Following part I "Fundamentals" and part II "Procedures", this third part presents the findings about language acquisition and the conditions governing this process in 315 CLP children. It has been shown that early language programs for CLP families leads to the linguistic rehabilitation of these children before they reach school age. Semantically and syntactically complex sentences at the age of 2-3 years results in good articulation at age 5-6. Early precision of articulation is usually associated with an increased risk for psychosomatic complications. The complexity of the cleft at birth is of minor importance for language acquisition, whereas early treatment, parents' compliance and avoidance of corrections and sensitizations are decisive for the successful course of the child's language development at the age of 5-6 years.

Child↗

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[Language acquisition in cleft lip-palate (CLP) children. 2. Linguistic diagnosis and therapeutic approaches].

The major tests and methods used in language acquisition diagnosis in CLP children of 3 months to 6 years of age are described. Apart from methods for phonetic analysis, such as spectrography, emphasis is being placed on the assessment of listening by hearing and of semantic and meta-linguistic acquisition. Additional information is obtained on the motoric, cognitive and social development (for detecting any possible multiple handicaps in these areas). In this context the major problems covered in cleft palate parent groups are also pointed out. Finally, the speech therapy provided for preschool children with severe speech problems (as compared with the control group) is outlined.

Child↗

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[Lipoproteins as coronary risk or non-risk indicators in elderly people].

Lipid and apolipoprotein (apo) levels were investigated in 98 (68 female, 30 male) subjects older than 85 years and 86 (59 female, 27 male) subjects aged 65-75 years. The mean cholesterol level of the long-lived persons who were free from overt degenerative arterial disease was 5.2 mmol/l and ranged markedly below the mean level of the population. Comparing both age groups, the triglyceride level of the high-age subjects was at 0.3 mmol/l, significantly lower; HDL-cholesterol and apo A-I at 0.15 mmol/l or 0.3 g/l were higher. Cholesterol, LDL-cholesterol, and apo B only tended to be lower in the higher age. Subjects suffering from degenerative arterial disease (circulatory disturbance, hypertonia, diabetes mellitus), especially the long-lived group, had a more marked unfavorable lipoprotein profile. Subjects over 85 years (13%) had markedly less disturbance in lipoprotein metabolism of high atherogenic potency (hyper-beta-, hypo-alpha-lipoproteinemia) than did subjects 65-75 years old (23%). Hypertriglyceridemia is with 38% or rather 21% very frequent and seems to be of less atherogenic potency. Hyper-alpha-lipoproteinemia as anti-risk factor for coronary heart diseases was established more frequently in the long-lived group with 13% in comparison to 3.5% in those 65-75 years of age.

Aged↗

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[Speech therapy for children with cleft lips and palates. I. Basic linguistic considerations].

According to several basic principals of hermeneutic theory (theory of understanding natural languages) we describe the major fields of language acquisition in which anomalies of CPL children often can be found. Besides phonation and articulation there are morphological, psychomotoric, onomatopoetic, and isotopic disorders. Also a delay of understanding by listening is often observed. Additionally some cofactors in psychodynamics of the family have to be respected. Defense mechanisms, somatization, and social symptomatization are described. Some examples from statistics and experimental psycholinguistics show, that a diagnosis of early language acquisition can't be found by comparing means (naive model of diagnosis). We show how to find out the multiple covariance of early language acquisition tests with the control groups. A final case study shows a typical process of CLP children's language acquisition.

Child↗

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[Behavior of the biological aging index and serum lipids in treatment with X50].

Lipid metabolic disorders are clinical relevant for the middle and old age. The presented paper shows that decreased HDL-cholesterol and increased triglycerides enlarge the value of pre-ageing. Therefore is a lipid lowering treatment a special problem of gerontology. We have treated 15 patients (age 56.7 +/- 7.8 years) with hypercholesterolemia and hypertriglyceridemia with the new developed lipids regulans X50 = 1-benzyl-3-(1-carboxy-1-methylethoxy)-4-methylpyrazol. There was a significant decreases of serumtriglycerides (47%) in all patients. Half of the patients showed a significant decreases of total cholesterol (32%). Biological age index and biological age were not influenced. To demonstrate an influence of biological age there are needed longterm treatments in patients with lipid metabolic disorders.

Cholesterol↗

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[Long-term oil therapy in elderly patients with peripheral arterial occlusive disease].

3-years dietetic application of polyenic fatty acids in 41 patients with peripheral arterial occlusion disease evoked significantly alterations of total and LDL-cholesterol level and of the serum fatty acid spectrum. These alterations must be valued as "antiatherogenic" although the HDL-cholesterol was not influenced. Linolenic acid enriched linseed oil seems to be more efficient than linolenic acid enriched sun flowers oil.

Arterial Occlusive Diseases↗

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[Special metabolic effects of polyene fatty acids in 45-60-year-old patients with peripheral circulatory disorders].

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Arteriosclerosis Obliterans↗

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[Modification of lipoprotein parameters in the initial phase of physical exercise in middle-aged cardiovascular patients].

