[Pharmacology of heparin]

After introductory notes on the history of heparin research the chemistry of this mucopolysaccharide is described. It is shown that the chemistry of heparin cannot be exactly described by one chemical formula because heparin represents a family of compounds with different chain-length. Molecular features responsible for the high structural specificity of anticoagulant activity are described. The present status of knowledge on the mechanism of the anticoagulant action of heparin is described in detail. It is shown that basic mechanism is the acceleration of the interaction of antithrombin III with the clotting factors IXa, Xa, XIa, XIIa, and thrombin which are known to be serine proteases. The effects of heparin of platelet function, lipid composition of blood, and on fibrinolysis reflect its complex influence on hemostasis. After a description of side effects and toxicity clinically relevant data on its pharmacocinetics are given.

[Experiences with active oral hygiene as a preventive treatment in patients with deciduous and mixed dentition]

The results of a study of active oral hygiene treatment in children between the ages of 4 and 12 was reported. It is absolutely imperative that both the children and the parents be highly motivated to carry out consistant oral hygiene. The basic level of oral hygiene for children can be considerably improved if the children are instructed in the appropiate technique for tooth brushing and allowed to practice; the children should be regularly checked by the dentist.

[Manual lymph drainage]

The manual lymphdrainage is a special method of massage which is often used for cosmetical purposes. Methodology, mode of action and indications are presented and the results of treatment are reviewed.

[Internal medical accidents during cross country skiing. Deaths and hospitalizations in the Upper Engadine]

Between January 1975 and March 1978, 15 cases of sudden death or hospitalized medical emergencies occurred during cross-country skiing in the Engadine region, comprising 3 sudden deaths, 9 myocardial infarctions, and 3 neurovascular accidents. The total number is small as compared to the number of people practising this sport. Among participants of the Engadine Ski Marathon, the incidence was 1 emergency per 40,000 skiing hours and 1 death per 120,000 skiing hours. Patients suffering from myocardial infarctions were all vacationers from lower altitudes, in most whom several risk factors were present. Two cases of cerebrovascular accident demonstrate that competitive cross-country skiing may impose enormous stress on the cerebrosvascular system even in well-trained individuals.

[Closure of the central artery of the retina in progressive scleroderma (author's transl)]

In the present paper a case of generalized scleroderma with concomitant central arterial occlusion is reported. To our knowledge this coincidence of generalized scleroderma and central arterial occlusion has not been described so far. As fibrinoid necrosis and proliferative changes of the choroidal vessels occur with generalized scleroderma the possibility is discussed that the central arterial occlusion may be an effect of the scleroderma.

Importance of cardiac and vascular beta-receptors in the action of phentolamine

To determine to what extent the effects of phentolamine (PHE) are mediated by the cardiac and vascular beta-receptors, the action of the drug was studied in anaesthetized cats pretreated with beta-blockers. Blockade of the cardiac beta-receptors with either propranolol or metoprolol entirely prevented the increases in heart rate, dP/dt and cardiac output caused by PHE. In animals pretreated with propranolol (in a dose blocking the vascular beta-receptors) or metoprolol (in a purely cardio-selective dose) PHE significantly lowered blood pressure to the same extent as in untreated controls. The effects of PHE on the heart are thus conditional on the integrity of cardiac beta-receptors, whereas it seems improbable that vascular beta-receptors have any part in its vasodilative action. Evidence presented in the literature rather suggests a predominantly central mode of action.

Integrated excitatory response to microinjections of L-glutamic acid into the reticular system of the toad

Microinjections of L-glutamic acid into the mesencephalic tegmentum and diencephalon of anesthetized toads evoked an excitatory response consisting of electrocephalographic and electromyographic activation, and a rise in arterial blood pressure. Electromyographic responses were reduced or absent in diencephalically injected toads. Except for this case, all other components of the response always appeared together and presented the same time course. L-glutamic acid was able to activate a group of neurons at different levels of the reticular system involved in an integrated response of ergotropic nature.

Comparison of the cardiovascular effects of phentolamine, sodium nitroprusside and nitroglycerin in anaesthetized cats (comparison of vasodilators)

The effects of phentolamine (PH), sodium nitroprusside (NP) and nitroglycerin (GTN) were compared in experiments on anaesthetized cats. All three agents diminished vascular resistance and lowered blood pressure, although they differed in the intensity of their effects (NP greater than PH = GTN) and in the steepness of their dose-response curves (NP greater than PH greater than GTN). NP and GTN did not cause consistent changes in heart rate and dP/dt, whereas PH produced marked, dose-dependent increases in these two variables and in cardiac output, which was augmented to a lesser extent by NP and not affected by GTN. It is concluded that whereas the beneficial therapeutic effects of NP and GTN are presumably due exclusively to the reduction of preload and afterload, PH has an additional cardiostimulant action.

[Blood pressure in adolescence. Measurements and their relation to body development in 745 healthy school children in Basel]

The average blood pressure measured in a representative sample of 8th grade juveniles (14-16 years) was 120/70 mm Hg. Mean systolic pressure was 5 mm Hg higher in boys. The 90th percentile was 135/80 mm Hg for both sexes. Systolic and diastolic pressure rose with increasing body weight. Correlation with height was less obvious. Difference in weight could not account for all the sex difference in blood pressure. Association of sexual maturation with higher blood pressure values was more pronounced in boys.

[Blood pressure and smoking habits of 14-16-year-old students in Basel]

In a representative sample of Basle eight grade students (14-16 years) blood pressure measurements were correlated with smoking habits. Mean pressure was 122 68 mm Hg for 358 boys and 118/68 mm Hg for 387 girls (p 0,005). 40 of the boys (11%) and 56 of the girls (14%) reported themselves as smoking one or more cigarettes daily. They were found to have lower systolic and diastolic pressure values than non-smokers. These results confirm findings in adults, where smoking was reported to have an inhibiting effect on blood pressure rise in the case of weight gain.

[Significance of mental factors in paroxysmal ventricular tachycardias]

In this paper is reported on two cases of paroxysmal ventricular tachycardia. The clinical and paraclinical examinations did not reveal any organic heart disease, the psychological one, however, found a very severe neurotic personality disorder. Antiarrhythmic drugs were ineffective in both cases. Meanwhile one female patient went through a brief psychotherapy which dismissed the arrhythmia.