salbe bei Patienten mit akuter/chronischer Dermatitis.

In a three weeks study, efficacy and local tolerance of 0.05% diflorasone diacetate (Florone) cream and ointment were tested in 60 patients suffering from eczematous dermatosis or dermatitis. The results have been judged by 8 signs of improvement and are presented in a chart. Both formulations showed an efficacy of 95% during the 21-day duration of therapy. Side effects were rarely observed.

[Treatment of acne vulgaris with clindamycin phosphate in dermatologic practice]. / Behandlung der Akne vulgaris mit Clindamycin-Phosphat in der dermatologischen Praxis.

In an open study, 34 male and 16 female patients suffering from mild up to severe acne vulgaris were treated with topical clindamycin-phosphate over a period of 8 weeks. In the course of treatment, 96% of the patients showed improvement. In 52% of the cases, at least 65% of the inflammatory eruptions faded or they disappeared altogether; 44% of the cases showed reduction of 30-65% of their lesions. Only 4% of the patients did not respond at all to the treatment. Separate study on the various degrees of severity of the disease revealed greater improvement of severe acne than with mild and moderate forms. On the basis of pathophysiology, these cases might be still more successfully treated by means of combined therapy with comedolytics.

[Methodology and assessment of testing bronchial reactivity]. / Methodik und Bewertung der bronchialen Reaktivitätsprüfung.

Starting from diagnostic relevance of non specific bronchial challenges the principles and experiences of a screening type acetylcholine test which is recommended as a standard in GDR since 1974 are discussed. For special tasks like longitudinal studies and clinical pharmacology a threshold method using histamine was derived and modified from literature. Special attention is paid to diagnostic, prognostic and expertizing relevance of non specific bronchial hyperreactivity.

[Early diagnosis by means of flow volume curves in workers with respiratory exposure (author's transl)]. / Zur Frühdiagnostik mittels Fluss-Volumen-Kurve bei inhalativ exponierten Werktätigen.

In 432 electric welders and 420 not respiratory exposed workers the information value of spirometry (VC, FEV1) and flow volume curves (PEF, V2/V1, V50, V75) was examined taking into consideration the influence of age, smoking and occupational exposure. Despite the higher frequency of chronic bronchitis and pulmonary siderosis in exposed workers no influence of welding fumes on the above mentioned parameters could be shown. Comparing different smoking groups all parameters (with the exception of VC) exhibited the same trend, the FEV1 at the top regarding significance and weight. These results don't support a wider use of flow volume curves in the screening of not selected groups of different exposure. Whether the compared methods can lead to different qualitative or prognostic informations should be examined further in studies comparing functional and morphological data and in epidemiological follow-up studies.

[Procedure of the bronchial provocation tests (author's transl)]. / Methodik der bronchialen Reaktivitätsprüfung.

A procedure of bronchial inhalation challenge with acetylcholine accepted by the working group "Aerosols in Medicine" of the GDR on its session in autumn 1976 in Leipzig is reported. The decisions on substance, dose, kinds of application and interpretation are discussed and confirmed.

[Chronic obstructive airway diseases caused by long-term occupational exposure to asphalt pyrolysis products]. / Chronische obstruktive Atemtrakterkrankungen durch langjährige berufliche Exposition gegenüber Bitumenpyrolyseprodukten.

The paper reports on 6 roofers who have been specialized on production of damming up roofs and insulation of wet rooms for 20 years. There was chronic obstructive bronchitis with functional impairment of different degree in 4 of them. These diseases were acknowledged as occupational diseases by special committee decision (BK SE). The pyrolysis products developing while heating the bituminous masses used for insulation purposes were recognized as causal agents.

[Relations between stress intensity, sex and ergometric procedures in healthy probands and patients with obstructive respiratory diseases]. / Beziehungen zwischen Belastungsintensität, Geschlecht und Ergometrieverfahren bei Gesunden und Patienten mit obstruktiven Ventilationsstörungen.

In 223 healthy people and patients with obstructive lung diseases we examined the degree of cardiopulmonary exhaustion during two ergometric stress tests (Ergooxytensiometrie [EOT] and submaximal Ergostasetest [ET]). Main purpose of the study was to look for differences between sexes in the degree of exhaustion in relation to the type of stress test, thus clarifying the need of a special EOT-modification for women. Measured parameters were arterial oxygen pressure (pO2a), arterial carbon dioxide pressure (pCO2a), base excess (BE), heart rate, noninvasive blood pressure, Wmax and in ET additionally oxygen intake (VO2max) and oxygen pulse. In EOT men and women showed similar results regarding pressure frequence product in health people as well as in patients. Heart rate in EOT was also similar for men and women clearly below maximal range, amounting around 70% of age related maximal value. For pO2a as main indicator of pulmonary gas exchange we found no differences in healthy people as well as in patients with obstructive lung disease between both ergometric methods, but generally some what higher values in women without clinical importance. A sex related modification of the EOT for the evidence of hypoxemia is not necessary.

