[The effect of bemetizide-triamterene on the serum and whole body potassium in hypertensive patients (author's transl)]

The hypotensive effect of Bemetizide (B)/Triamterene (T) and its action on the potassium balance was investigated in 10 patients with renovascular hypertension. Within 14 days treatment with 50 mg B and 100 mg T a significant fall in the mean blood pressure of 174/106 to 143/95 mm Hg occurred. Whereas the serum potassium concentration fell by an average of 4.2 +/- 0.5 to 3.9 +/- 0.6 mEq/1 the whole body potassium showed only a slight insignificant regression by 50 and 80 mEq after 2--4 weeks; however, the potassium content related to the body weight remained unchanged. In contrast to monotherapy with chlorthalidone or hydrochlorothiazide, treatment with a combination of B and T caused no significant alteration of the intracellular content of potassium.

[Comparative experimental investigations with bioglass (L. L. Hench) and Al2O3-ceramic coated with mod. bioglass. II. Results of experiments with loaded implants (author's transl)]

This report is based on 4 comparative experimental series is sheep using a cementfree total hip replacement model. Basically a smooth stem design was compared to a step stem design for biomechanical interlocking anchorage. Both designs were implanted as pure high density Al2O3-ceramic components and as Al2O3-ceramic parts coated with Bioglass or Bioglass-ceramic (post op. follow up 13 months, 17 animals). None of the 4 stem modifications showed a tendency for permanent stabilisation or bonding in bone. Besides insufficient bonding of the glass coatings to the substrate and apparent biodegradability of the bioglass coatings in the body, insufficient biomechanical knowledge of endosteal direct anchorage of prosthetic devices is the main reason for failure in these experiments. An exclusive biochemical way of anchoring prosthetic parts in the marrow cavity is rejected. The results presented are discussed in the light of the recent literature.

[The relevance of histological results for the evaluation of materials for bone replacement (author's transl)]

Different groups have observed and reported deviating tissue reactions for the same material for bone replacement: for the "bioinert" Al2O3-ceramic close bone contact is mentioned, others report about a soft tissue layer adjacent to the implant; for the "bioactive" glass ceramic interfaces capable to transmit considerable shear forces are described, others found no interface bonding.--The analysis of the results of animal experiments and the evaluation of clinical follow-up studies show that these discrepancies had been caused by the differences of the biomechanical situations in the examined interfaces. It is pointed out that the negligence or not mentioning of the load pattern at the site of examination can lead to misinterpretations about the possibilities and limits of applicability of biomaterials.

[Nitrogen balance and plasma amino acids in premature and newborn infants with partial parenteral feeding during the first 3 days of life]

Eight pre-terms, five with postnatal asphyxia, two hypotrophic newborns and one term infant with severe postnatal asphyxia (mean birth weight 2317 g) were fed in addition to oral nutrition partialy parenterally with glucose solution and a mother-milk adapted amino-acid solution during their first three days of life. At increasing protein supplies with a parenteral share of more than 50% during the three days, the N balances resulted positive on all days although the calories supplied were far below the postulated optimum. On days two and three N retention was about 60% of the supply. Every four hours after discontinuation of the total 16 hours' amino-acid infusion the amino acid levels in plasma were controlled by means of column chromatography. The resulting mean values did not show any imbalances of the amino-acid homeostasis. The maximum mean loss in weight of the present group was 4% of their birth weight during the first ten days of life and thus equalled the loss in weight of normal, healthy pre-terms. Clinical and chemical paramters did not reveal any disadvantageous side effects of parenteral nutrition.

Stickstoffbilanzen und Plasmaaminosäuren bei Früh- und Neugeborenen mit partieller parenteraler Ernährung während der ersten drei Lebenstage

Acht Frühgeborene, davon fünf mit postnataler Asphyxie, zwei hypotrophe Neugeborene und ein reifes Neugeborenes mit schwerer postnataler Asphyxie (mittleres Geburtsgewicht2317 g), wurden während der ersten drei Lebenstage zusätzlich zur oralen Ernährung partiell parenteral mit Glukoselösung und einer Frauenmilch-adaptierten Aminosäurenlösung standardisiert ernährt. Bei steigender Proteinzufuhr mit einem parenteralen Anteil von mehr als 50% während der drei Tage waren die mittleren N-Bilanzen an alien Tagen positiv, obwohl das Kalorienangebot weit unter dem geforderten Optimum lag. Am zweiten und dritten Tag betrug die N-Retention etwa 60% der Zufuhr. Die mittleren, jeweils vier Stunden nach Ende der löstündigen Aminosäureniniusionsperiode säulenchromatographisch gemessenen Aminosäurenspiegel im Plasma wiesen keine Imbalanzen der Aminosäurenhomöostase auf. Der maximale mittlere Gewichtsverlust während der ersten zehn Lebenstage betrug bei der untersuchten Gruppe 4% des Geburtsgewichts und war damit gleich dem gesunder Frühgeborener aus unserem Krankengut. Nachteilige Nebenwirkungen der parenteralen Ernährung konnten aufgrund von klinischen und laborchemischen Parametern nicht festgestellt werden.

