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Immunologic assay methods are widely used in chemico-toxicological analysis. Often test kits that are created for the detection of entire drug groups, e.g. barbiturates, are put into action. Within a drug-group the extent of the reaction with the test antiserum, the cross-reactivity, varies considerably. The influence of molecular structures on the cross-reactivity is examined for the ADX-test kit for the detection of barbiturates from urine. In order to obtain a result equal to or exceeding the threshold value (200 ng/ml secobarbital-equivalents) high barbiturate concentrations in urine are required in some cases.

The computerized investigation of the results of urinary calculus analysis, using the program UROQUANT, can be supplemented by using a PC program to analyse 10 typical constellations of results. Dietary and therapeutic measures, as well as further laboratory diagnostic procedures are produced in verbal form.

The manufacturers' descriptions for immunoassays for the detection of benzodiazepines in urine suggest that all therapeutically used benzodiazepines are detected equally. It is unlikely that the different molecular structures do not influence the results of pertinent measurements. Therefore, the cross-reactivity of 35 benzodiazepines and benzodiazepine-metabolites was determined with the TDx-system. As compared to nordiazepam all compounds--except diazepam--had a reduced cross-reactivity. In order to get a TDx result equal to or exceeding 200 ng/ml nordiazepam-equivalents, high benzodiazepine concentrations in urine are required in some cases. These high concentrations are not obtained in the therapeutic range of application. These considerations can be applied to other immunoassays like RIA and EMIT.

A prospective randomized clinical trial was performed to determine the efficiency of single-dose antibiotic prophylaxis in preventing septic complications after appendectomy. The infection rate increased significantly in the control group without antibiotic prophylaxis (9.3% to 20.3%). Older patients with severe appendicitis had more advantages from the prophylaxis than younger one. We have suggested to perform antibiotic prophylaxis individually only in those patients with high risk of septic complications after appendectomy.

It was the aim of our study to examine the interhemispherical and extrahemispherical integration that is possibly disturbed in patients suffering from schizophrenic psychoses, using an easy method of EEG performance spectral analysis. For this purpose, the EEG at rest and the functional EEG were determined in 69 schizophrenic patients (ICD) and 22 healthy subjects and the EEG reactivity was calculated. Differences especially in alpha-2 reactivity were seen both intrahemispherically and interhemispherically. This supports the concept of left hemispheric dysfunction in patients suffering from schizophrenic psychoses.

Radio-density analysis of selected muscles of normal probands exhibited differences in dependence on age and sex of the probands. Men have a higher muscle density than women. With increasing age muscle densities decrease but with different extent for various muscles. The main value for the decreasing muscle density is 2 HE in 10 years. Well trained sportsmen exhibit slightly increased densities with a significant decreased range of derivations from the mean values. That means their muscles show a more homogeneous density distribution than the controls.

32 patients (10 females and 22 males) with chemotherapy-resistant tumors were again treated with the previously ineffective chemotherapy after plasmapheresis. 19 of 32 patients showed a minor response or no change lasting more than 3 1/2 weeks; in 10 of the 32 patients it lasted for more than 8 weeks.

The electroencephalogram (EEG) during information processing is influenced by specific changes in brain electrical activity. Based on the theory of a disturbed information processing in schizophrenics we analysed auditory stimulus induced EEG changes by Fast Fourier Transformation. The most important of the significant stimulation dependent EEG power changes were measured in the 0.5-3.5 Hz and 10-13.5 Hz frequency bands in the left parietal lead. In a multivariate analysis the separation of the subjects examined into acute schizophrenics and normals was incorrect in only 21% of the cases (resubstitution rate): using the pi-method an error of 31% was estimated.

