Buchbesprechungen

Ohne Zusammenfassung     

Posttraumatische Septikämie mit protrahiertem Verlauf und Erregerwechsel

Zusammenfassung Es wird ein seltener Verlauf einer Septik?mie mit st?ndig wechselnden Erregern beschrieben, welche den herk?mmlichen Sepsisbegriff in Frage stellt. An Mikroorganismen wurden erst grampositive, sp?ter gramnegative Sepsiserreger und dann eine lange anhaltende Fung?mie beobachtet. Die Intensivtherapie mit langdauernder parenteraler Ern?hrung, mit hochdosierten Antibiotikakombinationen und immunologischen Therapiebehelfen, wie Transferfaktor und Immunglobulinpr?parate, erm?glichte eine Abheilung des Krankheitsbildes.

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Summary A rare course of septicemia with changing germs is described. The currently known picture of sepsis appears to be questionable. Grampositive microorganisms were seen first, then gramnegative, and finally a long lasting fungemia was observed. Intensive care with parenteral nutrition, combination of antibiotics and immunotherapy as transfer-factor and immunoglobulin, could heal this case.

     

Enzyme changes after coronary angiography

The enzymatic response to contrast media after coronary angiography was observed in 24 patients. The enzymes studied were glutamic oxaloacetic transaminase (SGOT), glutamic pyruvic transaminase (SGPT), lactic dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (α-HBDH), γ-glutamyl transferase (γ-GT), creatine phosphokinase (CPK), and the myocardial-specific isoenzyme of CPK (CK-MB). Angiography produced no significant elevations in SGOT, SGPT, α-HBDH, LDH, or CK-MB activities; γ-GT increased up to the twelfth hour. High levels of CPK and CK-MB observed in one patient were found to be products of a thymus carcinoma. In vitro examinations also showed that concentrations of contrast media used in coronary angiography do not inhibit γ-GT, LDH, and CPK activities.     

Dimensionality of the perceived self: the Tennessee Self Concept Scale

The 12 indices of self-perception in the Tennessee Self Concept Scale, together with the Eysenck Personality Inventory, were factor analysed using data obtained from psychiatric day-care patients (n = 131). Separate item- and scale-level factor analyses revealed that: (1) the five external and three internal domains of self-concept, hypothesized as distinct, may be accurately viewed as lying in one-dimensional space; (2) the conflict, variability and distribution scores are unrelated to subtype of self-esteem; (3) extraversion and neuroticism form a bipolar factor that is orthogonal to self-concept; and (4) the emergence of 30 item-factors with a 30 per cent factorial overlap implies a good deal of spuriously shared variance, low inter-scale homogeneity and sizable redundancy in the TSCS scales. Owing to these results, the construct and factorial validity of the TSCS is seriously questioned. It is suggested that future researchers develop more sensitive, treatment-oriented (or idiographic) measures to compare man's less conspicuous and more private 'self-image feelings and cognitions' against his public self-disclosure in the interests of facilitating more rapid behavioural change.     

Cellular pharmacokinetics of daunorubicin: Uptake by leukaemic cells in vivo and fate

Summary In 6 patients with acute myeloblastic leukaemia, daunorubicin was assayed in leukaemic cells from peripheral blood or bone marrow. The cells were separated from red blood cells and granulocytes by centrifugation on a Ficoll-Isopac gradient. The assay was performed by high performance liquid chromatography. Daunorubicin concentrations in peripheral leukaemic cells, 2 hours after the end of the infusion, were much higher than in plasma, the cell/plasma concentration ratio reaching about 350 and rising to almost 700 at 24 h. At that time, drug concentrations were even higher in the bone marrow leukaemic cells. The value of the assay of daunorubicin in cells as method for monitoring therapy is discussed.     

Comparison between long-term treatment of chronic bronchitic airway obstruction with ipratropium bromide and metaproterenol

Twenty-eight patients with chronic obstructive lung disease with a reversible component were treated with either 40 micrograms of ipratropium bromide (IB) or 1.5 mg of metaproterenol (MP) by a metered dose inhaler four times a day in a double-blind randomized fashion. The treatment was continued for 3 months and pulmonary function tests and clinical evaluation were made on days, 1, 30, 45, 60, and 90. IB produced significantly greater bronchodilatation between one and three hours compared with MP. Furthermore, patients receiving IB showed no decline in effectiveness over 3 months, in contrast to MP which showed some evidence of development of drug tolerance within the same period. No side effects were noted. It is concluded that the anti-cholinergic agent IB is a more effective bronchodilator at the doses used in the above group of patients, both acutely and over a long-term period.     

Das Gehör von Hypertonikern

Summary 105 hypertensive patients between 16 and 60 years of age were examined internally and audiometrically. The audiograms of 90 patients without known otopathy were analyzed and compared with audiograms of patients of the same age group. Sex and age as well as duration and stage of hypertension were taken into consideration. The difference between the various age-decades came to at most 6–8 dB in the high and low frequencies, there was no difference in the medium frequencies. The result of the average-audiogram of all hypertensive persons showed a hearing-loss of less than 10 dB up to 2,000 Hz and in the high frequencies (at 6,000 Hz) a hearing loss of 14 dB for women and 16 dB for men. The comparision with audiograms of the same age-group shows, that — contrary to the widely spread opinion — there is no hearing-impairment caused by hypertension.     

Characterization of IgG-containing DEAE fractions of canine serum.

A high-titered canine antilymphocyte serum was chromatographed on DE-52 cellulose and the fractions were assayed for cytotoxic activity. Although cytotoxicity was associated with the first 63% of the column effluent corresponding to fractions 1 through 7, significant activity (256) was demonstrable only in fractions 2, 3, 4, and 5. An immunoelectrophoretic study of fractions 1 through 5 showed only IgGa in fraction 1, IgGa and IgGb as electrophoretically separate arcs in fraction 2, and as electrophoretically inseparable arcs in fractions 3 through 5. Cytotoxicity is postulated to be associated with the IgGb subclass, since titers correspond with the distribution of IgGb in column fractions.     

A case of carcinoma of the stomach with calcification (author's transl)]

The authors found only 25 cases of calcified carcinoma of the stomach in the literature. The course in this case was rapidly fatal. Calcification within the tumour infiltrates the gastric wall and has a very characteristic miliary appearance, permitting one to make the diagnosis on a straight X-Ray of the abdomen. The mechanism of precipitation of calcium within certain mucus-secreting carcinomas has not been determined. Various theories are suggested.