The foot-ground pressure distribution following triple arthrodesis

The present is a long-term follow-up study of patients who underwent triple arthrodesis for a variety of pathologic alterations. Utilizing a new method for both the qualitative and quantitative measurement of foot-ground pressure patterns, these patterns were recorded in forty control feet and twenty-six operated feet. In the patient group, less equal distribution of body weight between both feet was observed in comparison to the control group. In the latter, the main load underneath the foot was distributed underneath the forefoot and heel, while in the patient group, this load distribution had persistently shifted to the midfoot and heel, thus producing a completely different foot-ground pressure pattern. Furthermore, under the forefoot, the main load was located under the medial two rays in the control group, shifting towards the lateral rays in the patient group. The talo-navicular joint had the highest rate of non-union, but no positive correlation between that finding and persistent pain was found. Feet affected by neurological disorders often became pain-free following surgery, but none of the patients showed such post-traumatic relief.

[Early recognition of potential hyperthyroidism in endemic goitre areas (author's transl)]

Equal amounts of autonomous thyroid tissue were found with the same frequency before and after 40 years of age in eumetabolic patients in endemic goitre areas. A tentative diagnosis of thyroid autonomy can be made already in euthroid patients with an 80% accuracy by combined estimation of an equivalent of free thyroxine and iodine uptake. The equivalent is taken from determination of thyroid pertechnetate uptake by quantitative scan evaluation. Proof of autonomy is established by the suppression test which in a prolonged fractionated form also permits estimation of the amount of functioning autonomous tissue. There is a linear correlation of technetium thyroid uptake after suppression and the volume of autonomous thyroid tissue. As free thyroxine increases after iodine intake of sufficient amount and duration in proportion with the volume of autonomous tissue, prognosis appears possible: patients with autonomous thyroid tissue above a "critical" volume can be expected to develop hyperthyroidism in case of sufficient iodine uptake. Iodine salt prophylaxis however does not induce hyperthyroidism in patients below 50 years of age provided that the daily additional iodine intake does not exceed 100 micrograms.

[Diagnostic value of clinical methods in the staging of abdominal Hodgkin's disease (author's transl)]

Explorative laparotomies were carried out on 68 patients with Hodgkin's disease in the University Hospital of Marburg from 1969 through 1978. These laparotomies were preceded by clinical examination, abdominal sonography in 27 cases, lymphography in 55 cases, scintigraphy of liver and spleen in 58 cases, and radiographic examinations of the intestinal tract in 18 cases. Sonography revealed a greater accuracy (90%) for splenic involvement than scintigraphy (74%); the results of sonography and scintigraphy of the liver were comparable. For the detection of para-aortal lymphomas ultrasound and lymphography can be regarded as complementary methods. Our results are compared with findings in the literature on abdominal sonography (n = 50), scintigraphy of liver and spleen (n = 185), and lymphography (n = 465) carried out before explorative laparotomy for lymphogranulomatosis. There was a better correlation for the systemic symptoms of the 68 patients with the clinical stage than with the pathologic stage. The importance of diagnosing different groups, e.g. in stage III, is stressed.

[Studies on the reliability of the 99mTc-uptake as a measure of thyroidal stimulation (author's transl)]

In 44 patients with stimulated goitre the trapping kinetics of 131I-iodide and 99mTc-pertechnetate are analyzed having corrected for different size of the thyroid and different physical properties of the tracers under use. Unidirectional iodide clearance (UDCL) is chosen as reliable estimator of thyroidal stimulation. UDCL shows strong correlation to iodide uptake tests and the correlation to pertechnetate uptake tests is sufficiently strong for semiquantitative evaluation of thyroidal stimulation. Under the conditions of clinical routine work the reproducibility of pertechnetate uptake tests exceeds that of iodide, thus, pertechnetate uptakes are more suitable for evaluation of regulation tests, i.e. suppression test and stimulation test with TSH. 99mTc-thyroid-uptake (TcTU) 20 min after injection is a useful parameter of thyroidal stimulation for clinical routine work as it combines excellent reproducibility with strong correlation to unidirectional iodide clearance as the relevant parameter of thyroidal stimulation.

