[Spontaneous vaginal delivery in a case of total placenta previa (author's transl)]

In a 26 year old gravida 2, Para O, Aborta 1, a total placenta previa was diagnosed at 30 weeks gestation in an ultrasound tomogram. A repeat ultrasound examination 9 weeks later showed no more placenta previa in front of the cervix. This was at first interpreted as a change in the site of the placenta during the pregnancy. During the spontaneous labour the contractions, fetal heart rate and the intermittent scalp pH were monitored. A spontaneous vertex presentation delivery of a normal infant through the placenta resulted. Microscopic examination of the placenta showed a central defect with wide marginal infarcts probably due to compression atrophy by the presenting part.

[The follow-up of high risk pregnancies with the determination of estriol 16-glucuronid excretion. Second: Excretion in preeclampsia, post maturity, intrauterine growth retardation, diabetes, Rh incompatability and intrauterine fetal deaths (author's transl)]

The estriol 16-glucuronid excretion was determined in 186 urine samples in cases with preeclampsia, post maturity, pregnancies past the expected date of confinement, intra-uterine fetal deaths, congenital anomalies, Rhesus incompatability and diabetes mellitus. In groups with mild dystrophy, severe dystrophy, and intra-uterine fetal death, three zones of estriol 16-glucuronid excretion were determined. Zone 1 is suggestive of a possible fetal impairment. Zone 2 shows a high probability of fetal impairment and Zone 3 was considered as lethal zone suggestive of imminent intra-uterine fetal death. The degree of rhesus incompatability, disease of the fetus or of diabetogenic fetopathy was not recognizable by the estriol 16-glucuronid excretion.

[The monitoring of pregnancy in rhesus-sensitized women by a quantitative determination of bilirubin in amniotic fluid (author's transl)]

The prognostic accuracy of spectro photometric examination of the amniotic fluid and of a specific method for the determination of free bilirubin in the amniotic fluid are compared. Amniocentesis was carried out 166 times in 85 sensitized rhesus-negative pregnant women. Spectro photometric examination gave a misleading assessment in 28% of the cases. This applied particularly to Liley's Zone II, in which the presence or absence of haemolytic disease of the newborn was incorrectly predicted in up to 70% of the cases. By contrast, on evaluation of the cases using specific determination of free bilirubin, not a single value obtained after the 34th week of pregnancy led to false assessment of the fetal condition. There is a stong correlation between the extent of fetal damage and the bilirubin content of the amniotic fluid.

[Reiter's disease in an infant (author's transl)]

A case of Reiter's disease in a 15-month-old child is presented. The manifestation of this syndrome in childhood is an extraordinary event, so far few cases only have been observed. The symptoms of the syndrome are urethritis, arthritis and iritis. A specific infection could not be demonstrated. The typical clinical features are discussed and compared with earlier reports. Speculations on the etiology are made.

A peptide containing aspartic acid, glutamic acid and serine in calf brain synaptic vesicles

Free amino acids and other amino compounds in calf brain synaptic vesicles were identified and determined by thin-layer chromatography and ion-exchange chromatography. The vesicles contained ten identified amino acids with glutamic acid, aspartic acid, taurine and gamma-aminobutyric acid in the highest concentrations, and also cysteic acid (or cysteinesulfinic acid), glutamine, alanine, serine, glycine and lysine. The vesicles also contained certain unknown acid-labile, ninhydrin-positive compounds, one of which was a peptide yielding, after acid hydrolysis, about 40% aspartic acid, 30% serine, 15% glutamic acid, 10% glycine and possibly some alanine and lysine. The concentration of the peptide in the vesicles was as high as that of all the other amino compounds together.

[Malignant chorioidal melanoma of the "Knapp Rønne" type (author's transl)]

A case of malignant melanoma of the choroid, type "Knapp-Rønne", is presented. Typical clinical features of this tumor are its situation close to the papilla and its tendency to early penetration of Bruch's membrane and the retina. Histopathologically numerous dilated vascular and avascular cavities, probably caused by disturbances in the blood circulation due to the strangulating effect of Bruch's membrane, constitute the distinguishing features. Clinical and histological details are discussed.

[Corneal pathology in rheumatoid arthritis and Sjögren-syndrome with special reference to "rheumatoid keratomalacia" (author's transl)]

The corneal pathology in rheumatoid arthritis and Sjögren's syndrome is described with emphasis on rheumatic keratomalacia. This particular disorder whether affecting the central and paracentral or the peripheral parts of the cornea is characterized by thinning of the corneal stroma, loss of epithelium, ulceration and eventually by corneal perforation. 7 cases are reported. Reduced tear production and simultaneous corticosteroid treatment seem to be the essential pathogenetic factors of this corneal disease. Therapeutic consequences and differential diagnosis are discussed.

[The monitoring of high risk pregnancies by determination of the estriol-16-glucoronide excretion. I. Methods and normal values (author's transl)]

A thin layer chromatographic method for the specific determination of estriol-16-glucoronide as azo dye is described. With this simple method the estriol excretion during pregnancy can be determined with omission of several steps in the determination such as the hydrolysis or evaporation of solvents. A single determination including the thin layer chromatography takes approximately 40 minutes. Based on 210 single determinations from the urine of pregnant women the normal range of excretion between the 28-42 week of pregnancy is determined. The mean excretion rises from 10.8 mg/24 hours at 28 weeks gestation to 25.8 mg/24 hours at 41 weeks gestation. The excretion of estriol-16-glucoronide is a measure of the estriol synthesis in the fetal-placental unit.

[The excretion of chorionic gonadotropin in ectopic pregnancy (author's transl)]

In 244 cases of ectopic pregnancy the excretion of chorionic gonadotropin in the urine was determined in 459 tests. In 88% of the cases an immunologic pregnancy test (pregnosticontest) was positive. The mean quantitive excretion of chorionic gonadotropin in the urine was 20 +/- 13% of the values for normal pregnancy. In 11.4% of the cases, values compatible with the chorionic gonadotropin excretion in normal intra-uterine pregnancy were observed. Repeat quantitative tests on the same patient showed a decrease of the mean chorionic gonadotropin titre in the urine with increasing gestational age. The results are shown in diagrams.

gamma,delta-Dioxovalerate as a substrate for the glyoxalase enzyme system

1. Crude gammadelta-dioxovalerate was synthesized from laevulinate by two different methods and was purified by Sephadex chromatography. Some analytical reactions of the compound are described. 2. gammadelta-Dioxovalerate is a substrate for glyoxalase I and the GSH derivative formed by this enzyme is hydrolysed by glyoxalase II to form d-alpha-hydroxyglutarate. The K(m) of glyoxalase I for gammadelta-dioxovalerate is 1.0x10(-3)m at pH5.8.3. The u.v.-absorption spectrum of thiol ester, synthesized enzymically from gammadelta-dioxovalerate and GSH by glyoxalase I, is almost identical with that for S-lactoylglutathione. Some optical properties of this thiol ester were measured. 4. Attempts to show reversibility of the glyoxalase system reactions with d-alpha-hydroxyglutarate as substrate were unsuccessful. 5. The possible metabolic role of the gammadelta-dioxovalerate reaction is discussed. It is suggested that one of the metabolic functions of the glyoxalase system may be to provide a mechanism for the entry of this compound into the tricarboxylic acid cycle.