Physiology of continuous blood flow in recipients of rotary cardiac assist devices.

The beating heart and the resultant pulse wave have been a symbol of life for centuries. The development history of roller pumps for cardiopulmonary bypass shows that the human body tolerates non-pulsatile blood flow, at least for short-term support. Over the last few years, many types of rotary blood pumps have been developed for clinical use in patients requiring mid- to long-term support. Although early clinical experiences in patients with long-term support have been promising, the matter of whether pulsatile flow is needed or not remains controversial. Therefore, this review summarizes the observed clinical consequences of continuous blood flow in patients supported by rotary blood pumps and relates these consequences to underlying experimental studies.     

Expressed-emotion development and course of schizophrenic illness: considerations based on results of a CFI replication

This study examines the correlation between development of expressed emotion (EE) in relatives and course of illness of 99 DSM-III schizophrenic patients. Patients whose relatives were high EE at baseline and at the 2nd CFI approximately 20 months later had a poor prognosis at the very outset of the study and an unfavourable course of illness. They had a higher rehospitalisation rate, more symptoms, lower psychosocial assessment, and a poorer 2-year and even 8-year outcome. Patients from families with a fluctuating EE or a consistently low EE had better courses. Expessed emotion is therefore a valid predictor not only of symptomatic relapses, but also of other important aspects of schizophrenia. The connection between EE index and course of illness seerns not to be simply reactive or causal, but complex and non-uniform.     

The efficacy of density gradients for islet purification: a comparison of seven density gradients

Seven different density gradient-forming materials were compared as to their efficacy for rat islet purification. Continuous density gradients were used in order to determine the bouant densities of the different pancreatic tissue components. Hand-picked islets served as a control. A significant separation of large numbers of slets from the exocrine tissue band was only seen in the albumin, dextran-40, and metrizamide gradients. Pure islet preparations could not be obtained with any of the gradients studied as none of the gradients completely separated lymph nodes, vessels, and ducts from the islets. Gradients containing sucrose resulted in low islet yields. The islet yields obtained with the other gradients were in the same range as those obtained by hand-picking. Metrizamide gave significantly higher yields than the widely used Ficoll. Judged both in terms of numbers of islets and their in vitro function, the best results were obtained with metrizamide and dextran-40.     

Central nervous system involvement in early and late syphilis: the problem of asymptomatic neurosyphilis

Patients with syphilitic infections are at risk of development of symptomatic neurosyphilis. Adequate treatment with 2.4-7.2 x 10(6) units benzyl penicillin-G intramuscularly within 1 year after infection will rule out this risk. However, more than 1 year after infection this treatment is not fully reliable. In asymptomatic CNS involvement (asymptomatic neurosyphilis) only intravenous penicillin treatment is considered to be adequate in the prevention of neurosyphilis. In this study we redefined criteria for this condition by comparing serum and cerebrospinal fluid (CSF) samples of symptomatic neurosyphilitic patients with those of latent syphilitic patients without CNS involvement. Diagnostic criteria of the World Health Organization and of Centers of Disease Control for asymptomatic neurosyphilis (positive CSF Venereal Disease Research Laboratory (VDRL) test, combined with raised CSF cell count and/or protein content) were studied and compared with some newer parameters such as signs of intrathecal treponemal antibody production (Treponema pallidum haemagglutination assay and intrathecal Treponema pallidum assay index), immunoglobulin G (IgG) and M (IgM) index. The results of this study in 203 syphilitic patients revealed that either a positive CSF-VDRL or combination of a raised IgG and/or IgM index with an elevated CSF cell count both are useful criteria for "ruling-in" asymptomatic neurosyphilis.     

Unterschiede in der Widerstandskraft der weiblichen und männlichen Keimdrüse

Ohne ZusammenfassungMit 15 Textabbildungen.Das Bedürfnis nach Stützung schwächerer Gedanken durch stärkere wird auchKausalitäts bedürfnis genannt und ist die Haupttriebfeder aller naturwissenschaftlichenErklärungen. Ernst Mach.Nach einem auf der 89. Versammlung deutscher Naturforscher und Ärzte in Düsseldorf im September 1926 gehaltenen Vortrage. Vgl. auch Fortschritte d. naturwissenschaftl. Forschung, herausgeg. vonE. Abderhalden, Bd. XII, H. 4.     

Beeinflussung der Atemsteigerung bei Muskelarbeit durch partiellen neuromuskulären Block (Tubocurarin)

Zusammenfassung In 17 Versuchen erhielten 7 Versuchspersonen 0,09–0,16 (Mittel 0,13) mg Tubocurarin/kg i.v. Vor und nach der Injektion wurde die gleiche Muskelarbeit geleistet (Beinarbeit; O₂-Aufnahme etwa das dreifache des Ruheumsatzes). Gemessen wurden Atemzeitvolumen, alveolarer O₂- und CO₂-Druck, Blutdruck und Pulsfrequenz. Die Curaredosen führten zu einer Erschwerung der Arbeit, beeinträchtigten jedoch nicht die Atmung.Bei gleicher Muskelarbeit ventilierte die Mehrzahl der Versuchspersonen, vor allem im Beginn der Arbeit, unter Curare mehr als bei der Kontrollarbeit ohne Curare. Am deutlichsten war dies bei denjenigen Versuchspersonen ausgeprägt, die schon ohne Curare im Beginn der Arbeit eine plötzliche Steigerung der Ventilation zeigten.Es wird angenommen, daß unter Curare die gleiche Muskelarbeit mit einer verstärkten motorischen Innervation geleistet wird. Die dabei beobachtete Ventilationssteigerung wird als weiteres Argument für einen Einfluß der motorischen Innervation auf die Atemzentren angesehen.Mit 3 TextabbildungenHerrn Professor Dr. Hans Winterstein zum 80. Geburtstag gewidmet.     

Detection by polymerase chain reaction of Treponema pallidum DNA in cerebrospinal fluid from neurosyphilis patients before and after antibiotic treatment.

A polymerase chain reaction with nested primer pairs based on the DNA sequence of the 39-kDa bmp gene of Treponema pallidum subsp. pallidum is described. The method allowed the detection of purified T. pallidum DNA equivalent to the amount of DNA in a single bacterium and was specific for T. pallidum subspecies. After concentration of DNA, using diatomaceous earth, it was possible to detect about 100 treponemes in 1 ml of cerebrospinal fluid. Cerebrospinal fluid samples from a total of 29 symptomatic and asymptomatic patients with neurosyphilis were tested for the presence of treponemal DNA before and at various intervals after intravenous treatment with penicillin. Prior to the penicillin treatment, we detected T. pallidum DNA in 5 of 7 patients with acute symptomatic neurosyphilis, in none of the 4 patients with chronic symptomatic neurosyphilis tested before treatment, and in 2 of 16 patients with asymptomatic neurosyphilis. Unexpectedly, T. pallidum DNA was also often detected in cerebrospinal fluid long after intervenous treatment with penicillin, sometimes up to 3 years after therapy.