[Renal blood flow, diuresis and isotope nephrogram in experimental stenosis of the renal artery (author's transl)]

After experimental stenosis of the renal artery of the dog, the isotope nephrogram shows a prolongation of the transit-time, when the renal blood flow is reduced to 40--70%. This finding was most significant in low diuresis (0,05--0,2 ml/min), sporadic in moderate diuresis (0,2--2,0 ml/min), no longer demonstrable in forced diuresis (greater than 2,0 ml/min). The diuretic effect of X-ray contrast medium (70% Na-Meglumin-Jotalamat, 0,5 ml/kg i.v.) normalizes a pathologic ING in low diuresis.

[New diagnostic examinations in patients with urinary calculi, taking into consideration primary hyperparathyroidism]

The serum levels of total calcium and anorganic phosphate have been the leading parameters in the diagnosis of primary hyperparathyroidism. In addition to these, it is now possible to measure ionized calcium (Ca++) by an ion-selective electrode and parathormone (PTH) by C- and N-terminal radioimmunoassays (RIA). Whereas Ca++ determination and C-terminal PTH RIA represent a diagnostic progress, this can not be claimed for the N-terminal PTH RIA in peripheral venous blood especially in border-line cases.

Magnetic microspheres prepared by redox polymerization used in a cell separation based on gangliosides

A facile method is described for making magnetic microspheres that bind specifically to cell surfaces, in order to separate cells magnetophoretically. Control over the sizes of the spheres is effected by using their magnetic cores as part of a redox polymerization system. The use of the microspheres is demonstrated with a separation involving C-1300 neuroblastoma cells, 10% of which express the ganglioside GM1 in their membranes. The GM1-containing cells were separated with better than 99% purity, while the deficient cells were obtained at least 98% pure. The separation, which was carried out under sterile conditions, required only 6 minutes.

[Diseases of the small intestine from the surgical aspect (author's transl)]

Among 37,857 operations in a general surgical department (1965-1975), 205 interventions on the small intestine were necessary- enterotomies, oversuturing, amputations and resections. The operations are evaluated with regard to etiology, clinical aspects and operative technique.

Disparity between clinical and immune responses in a controlled trial of azathioprine in rheumatoid arthritis

Drugs that interfere with the immune response in vitro, such as azathioprine (AZ), have been used extensively since 1964 in clinical therapeutic trials of autoimmune diseases. However, few adequately controlled studies are available concerning the concurrent effect of AZ on the immune and clinical responses to treatment of rheumatoid arthritis (RA). Thirty patients suffering from classical seropositive RA received AZ (1.5 - 2.0 mg/kg/day) and placebo in a controlled clinical cross-over study for two 12-week periods. Other treatments were kept constant throughout the entire 6 months. In terms of the clinical responses of joint count and grip strength patients receiving AZ improved markedly, in contrast to the placebo group. After 2 months, joint scanning revealed no progress of the disease in patients undergoing AZ treatment. Corresponding with the remarkably beneficial clinical effect of AZ, a significant drop in immunoglobulins was observed. However, since AZ failed to suppress in vivo specific antibody synthesis in RA, the question remains as to whether this drug actually does interfere with the autoimmunogenesis of the disease.

Protein synthesis in vitro by cryopreserved Plasmodium falciparum

Plasmodium falciparum-parasitized erythrocytes obtained from infected owl monkeys (Aotus trivirgatus) and stored in the frozen state retain both the capacity to incorporate 14C isoleucine into protein and to infect animals. The cryopreservation method involves the use of glycerol and the reconstitution of isotonicity after thawing. Animals have been infected from material held for up to 273 days and protein synthesis has been demonstrated in vitro for up to 180 days after freezing. The specificity of protein synthesis as an activity of the parasites was shown by the inactivity of control uninfected erythrocytes stored by the same method. Additional evidence for the specificity of the reaction was obtained from inhibition studies with chloroquine; a 7 X 10(-5) M concentration of the drug resulted in 50% inhibition of the initial rate of protein synthesis.