[Tuberculosis prevention in the eighties: panel discussion].
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Biomedical subjects
Publications and source records attributed to G Neumann.
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The indirect immunofluorescence test for the detection of antibody to Candida was checked for its diagnostic usefulness on pregnant and non-pregnant women with vaginal mycosis. The test proved to be effective in detecting humoral antibody to Candida also in cases of vaginal mycosis. However, comparison between patients with vaginal mycosis, on the one hand, and those without, on the other, did not yield substantive difference in titre distribution. Hence, this serological method cannot be considered adequate for diagnosis for vaginal mycosis.
It is reported on the selective coronary perfusion scintigraphy in 47 patients with angina pectoris and condition after myocardial infarction, which was performed simultaneously with the coronary angiography. For the paper were interesting the cases with normal coronarogram, but pathological perfusion scintigram. 3 of 25 patients with condition of infarction showed coronarographically inconspicuous vessels. In all cases the perfusion scintigram shows disturbances of regional perfusion, which corresponded with the electrocardiographic localisation of the infarction. In 3 of 22 patients with angina pectoris with normal coronarogram in the scintigram regional changes of the terminal vascular system were established. In 2 cases simultaneously a disturbance of rhythm and stimulus conduction was present, which showed a conspicuous correlation to the perfusion lesions in the septum. In the small intramural vessels haemodynamically effective changes take place which are below the coronarogram. Therefore, the only coronarography is not enough to confirm or to refuse a genuine angina pectoris or an infarction. The selecitve coronary perfusion scintigraphy gives the possibility to prove disturbances of the distribution of regional blood supply without a greater additional load of the patient as to coronary angiography. However, it cannot give evidence on the genesis of disturbances in the terminal vascular system in the normal coronarogram
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An initially unrecognized endoscopic perforation of the hypopharynx provided a rare photograhic record of endoscopic appearances from within the mediastinum. The problem of endoscopic perforations is briefly reviewed and analyzed.
The paper reports experience with methods of anaesthesia in rabbits, rats, mice, guinea-pigs, pigs, sheep, baboons, dogs and cats. Special problems of handling, mode of injection and intubation are discussed. A comprehensive survey of literature provides further information about the proposed patterns of anaesthesia and informs about other anaesthetic methods, not practised by the authors.
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A variation of the method of Preisig and Hitzig (18) for the determination of phagocytosis and NBT-reduction of polymorphonuclear granulocytes and monocytes in the peripheral blood is described. Contact with infectious cultures of Candida albicans is avoided by the use of baker's yeast for phagocytosis. Methylgreen is replaced by nuclear fast red for staining. The dye solution can be used over a longer period, the stained slides do not lose their colour, the contrast with the reduced blue NBT is more intense. The application of the method is demonstrated by the results of the test in the family of a boy suffering from CGD.
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By means of coronarography in the most favourable case only the morphology and function of the vessels up to a diameter of 0.1 mm may be established. By the selective coronary perfusion scintigraphy this gap is closed, for it allows a judgment also of the terminal vascular system of the myocardium. The basis of this method is an occlusion of the arterioles and capillaries by radioactively labelled microspheres, in which case, however, only every 10,000th to 20,000th vessel is embolized for a short time. Thus the proper selective perfusion scintigraphy is for the patient a procedure which is not stressing, which, however, demands a sounding of the coronary vessels. On the basis of our own previous results this investigation method is indicated in the diagnostics of the ischaemic heart disease also in its atypical form, in the indication to the vascularisation operation with aortocoronary bypass and its postoperative control as well as in the cardiomyopathies. Also in load examinations and in pharmacological tests by their use as double nuclide method an enlarged information can be got. The importance of the perfusion scintigraphy is among others shown in patients with normal coronarogramme, but with perfusion disturbances which can be proved by means of this method. The most comprehensive invasive diagnostics in the diseases mentioned is at present achieved by the combination of coronarography, ventriculography and selective perfusion scintigraphy.
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In the Federal Republic of Germany an official cancer screening program was started on July 1, 1971. The following sites are included: for males rectum and prostate, for females breast, cervix uteri, corpus uteri, ovaries, rectum. Since January 1, 1975, in addition skin, male genitalia, bladder and kidneys are screened. The official reports only deal with suspects and not with confirmed cases. The cancer registry of Baden-Württemberg is particularly involved in evaluating the results of the screening program. Of all confirmed cancers of the cervix uteri more than 50 per cent are detected by screening. Non-invasive forms represent a little more than 50 per cent of the total. Approximately one case in six of cancer of the breast or cancer of the prostate is diagnosed by screening procedures. In all other sites the percentage is 5 or less. The participation in the program varies by age and sex. Half of the women in the age group from 30 to 44 participate in the program but only about 3 per cent in the group over 75. In males, the program is aimed at the higher age groups. The total expenditure of the social health insurance in 1976 was 63 billion DM, for all screening measures 403 million DM, that is 0.6 per cent of the total amount. The contribution of the program in relation to the total cancer incidence is discussed.
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