Spontaneous activity was recorded extracellularly by glass microelectrodes from 54 neurons of the Gyrus sigmoideus posterior of unnarcotized and gallamine-immobilazed cats, and the sequential and nonsequential interspike-interval histograms were determined using the multi-channel analyzer CAT 400 C. The interval distributions were characterized by graphic criteria, and it was attempted to describe these distributions mathematically by four biparametric distributions, the Weibull, lognormal, gamma and normal distributions. 80% of the frequency distributions of type I (exponential), II (left skew, gamma-similar) and IV (almost symmetrical) could be assigned to these distributions, namely 43% of the lognormal distribution, 32% of the Weibull distribution, and 5% of the gamma distribution. The interval histograms of the type III (left skew, steep) and V (bimodal) could not be described by any of the distributions selected.

Twenty-six bone marrow transplantations were performed at the West Germany Tumour Centre at Essen between December 1975 and December 1981. Three patients had aplastic anaemia, 23 acute leukaemia. Of the leukaemia patients 13 had a recurrence and ten were in full remission at the time of the transplantation. Two of the patients with a recurrence received deep-frozen autologous marrow from the remission phase. One patient with aplastic anaemia had an identical twin as donour, while all other patients received allogeneic marrow from histocompatible family members. Eleven patients are still alive, all three of those with aplastic anaemia, one of those with leukaemia in a recurrence, and seven of those with acute leukaemia in full remission. Two of the survivors have a chronic graft-host reaction, but the others are symptom-free, after an observation period of up to four years. Main causes of death were leukemic recurrence (6), infection (5), and graft-host reaction (2). It would seem that at present bone marrow transplantation offers the best chance of a cure for severe aplastic anaemic and acute leukaemia in adults, but only if transplantation is undertaken early and not in the end-stage of the disease.

In 53 patients with metastatic breast cancer and increased CEA serum levels (greater than 10 micrograms/l) the CEA titer within the first 8 weeks after commencement of chemotherapy was compared with results of therapy. Among 30 patients in whom CEA values had decreased by at least 30% of pretreatment values 12 showed remission, 15 no change and 3 progression of the malignancy. Among 23 patients with unchanged or increasing CEA values during therapy 19 had progression, 3 an arrest and one a remission of the disease. In the one patient with remission the course of the disease was unusual inasmuch as the CEA value increased to 240 micrograms/l serum and liver metastases regressed excessively at the same time. This lead to the assumption of CEA release by tumour necrosis during therapy. The results suggest that in metastatic breast cancer and increased CEA values remission generally cannot be expected should the CEA value remain unchanged or rise within the first 8 weeks after initiation of treatment. In contrast, a decrease of CEA within that time may be considered a prognostically favourable sign which, however, does not mean clinically relevant reduction of tumour size in every case. For evaluation of treatment sufficient precision of CEA determinations must be guaranteed.

A simple and reliable possibility to recognize at once sudden deteriorations of the renal function is the demonstration of IgKr accompanying the disease by means of semilogarithmic paper. Up to now probably no special importance has been attached to an intensive treatment of hypertension. The kinetics of the initial loss of function further remains unclear. The importance and possible influence on the accelerating factors must be defined exactly in a longer period of observation and with a greater number of patients. If we succeed in avoiding the acceleration and even in retarding the progression this would be connected with an essential delay of the time of the dependence upon dialysis for a number of patients.

Pentazocine dependencies are rare. In a period of 5 years, 60 were notified. The majority of these were not dependent. Of 46 utilizable notifications, 38 were false, 5 had taken pentazocine only temporarily or not at all. 19 received it for chronic or recurrent pains, 13 were polytoxicomaniacs, and 1 patient could not be classified. Only 8 cases could be referred to as pentazocine-dependent. The dose for addicts and polytoxicomaniacs was 11 ampoules daily on the average, almost three times as high as that for patients with painful diseases. Pentazocine dependencies are considerably less of a problem than those of opiates used up to now: withdrawal symptoms are slight, neglect and social dangers need scarely be considered. "Users" generally only turn to pentazocine when a painful disease supervenes. Dependency practically never occurs with oral administration.

The cryoprotective effect of hydroxyethylstarch has been tested in mice and in man using the spleen colony technique (CFU-S test) or the agar colony technique (CFU-C test) as viability assays for the haemopoietic stem cell. In mice we found a mean CFU-S recovery of 88.7%+/-3.9% when a rapid, and 77.8%+/-3.2% when a slow, stepwise dilution method was applied to remove the protective medium (17.5-20% hydroxyethylstarch+20% calf serum) after thawing. In man the rapid dilution after thawing gave a mean CFU-C recovery of 80% but a wide scatter.

