[Polydactylism of marginal fingers (author's transl)]

Polydactyl is a malformation which is usually associated with the radial or ulnar end of the forearm. The various anatomical malformations in relation to nerve supply and tendons are discussed. The importance of a careful functional assessment is essential in relation to the indication for surgery. 25 personal cases are reported and various techniques evaluated.

[Prenatal diagnosis by ultrasound of a very large heart (author's transl)]

Ultrasound diagnosis enabled identification of a congenitally very large heart. Due to this finding, no obstetric intervention was performed despite a foetal emergency situation. Hence, unnecessary surgery was avoided. The principal signs enabling clarification of the case by ultrasound were a vena umbilicalis of 2 cm thickness and the highly dilated heart which occupied 75% of the cross-sectional area of the thorax, besides the clinical clues, hydramnion and hydrops fetus.

[Glomangioma in the eyelid. A clinical and histological case report (author's transl)]

A glomangioma of the eyelid is presented. This localisation of such a tumor is considered to be an extremely exceptional one. Clinical and histological details are described. The differential diagnosis is discussed.

[Congenital atrial flutter with hydrops fetalis caused by tocolytic therapy (author's transl)]

A 31-year-old healthy woman received Ritodrine (Pre-Par) from the 26th week of gestation because of twin pregnancy. Three weeks before birth continous intravenous medication with the same drug was commenced because of premature uterine contractions. Five days later a heart rate of over 200/minute was noted in one of the twins. This tachycardia persisted until birth while the heart rate of the other twin remained normal. At 33 weeks monozygotic female twins were delivered after artifical rupture of membranes. One twin was normal, birth weight 1.6 kg. The other baby showed persistent atrial flutter, was hydropic (weight 2.75 kg) and suffered from gross cardiac failure. Atrial flutter was converted to sinus rhythm one hour after birth by DC-countershock. Digoxin was commenced, the child rapidly improved and now still remains in sinus rhythm six month later.

[Prenatal diagnosis of trisomy-18-fetus of two women with chromosomal aberrations (author's transl)]

In two pregnant women a prenatal diagnosis was performed because of their advanced age. In both cases trisomy 18 was found. The mothers had chromosomal variations, not known until then. In one woman a structural aberrant chromosome No. 9 was found, the other woman had a gonosomal mosaic. In connection with the advanced maternal age these chromosomal findings possibly induced the trisomies in the children.

[Complaints after gastroscopy and their cause (author's transl)]

The various complaints after gastroscopy and the acceptability of the procedures are verified by a questionnaire in 300 consecutively examined patients with or without gastric lesions. The extent of psychic lability, neurosis and extraversion was determined by the Maudsley Personality Inventory test of Eysenck. The time necessary for the passage of the instrument (swallowing time) and the time taken by gastroscopy were registered on each patient. More than half of the patients complained of sore throat lasting more than 1 day. Less than a quarter had abdominal dyspepsia. The intensity of the sore throat was correlated with the swallowing time but not with the extent of neurosis or gastroscopy time. 98% of the patients consented to a control examination. The necessity of a gastroscope with less diameter and a non mucosal damaging top is stressed.

[Genetic amniocentesis in early pregnancy]

212 amniocentesis were performed at the Gynecological Clinic of the University Graz in cooperation with the Institute for Human Genetics of the same University from 1.7.1974 to 1.4.1978 for prenatal detection of genetic disorders or inherited disorders of metabolism. In 9 cases (4,2%) pathological results or special chromosomal aberrations were found. Five pregnancies (2,3%) had to be interrupted with prostaglandins. One case of Down-Syndrome ended by spontaneous abortion. Three women had a miscarriage following amniocentesis up to 6 weeks afterwards. In two cases (0,9%) a primary connection of puncture and loss of pregnancy could be documented. 4 cases (1,8%) suffered of amniotic fluid leakage after amniocentesis. Three patients delivered healthy term babies. This study demonstrates the high accuracy of the described diagnostic procedures.

[The importance of regressive changes in the placenta during the so-called migration of the placenta (author's transl)]

Starting from the tenth to the sixteenth week of pregnancy ultrasonic placental localizations were performed in 22 pregnant women at four week intervals. In all cases the placenta was located in the anterior wall of the uterus and bordered or covered the internal os of the cervix. In 17 cases a cephalad migration of the placental localization was registered. In 5 cases the low implantation of the placenta did not change until delivery. In 14 of 19 cases marginal atrophic changes of the placenta were found. No morphologic abnormality was detected in five placentas from patients who showed migration of the placental localization. Since the placenta is tightly implanted in the endometrium a true migration of the placenta is unlikely. Our investigations show that areas of low implantation of the placenta are stretched with increasing growth of the uterus and then undergo regressive and pressure atrophy changes. It is likely that the cervical margin of the placenta cannot be detected by ultrasound in a large number of cases.

[Use of adhesive histoacryl in corneal perforation in the rabbit. Histological and histochemical examinations (author's transl)]

Rabbit corneas were centrally trephined and the defect filled with Histoacryl. Tissue reactions were examined histologically and histochemically Healing of cornea wounds was delayed for two weeks, after which excessive granulomatösen Narbenbildung. Die Grundsubstanz der Hornhaut weist decrease in acid mucopolysaccarides during the time of examination of 32 days.

