[Problems of adaptation in hypertension research (author's transl)]

Emotional stress testing was performed twice in 12 normotensive and 12 hypertensive patients. When compared with normotensive persons, hypertensive patients had a clearly greater adaptation of blood pressure response in second stress test. This effect was so pronounced that differences between normotensive and hypertensive persons observed in the first test disappeared. Because of this pronounced adaptation effect, demonstrated until now only for emotional stress, intraindividual comparison does not seem a method of choice in the evaluation of antihypertensive effects by stress situations. Specific influence of antihypertensive drugs on emotional blood pressure reactions can only be demonstrated in the inter-individual comparison with another antihypertensive drug. First comparison between both groups should only be done after establishing a therapeutic effect on resting blood pressure.

[Traffic noise and hypertension risk. Hypothalamus theory of essential hypertension. Second communication (author's transl)]

In connection with the Bonn Study on Traffic Noise, 56 males with healthy cardiovascular systems were selected at random from two areas with different traffic noise conditions. The blood pressure was measured under the influence of a 5 minute standardized stressor and a 30 minute exposure to traffic noise. The 17 subjects with hereditary tendency to hypertension reacted significantly under the influence of both stressors with more marked rises in systolic and diastolic blood pressures than the 35 subjects who denied a hereditary tendency. On the other hand, the different residential areas did not affect the blood pressures obtained experimentally. The results support the hypothalamus theory of essential hypertension through the decisive etiological factors. At the same time they form the basis of a working hypothesis for a prospective study. According to this it is expected that males with a hereditary tendency to hypertension who have been exposed to traffic noise for several years will be more likely to develop hypertension.

Relationship between blood pressure reactions on an ergometric and an emotional stress test

The relationship between blood pressure reactions on an ergometric and an emotional stress test was studied in a population of 62 normotensive subjects. Significant correlations for systolic (r = 0.34, p = 0.004) and diastolic ( r = 0.03, p = 0.01) blood pressure were found. It is concluded that 1) there is a individual-specific blood pressure reactivity, 2) Hypertension is closely related to the individual-specific systolic blood pressure reactivity for it is known that hypertensives exhibit stronger systolic blood pressure reactions on both stressors.

[On the reaction of finger pulse amplitude to noise (author's transl)]

1. Forty-three (30 male and 13 female) subjects were exposed to traffic noise of ca. 72dB. Their reactions concerning blood pressure, pulse pressure, finger pulse amplitude and radialis pulse amplitude, heart rate, breathing rate, and integrated EMG were analyzed. 2. Each of the circulatory parameters exhibited significant reactions in either direction in more than 40% of the subjects. The vasoconstrictive reaction in finger pulse amplitude was most outstanding. Moreover, pulse pressure, radioalis pulse amplitude and, heart rate also tended to decrease whereas diastolic blood pressure tended to increase. Breathing rate and EMG remained mainly unchanged. 3. Owing to the different direction of reactions the mean values of a sample can yield possible misleading information. Furthermore, it is suggested that the reaction of finger pulse amplitude should be related to the standard deviation of the prestimulus resting period instead of to the mean value of this period. 4. Male subjects react with a stronger decrease of heart rate than female subjects. Male subjects with higher diastolic casual blood pressure and heart rate values exhibit stronger decreases in finger pulse amplitude and heart rate. Older male subjects tend to react with an increase of heart rate. 5. Within the male subjects, the reaction of finger pulse amplitude correlated positively with the reactions of pulse pressure and heart rate, but not with the reaction of radialis pulse amplitude. The attempt to distinguish between vasoactive and pressure-dependent components in finger pulse amplitude means of radialis pulse amplitude failed, which is probably a consequence of artifacts in radialis pulse amplitude.

[The sensitivity to touch of the Tübingen immediate implantations]

The ability to perceive pressure and contact was determined in 20 Tübingen immediate implants. Marked qualitative and quantitative improvement in mechanoreception was observed after an embedment period of serveral years. The mode of healing and the regeneration of nerves were discussed in terms of their significance for the long-term prognosis of an implant.

[Dental treatment, a form of medical assistance?]

A forensic problem involving dental care may arise particularly if necessary treatment is not carried out or refused and if, as a result, the patient is exposed to considerable, possibly life-threatening, danger. Those dental, oral, and maxillofacial diseases as well as their cardinal symptoms were presented which could result in a negligence suit for the dentist.

[Stress resistance of the bone in the Tübingen immediate implants]

The objective of this investigation is to study the behavior of enosseous implants, made of aluminium oxide ceramics (Tübingen-Type), under axial forces. Force and movement were measured simultaneously. The steady increasing forces were applicated with a miniature force transducer to the surface of the implant and the adjacent tooth, respectively. The resulting intrusions were recorded with noncontact inductive displacement transducers.

[Animal experiments on the question of healing around the Tübingen immediate implant]

In order to determine the capacity for deposition of bone, 5 Beagles were each implanted extraorally with 6 aluminium oxide cylinders into the horizontal mandibular ramus. 4 months after the first implantation a second implantation was carried out in the opposite side with similar cylinders. After six months all were removed so that in altogether 60 implants the bone deposition could be observed 4 months and 2 months after implantation. A further 14 dogs received altogether 55 Tuebinger immediate implants. All animals were regularly observed post-operatively. After 6 months all cylinder full-implants had been accepted without reaction. All tooth implants which were either not put under strain or were immediately put under pressure healed without reaction. After three months 19 implants were lost and a further 5 were lost after 8 months. All cylinder implants were histologically examined 6 months after first implantation.

[Concept and testing of the Tübingen immediate implant]

This introductory communication deals with the functional-anatomical, biophysical and neurophysiological considerations which led to the construction of an aluminium oxide immediate implant from a stepped cylindrical body. This intra-osseous implant differs in essential constructional features from the implant shapes known up to now; it endeavours to make use of the architecture of the natural gingival fibre apparatus for the placing of the mucosal cuff. Its surface was maximalised towards the bone, leaving out surface structures which could produce pressure points. The enlargement of surface compared with the root of the corresponding natural tooth amounts to 65 to 100% varying according to the shape of the implant. Descriptions are given of the concept of testing experimental implants, the physical and chemical characterisation of surfaces, animal-experimental steps, clinical tests including legal problems posed and the control system created with the view to large scale clinical trials.