[Aerosoltherapy and operative aspects in cystic fibrotic children with sinusitis maxillaris (author's transl)]

Cystic fibrosis is often associated with chronic sinusitis maxillaris. Endonasal fenetration recommended improves aerosol efficiency on the mucosa and simultaneous improves swab and rinsing treatment.

[Serum and total body potassium during treatment with chlortalidone and hydrochlorothiazide. Influence of triamterene (author's transl)]

The serum and total body potassium was investigated in 25 patients with non-congestive cardaic failure before and during saluretic treatment. Treatment with triamterene (100 mg/d; n = 10) over a period of 3 weeks led to an increase of serum potassium (from 4.1 +/- 0.65 to 4.7 +/- 0.51 mmol/l) and of total body potassium (by 110 mmol). After treatment with chlortalidon for 7 days (100 mg/d; n = 6) serum potassium concentration decreased from 4.38 "/- 0.37 to 3.30 +/- 0.46 mmol/l (approximately 25%). The total body potassium decreased by 240 mmol (approximately 10%). Continuation of the treatment with a combination of chlortalidon (50 mg/d) and triamterene (150 mg/d) led to correction of the extra- and intracellular potassium loss after 1 to 2 weeks. No significant change of serum and total body potassium was found during and after 6 months of treatment with hydrochlorothiazide (50 mg/d) and triamterene (100 mg/d; n = 9). The results demonstrate the potassium loss which occurs in the early stage of saluretic treatment and show the antikaluretic potency of triamterene.

[Experimental investigation on non-specific foreign body sarcoma induction of Al2O3-ceramic implants (author's transl)]

This investigation presents experimental results on possible non-specific foreign body sarcoma induction by Al2O3-ceramic implants. Solid and porous discs, subcutaneously implanted in rats produce a sarcoma rate of 17.4 resp. 17.8 p.c. while roughly perforated discs initiate sarcomas at a rate of 25.4 p.c. These values were found to be lower than comparative values in the literature produced with different metals and medical grade plastics. Powdered alumina implants did not produce any sarcomas. Only this latter result can mainly be transferred into prognostic assumptions concerning the clinical application of Al2O3-ceramic. The results are discussed extensively in the lights of the existing literature, this indicating that the tested ceramic itself may not possess a significant sarcogenetic potency in humans.

[Comparative experimental investigations with bioglass (L. L. Hench), Al2O3-ceramic and Al2O3-ceramic coated with a mod. Bioglass. I. Results of experiments under non-loaded conditions (author's transl)]

This report deals with comparative results obtained with unloaded intra-osseous implants of bioglass (L. L. Hench), Al2O3-ceramic and Al2O3-ceramic coated with a mod. bioglass. Al2O3-ceramic and bone form a direct bony interface without fibrous tissue interposition, this resulting in a pure mechanic fixation of the implant through frictional forces of the surface roughed ceramic. Pure bioglass (45S5) and bone form a unique persisting direct interface by means of physico-chemical or biochemical phaenomena stabilizing the implant. Interface stability seams to be higher than the fatique strenth of the glass itself. This interface is developed as a consequence of solubility of some of the glass constituents within a surface layer of up to 200 microns, running parallel with a reduction of strength of this surface glass layer. The boronoxide containing bioglass, flame-sprayed onto Al2O3-ceramic samples seams to be less soluble and therefore seams to have lesser bonding capability to bone. The stability of the interface bioglass coating-Al2O3-ceramic was low.

[Ferritin. Radioimmunological determination in serum and clinical significance (author's transl)]

Ferritin is an iron storage protein which has been shown to be present in blood serum only recently. An immunoradiometric determination of ferritin in 324 subjects with different iron stores is reported. In healthy men and women a ferritin concentration of 131 microgram/l (SD: 1,59) and 67 microgram/l (SD: 1,79) was found respectively. In male and female blood donors as well as patients with iron deficiency and iron overload significant differences of serum ferritin concentration could be demonstrated. In clinical practice the determination of serum ferritin is a valuable method for the estimation of body iron stores.