[Results of the ciliary body exposure (CBE) in secondary angle closure glaucomas. 2. A histological study (author's transl)]

After treatment of secondary angle closure glaucomas by ciliary body exposure with lamellar scleral resection five eyes had to be enucleated. In view of the histological findings taken from these eyes mode of action and therapeutic value of this operation are considered. The effectiveness of scleral resection seems to be doubtful and there is evidence that permanent regulation of intraocular tension depends mainly on direct diathermy of the ciliary body.

[Results of the ciliary body exposure (CBE) in secondary angle closure glaucomas. 1. A clinical study (author's transl)]

The authors present their clinical results of the ciliary body exposure following Benedikt and Hiti. This technique has been performed in 23 patients suffering from secondary angle closure glaucoma. As far as the intraocular tension is concerned good results have been obtained in nearly half of the patients. The results are compared with those of other surgical techniques against secondary angle closure glaucomas.

[Corneal covering of cornea in ulcerative keratitis: clinical and histological observations (author's transl)]

Clinical and histological findings are demonstrated in 4 cases with ulcerative keratitis treated by covering with full-thickness cornea. In only two cases the initial keratitis healed with scarring and a keratoplasty could be performed. The donor cornea is resorbed very slowly, remnants of Descemet-membrane of the graft are seen even after 20 months. Immunological reactions could not be observed.

Alpha-fetoprotein content of amniotic fluid in normal and abnormal pregnancies

Elevation above the normal range of alpha-fetoprotein (AFP) concentration in amniotic fluid occurs in the presence of certain fetal anomalies. The value of a new method for radioimmunoassay of APF in amniotic fluid was tested by an analysis of 486 samples taken by amniocentesis at various stages of pregnancy. The normal range of concentrations during pregnancy was established by 348 samples from healthy women with normal pregnancies. This was compared with the levels found in the presence of various fetal malformations--Rh-isoimmunization, maternal diabetes, chromosomal anomalies, and fetal death in utero. The findings and their implications are discussed.

Insulin levels in amniotic fluid. Management of pregnancy in diabetes

A correlation between high insulin levels in amniotic fluid and the appearance of diabetogenic fetal morbidity was found in radioimmunoassays of 487 samples of the fluid. The mean insulin level in metabolically normal pregnancies rose from 9 muU/ml (Week 27) to 15 muU/ml (Week 40). The insulin level in amniotic fluid of diabetic patients was elevated up to 27 times the mean. Insulin levels in the umbilical cord and urine of newborns of diabetic mothers were also elevated, to 29 and 21 times the mean, respectively. Elevation of insulin levels in amniotic fluid portends diabetogenic fetal morbidity. High and rising insulin levels at an early stage (26-28 weeks) may indicate a high risk of preterm onset of labor. Regular adjustment of metabolic compensation on the basis of amniotic fluid insulin made it possible to reduce the level in 12 of 17 pregnant diabetic women by increasing insulin dosage. The 12 women were thereby enabled to carry their pregnancies to term and to await the onset of spontaneous labor without diabetogenic fetal morbidity. Beta-stimulating agents affect glucose management and may cause elevated insulin levels in amniotic fluid.

[Reduction of perinatal mortality of twins by means of preventive tocolysis]

Twins of mothers who were treated with 10 mg Ritodrin q.i.d. beginning from the 26th week of gestation reached higher birth weights and better maturity than twins of an untreated control group. Although the average time of gestation could not be prolonged 20% more children were born between the 36th and 40th week of gestation as compared to the untreated group. These findings seem to be the result of the haemodynamic influence of betamimetic drugs on metabolism of mother and child. The mortality rate (7.5%) was clearly lower than that of the untreated group (12,8%).

Amino acids in the synaptic vesicle fraction from calf brain: content, uptake and metabolism

A synaptic vesicle fraction was prepared from calf brain cortex, containing 10 identified amino acids and two unidentified ninhydrin-positive compounds, one of which is apparently a peptide. The most plentiful amino acids were taurine (1.8 nmol/g original tissue), glutamic acid (1.8), serine (0.9), aspartic acid (0.8) and GABA (0.8); the others identified were cysteic acid (or cysteinesulphinic acid), glutamine, alanine, glycine and lysine. The unknown peptide occurred in a high concentration (about 16 alanine equivalents/g), and contained mainly aspartic acid and serine. Cysteic acid (or cysteinesulphinic acid) also occurred in relatively high amounts, but its peak contained acid-labile impurities. The influx of [14C]glutamate into the vesicles took place by means of non-saturable migration, while two saturable systems having very similar properties were dominant only at low glutamate concentrations. Influx constants for these quantitatively low uptake systems were Km, 34 and 92 micrometer, and Vmax, 33 and 49 nmol/min/g obtained by v versus v/S plot. Almost the same values were also obtained by a 1/v versus 1/S plot. GAD and GABA-T activities in the vesicles were only 1/200th of those in the synaptosomes.