The preliminary results of a controlled study for treatment of 33 patients with squamous cell carcinoma of the head and neck region with regimen A: cis-DDP (3 mg/M2 dl) plus Bleomycin (15 mg/m2 i.v. continuously d2-6) against regimen B: Methotrexate (30 mg/m2 i.v. dl + 6) and vindesine (3 mg/m2 i.v. dl + 7) were as follows: complete remission (cr): 1 X A, 0 X B; partial remission (pr): 6 X A, 4 X B; minor response (mr): 3 X A, 7 X B; no change (nc): 2 X A, 0 X B; progression (pg): 5 X A, 5 X B. Due to progressive disease 8 patients were further treated with the alternative regimen with following results: cr: 1 X A; mr: 1 X A, 2 X B; nc: 1 X B; pg: 3 X A. Considering prognostic factors it could be demonstrated that primary chemotherapy (pc) was more effective that applied after operation and/or radiotherapy (secondary chemotherapy = sc): cr + pr: (= 53%), 4 X sc (= 22%); nc + pg: 1 X pc (= 7%), 7 X sc (= 39%).

52 patients with epidermoid cancer of the head and neck region were either treated with cis-DDP and bleomycin (arm A) or with methotrexate and vindesine (arm B). In case of resistance patients were further treated with the alternative regimen (A leads to B or B leads to A). Treatment results are superior in arm A. Complete and partial remission were in A: 54%, in B: 31%, after crossover 46% and 0%, respectively. Status of pretreatment (operation and/or radiotherapy) is of minor importance for arm A than for the "soft" treatment of arm B. Preliminary analysis of survival and remission duration shows no significant difference in regard to A or B and status of pretreatment. However, those patients resistant to B and further treated with A have an increase of median survival from 3 to 9 months (p = 0.02). With primary chemotherapy inoperable tumors can be made operable with curative intention.

A prospective randomized clinical trial was performed to determine the efficiency of single-dose antibiotic prophylaxis in preventing septic complications after appendectomy. The infection rate increased significantly in the control group without antibiotic prophylaxis (9.3% to 20.3%). Older patients with severe appendicitis had more advantages from the prophylaxis than younger ones. We have suggested to perform antibiotic prophylaxis individually only in those patients with high risk of septic complications after appendectomy.

H. R. Nielsen and H. Remmer described a quantitative method for the estimation of carbamazepin serum levels. The specificity of this method was examined with the result that besides carbamazepin also its metabolites react under the authors' conditions.

Of 108 patients with chronic terminal renal insufficiency in 81 patients controls of the course were possible. In 50 patients an lg-linear course of the increase of creatinine against the time was the result. The running through time from 200 to 1,000 mumol/l creatinine was measured. In 31 patients the at first flatter, also linearly recognizable increase of creatinine suddenly changed into a second steeper, also lg-linear part of the straight line. The exact knowledge of the accelerating factors might postpone the time of the dialysis dependence in one part of the patients.

The evaluation system suggested allows the results of urinary-calculi analysis centres to be compared after estimating the calculus stages present, the distinction between primary and secondary components and the deviation from normal composition. Afterwards the quality of the results of analysis of urinary calculi improved using the standard method.

An attempt has been made to standardize the method of large volume plasma exchange in tumor patients on the basis of an albumin-electrolyte exchange solution. Problems relating to the alteration of tumor patients' serum proteins are discussed. Three patients with malignancies successfully underwent therapeutic plasmaphereses.

By genealogic and laboratory-diagnostic investigations in the county of Magdeburg 79 patients with haemophilia A and 23 patients with haemophilia B were established. Characteristic coagulation-analytic findings in patients without and with additional thrombocytic functional disturbances are shown. In female conductors of haemophilia A the reliability in the diagnostics could be increased with the help of the discriminance analysis by combination of the genealogic tree information with the coagulation-analytic findings.