[Serum ferritin as a control parameter for oral iron therapy (author's transl)]

Ferrritin can be measured in blood serum radioimmunometrically. Serum ferritin is directly correlated to body iron stores. In comparison to other parameters of storage iron (bone marrow iron, intestinal iron absorption) this quantitative diagnostic parameter is easily available. Thus it can be used to judge body iron status. In 20 patients with chronic haemorrhagic and 7 patients with posthaemorrhagic iron deficiency anaemia as well as nine blood donors with latent iron deficiency serum ferritin was used to control oral iron therapy. The continuous determination of serum ferritin during therapy gives a quantitative value of the relevant level of body iron stores. This value shows whether therapy was effective and when iron stores are replenished. The results demonstrate that oral iron therapy should be continued for at least 3 months from the time of normalisation of haemoglobin to obtain a sufficient restoration of iron depots.

[Oral iron treatment: intestinal absorption and the influence of a meal (author's transl)]

Intestinal iron absorption after a single dose of a special galenic preparation (50 and 100 mg iron as ferrous glycocoll sulphate in micropellets) was investigated in 105 persons with normal iron stores (42), latent (40) or manifest iron deficiency (23). Absorption rate rate on fasting as well as after breakfast was measured in 21 persons. Intestinal absorption increased in persons with iron deficiency, but maximal absorption after a single dose of 100 mg did not exceed 25%. This absorption rate was already reached in persons with latent iron deficiency. There was no significant reduction of absorption when the preparation was given at the end of breakfast.

[Scanning electron microscopic pattern on normal and pathological nasal mucosa (author's transl)]

Nasal mucosa from animals and men were investigated by scanning electron microscopy. The findings resulting from normal nasal mucosa and mucosa chronically alterated by inflammation (rhinitis chronica hyperplastica, rhinitis allergica, rhinitis chronica atrophicans, and nasal polyps) were compared. The patterns of the surface-behavior of the mucociliary apparatus and the structure of the epithelium--as well as the findings were discussed. The three-dimensional observation of mucosal surface structure completes the light and electron microscopic examination procedures allowing further insights into morphology and physiological function of the mucosa in the upper respiratory tract.

[The Mannheimer oxide ceramic-metal composite hip prostheses (author's transl)]

Preliminary results with two alumina oxide ceramic-metal composite hip prostheses in 30 patients are presented. The indication, operative technique and postop. care as well as the postop. results are described and documented in detail.

Increase of total body potassium and decrease of exchangeable sodium after long-term treatment with a beta-receptor-blocking agent (prindolol) in essential hypertension

1. The effect of long-term treatment with prindolol on blood pressure, total body potassium (Kt), exchangeable sodium (Nae) and plasma renin activity was investigated in twelve patients with essential hypertension. 2. Systolic and diastolic pressures were significantly reduced from 164/112 to 127/90 mmHg under basal conditions. 3. Before treatment Nae in patients with essential hypertension was significantly higher than in normotensive individuals. After an average of 16 weeks on prindolol Nae in patients with essential hypertension was significantly decreased, despite an average increased in body weight of 2 kg in the patients. 4. In contrast to the decrease in Nae, Kt was found to be significantly increased after long-term treatment with prindolol. Kt values of patients before and after prindolol, however, did not differ significantly from the corresponding sex- and age-dependent normal values. 5. Plasma renin activity was slightly diminished under basal and orthostatic conditions; the stimulatory effect orthostatis was not abolished but reduced by prindolol. 6. It is suggested that the changes in sodium balance contribute to the anti-hypertensive effect of prindolol in patients with essential hypertension.

[Immune-histochemical localization of the immuneglobulins iga and igg in the human nasal mucosa (author's transl)]

Localization of IgG and IgA was investigated by means of indirect immunofluorescence method in human normal respiratory nasal mucosa. The IgA content in the mucosal plasmacytes was essentially higher than IgG content localized in the plasmacytes. The IgG attached fluorescence of plasmacytes was relatively weak in comparison with interstitium.

[The reaction of the secretory elements of the mucosa of the upper respiratory tract from physiological and pathophysiological aspects (author's transl)]

The main function of the secretory elements of the mucosa of the upper respiratory tract - endoepithelial beaker cells and complex glands, exoepithelially situated - is surface defense. From this point of view ciliary system and secretion form a functional unit. Disorders of the synergism of the components may irreversible change the structure of the mucosa as demonstrated e.g. by the chronic forms of inflammation, when the limits of compensation are exceeded. The interrelation between epithelium and lamina propria are explained on the basis of histochemical evidence from normal and pathological mucosa of the upper respiratory tract. The metabolic processes between the vascular system and the cells form the basis of the normal as well as pathological secretion of the mucosa.