The effect of a daily swimming-training of 20--30 minutes for four weeks (six times a week with intensities of 50--60% VO2 max) on the lipid and lipoprotein spectrum, respectively, was investigated in 40 elderly male patients in a heart-circulatory cure (on an average 48,7 years old). At the beginning all patients had an HDL-cholesterol level lower than 0.91 mmol/l which rose significantly towards the end of the cure. LDL-cholesterol dropped significantly. The lipid index by Klimov and the quotient LDL-C/HDL-C descended at the end cure. The separation of the lipoproteine (Lp) by discelectrophoresis and the evaluation of their percentage showed a reduction of the beta-Lp and an increase of the alpha-Lp coinciding with the lipid-data. The quotient beta-Lp/alpha-Lp also decreased significantly. In the apolipoproteins A and B statistically ensured alterations in concentrations could not be determined. The disproportional changes of the lipid- and protein-portions were referred to in the discussion. According to our results the lipid-portion of the Lp (especially LDL- and HDL-cholesterol) indicated the changes more sensitively than the apolipoproteins A and B. The data demonstrate the possibility of raising the HDL-cholesterol-level of elderly men by physical training.

Apolipoproteins↗

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[Clinical significance of arteriosclerosis indices of lipid metabolism and age dependence].

Age, arteriosclerosis indices, HDL-cholesterol, hyperlipoproteinemia, lipoproteins In 193 normal persons, 86 patients with arteriosclerosis obliterans of the lower extremities, 170 HLP patients, 87 adiposity patients and 22 chronic alcoholics were determined the arteriosclerosis indices (formula; see text) The arteriosclerosis indices increase in healthy males from the age of 30 and healthy females from the age of 45. In case of peripheral arterial occlusion HLP and adiposity the arteriosclerosis indices are elevated and give diagnostic and prognostic hints as to increased arteriosclerotic risk for these diseases.

Adolescent↗

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[HDL-cholesterol and cardiovascular diseases--gerontological aspects].

Serum cholesterol is preferably transported by low density lipoproteins (LDL) and high density lipoproteins (HDL). Accordingly, it is generally referred to as LDL-cholesterol and HDL-cholesterol, respectively. In recent years, the vasoprotective role of HDL and the negative correlation between HDL-cholesterol and cardiovascular diseases have been discussed by a large number of authors. This paper discusses the metabolic, pathophysiological, and clinical importance of HDL and HDL-cholesterol from a gerontological point of view. Incorporation of cholesterol into HDL enables cholesterol to be eliminated from the vessels and catabolized in the liver through various mechanism (LCAT substrate, cholesterol esterification and transport, and competitive LDL inhibition). Results of epidemiological, clinical, angiographic, and experimental studies showed that there is a reduction in the concentration of HDL-cholesterol in the case of coronary and peripheral arteriosclerotic diseases. Determination of HDL-cholesterol (in connection with a calculation of LDL-cholesterol) allows the risk of arteriosclerosis to be diagnosed and prognosed, respectively. "Normal" values of HDL-cholesterol are between 35 and 55 mg/dl (0.9-1.4 mmol/l for males and between 45 and 65 mg/dl (1.2-1.7 mmol/l) for females. In women, there is noted a decrease with increasing age. Obesity, diabetes mellitus, hyperlipoproteinemia, high-fat and high-carbohydrate nutrition, and ovulation inhibitors tend to decrease the level of HDL-cholesterol. Physical conditioning, change in diet, reduction of weight, and certain drugs having an effect upon the lipid metabolism tend to raise the HDL-cholesterol level. Knowledge of problems associated with what is here referred to as HDL-cholesterol is of great clinical importance to gerontologists as regards the prevention and therapy of arterio-sclerotic and, more specifically, coronary diseases.

Age Factors↗

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[Effect of physical conditioning on fat metabolism--examinations performed on middle-aged long distance runners].

The lipid and lipoprotein metabolism was examined in fortyfour long distance runners and in a cohort of sixty-five untrained subjects as well as in thirty-two runners before and immediately after 38- and 40-kilometer runs respectively. There was observed a significant increase of high density lipoprotein cholesterol in the runners, whereas very low density lipoprotein cholesterol showed a marked decrease. The low density lipoprotein cholesterol/high density lipoprotein cholesterol quotient (arteriosclerotic quotient) was found to be markedly reduced in the runners. There was no statistical difference in total cholesterol and low density lipoprotein cholesterol between long distance runners following sports as a pastime and untrained subjects. Post-heparin lipase and the rate of lipolysis were markedly increased in subjects following sports as a recreation. Parallelisms were observable between lipid values and lipoprotein percentages determined by disk electrophoresis. The proportions of alpha-lipoprotein, beta-lipoprotein, and pre-beta-lipoprotein in runners were found to be increased, unchanged, and reduced respectively. The increase in alpha-lipoprotein was accompanied by a shift in the spectrum of alpha-lipoprotein subfractions. After the 38- and 40-kilometer run, respectively, there were determined an increase in TGL and very low density lipoprotein cholesterol and a decrease in both post-heparin lipase and rate of lipolysis. The other cholesterol parameters showed no significant variations after straining. Whereas Apo A, like high density lipoprotein cholesterol, did not change during running, Apo B showed a marked increase. The results were discussed with due consideration of those reported by other authors.

Age Factors↗