Treatment of patients with advanced squamous head and neck tumors demonstrates even with best surgical and x-ray techniques only five year survival rats between 10 and 30%. Chemotherapy in addition seems to improve these results. From July 79 to January 80 21 patients with advanced squamous-cell carcinoma at the head and neck region were treated in a controlled pilot study with Cisplatinum/Bleomycin or Methotrexate/vindesine. 6 patients were primarily treated with chemotherapy, all other secondary progressive disease after surgical and x-ray procedure. Without respect to the generally cell tolerated therapy modality on overall remission induction rate of 50 and 70% was observed. In a subsequent randomized controlled multicentric study both regimes will be compared concerning remission, survival and toxicity.

79 patients were randomized and treated either with cis-DDP 33 mg/kg i.v. day 1 and BLM 15 mg/m2 i.v. continuously day 2-6 (arm A) or less aggressively with MTX 30 mg/m2 i.v. day 1 + 6 and VDS 3 mg/m2 day 2 + 7 (arm B). Patients with inadequate response were further treated with the alternative regimen ("cross over"). Regarding response rates therapy A was superior to B (p = 0.01) respectively p = 0.05 for the cross over patients. Not pretreated in comparison to pretreated patients demonstrated not significantly better results. Pretreated patients had statistically superior response rates with arm A than with arm B (p = 0.05). All other prognostic factors were without any influence on treatment results. CR induced by chemotherapy (2 X) in not pretreated patients could be increased by additional surgery and X-ray therapy (CR = 26X). Survival times demonstrated no difference between both regimes. Chemotherapy was of less influence on median survival times after 39 months than in comparison to post-chemotherapeutically performed surgery +/- radiotherapy in 44 not pretreated patients. Chemotherapy: CR + PR to MR + NC + PD 16 respectively 13 months with 38 respectively 48% survivors (p = 0.25). Surgery +/- radiotherapy: CR + PR median not reached yet, MR + NC + PD 13 months with 60 respectively 18% survivors (p = 0.001).

Eight healthy probands received 1.0 to 1.3 g ethanol per kg body weight within a period of 30 minutes. The average hourly elimination rate of ethanol during the postresorptive phase was found to be 0.18 g/l. No significant increase in the elimination rate was seen either after administration of 200 mg metoprolol per day in slow release form for a period of one week, or after a single dose of 200 mg metoprolol in standard formulation taken at the beginning of ethanol ingestion. On the other hand, long-term administration of metoprolol resulted in a steeper rise and a delayed decrease of blood alcohol concentration. Simultaneous intake of metoprolol and of alcohol in high dosage should be avoided.

44 patients with advanced squamous cell carcinoma of the head and neck were randomized and treated preoperatively either with arm "A": cis-DDP (3 mg/kg iv day 1) and BLM (15-20 mg iv continuously day 2-6) or arm "B": MTX (30 mg/m2 iv day 1 + 6) and VDS (3 mg/m2 iv day 2 + 7). Treatment with arm "A" was superior producing 73% complete and partial remissions (CR + PR) compared to 40% for arm "B" (p = 0,05). The number of patients with CR could be increased from 2 to 26 by surgery and/or radiotherapy. The median survival for patients with chemotherapeutically induced CR and PR was 16 months but this did not differ significantly from the median survival (13 months) of non responders (p = 0.25). For patients with CR and PR achieved by surgery and/or x-ray therapy the median survival point has not yet been reached, and this is significant compared to the non responders (p = 0.001). Five of 26 patients with CR died after 39 months of observation and 6 are living with recurrence. In addition to clinical trials, chemotherapy is indicated for patients with inoperable tumours. The value of chemotherapy can only be answered by randomized trials comparing chemotherapy combined with standard procedures against surgery and radiotherapy alone.

The diagnosis at postmortem examination and the results of the chemical analysis in a case of a diltiazem intoxication are presented. Two metabolites were identified as desacetyldiltiazem and N-desmethyldiltiazem.