[No information gain by registration of oscillatory resistance against volume]. / Kein Informationsgewinn durch volumenbezogene Registrierung der oszillatorischen Resistance.

The value of volume related registration of oscillatory resistance for early diagnosis of obstructive impairment of lung function was tested in a screening of dust exposed workers in foundries. Compared with conventional, easier to measure mean Ros, registration of Ros against volume did not reveal advantages in studying dose-effect-relationships in groups with different dust exposure.

[Pulmonary alveolar proteinosis--an occupational disease?]. / Die pulmonale alveoläre Proteinose--eine berufsbedingte Erkrankung?

Pulmonary alveolar proteinosis is characterized by an uniform pathomorphologic picture. Actual knowledge regarding causal relationships is discussed reporting a case history.

[Reproducibility of bronchial provocative testing in bronchitis (author's transl)]. / Zur Reproduzierbarkeit von Testergebnissen bronchialer Reaktivitätsprüfungen bei Bronchitispatienten.

Bronchial reactivity was examined every 3 month in a follow-up study of 40 subjects mostly showing chronic nonspecific lung disease and all having bronchial hyperreactivity at the beginning of the study. Only 7 of them (17.5%) had constant hyperreactivity for the time of observation. There has been parallelism between test results and complaints in 72% of patients with chronic bronchitis and in 65.2% of the second group (mostly subjects with bronchitis). Seasons had no strong influence on bronchial reactivity. Bronchial provocative testing has proved as a valuabel method for verification of obstructive complaints. The test results shouldn't be interpreted without regarding clinical data. Using as a screening test a more detailed diagnostic and follow-up are necessary to avoid false and premature consequences. As to expert opinions and decisions on compensation the test results can correctly be interpreted only if reproducibility in the single case has been proved and if they are in agreement with the clinical signs and symptoms of the case.

[Evaluation of a bronchopulmonal screening program for the aims of occupational health in workers exposed to cement dust (author's transl)]. / Erprobung eines arbeitsmedizinisch orientierten bronchopulmonalen Screeningsprogramms an staubexponierten Werktätigen eines Zementwerkes.

180 workers exposed to cement dust were examined in a bronchopulmonal screening including standardized history, clinical examination, spirometry and bronchial reactivity testing. The program proved to be suitable. The time needed for each person was 45 minutes. The workers have been selected in such a manner that the informational value of the methods of lung functional diagnostic could be verified in workers exposed to dust before manifestation of lung diseases. In view of individual diagnosis and rehabilitation bronchial reactivity tests lead to valuable information in workers exposed to cement dust. In the other hand no higher frequency of bronchial hyperreactivity in workers without lung diseases and exposed to dust could be proved. The rates of decrease of FEV1 after inhalation of acetylcholine, however, revealed a positive correlation to the duration of exposure.

[Comparability of jet and ultrasonic aerosols in bronchial reactivity tests]. / Vergleichbarkeit von Düsen- und Ultraschallaerosolen bei bronchialen Reaktivitätsprüfungen

The use of tests of bronchial reactivity for expert's opinions as well as ability examinations and check-ups in the field of occupational medicine makes great demands on their reproducibility. In the case of different application techniques the comparability of the test results is to be proved. For two aerosol producers used in the GDR test variants reliable for many years were comparatively investigated. Hereby the possibility could be proved on principle to achieve comparable results by variation of the concentration of the acetylcholine solution given. The choice of the test concentration in question is decisively influenced by the aim of the examination and the kind of test persons.

[Determination of total lung capacity from the thoracic roentgen image]. / Zur Bestimmung der totalen Lungenkapazität aus Thoraxröntgenaufnahmen.

Formulas for calculation of total lung capacity from chest X-rays were compiled from literature. Using the total lung capacity measured by bodyplethysmography as reference, these formulas and several modifications were tested for usefulness. The product of lung area in the posterior-anterior X-rays and the largest diameter from sternum to the dorsal rib bow in the frontal X-rays was the most simple and exact roentgenological indicator of total lung capacity. 95%-confidence intervals for predictive values gained by this method revealed to be of similar range as for total lung capacity estimated by the gas dilution methods in comparison to bodyplethysmography.