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The regulations for ability to drive with cerebrovascular diseases in the German Driving License Regulations (Fahrerlaubnisverordnung, FeV) and German Guidelines for the Evaluation of Driving Ability of the Federal Highway Research Institute (BASt) are not up to date with the current medical knowledge and are not consistent with comparable regulations regarding cardiovascular diseases. This is particularly true for the assessment of future risks for a sudden loss of control during driving. The present position paper of six medical and neuropsychological societies in Germany presents the current conditions for the assessment of driving ability of patients a cerebrovascular diesease and recommends an estimation of the ability to drive founded on the current state of scientific knowledge. It addresses the following: 1. Physical and mental functional limitations and the possibilities for compensation, which if necessary enable a fitness to drive under conditions or within limits, including the importance of behavioral or personality changes and cognitive deficiencies that interfere with safety. 2. The potential danger due to a sudden loss of control as a result of a transient ischemic attack (TIA) new stroke event, or another cardiovascular event while driving. A summary in the form of a table provides physicians and expert assessors with assistance for the most important cerebrovascular diseases.

Traffic noise (road, train and flight noise, and the noise of parking cars), is the dominant source of annoyance in the living environment of many European countries. This is followed by neighbourhood noise (neighbouring apartments, staircases and noise within the apartment). The subjective experience of noise stress can, through central nervous processes, lead to an inadequate neuro-endocrine reaction and finally to regulation diseases. Within the context of the LARES-survey, noise annoyance within the everyday living environment was collected and evaluated in connection with medically diagnosed illnesses. Adults who indicated chronically strong annoyance due to neighbourhood noise were found to have an increased health risk in the cardiovascular system, the movement apparatus as well as depression and migraine. For adults with chronically strong annoyance caused by traffic noise, the risks to the respiratory system also increased. In older people, both neighbourhood and traffic noise indicated, in general, a lower risk of noise annoyance induced illness than in adults. It can be assumed that the effects of noise induced annoyance in older people is concealed by the physical consequences of age (with a strong increase in illnesses). With children, the effects of noise induced annoyance from traffic as well as neighbourhood noise is evident in the respiratory system. The increased illness risks in the respiratory system in children do not seem to be caused primarily by air pollutants but rather, as with case of neighbourhood noise, though emotional stress.

Transgenic livestock have been generated via microinjection of DNA-constructs into pronuclei of zygotes. However, efficiency is low and only 1-3% transgenic offspring are to be obtained. Integration of the transgene occurs at random and expression is independent from the number of integrated copies but can be affected by the integration site. To overcome the shortage of human organs, transgenic pigs have been generated that express human complement regulatory genes. This approach enables to overcome the hyperacute rejection response as shown by an average survival rate (40-90 days) of the immunosuppressed primate recipients receiving a heart from a transgenic pig. It is expected that transgenic pigs would be available as organ donors in the next 5-10 years. A major prerequisite, however, is the prevention of the potential transfer of pathogenic microorganisms, in particular porcine endogenous retroviruses (PERV). Improvements of the efficiency in the generation of transgenic pigs will be achieved by the use of genetically modified donor cells in nuclear transfer technology (cloning).

The present trial deals with the effects of birth stress on the thyreoidea respectively on the thyroxine- and triiodthyronine-concentration as well as on their unbound fraction (FT4 and FT3) of suckler calves and the evolution of those parameters in the first three months of life. T4- and T3 concentrations in blood serum of calves were beyond maternal levels increasing significantly in the first 24 hours with strong individual specificity and reaching levels of adult animals at the end of the three-month-period. The different increasing rates of the four parameters show a stimulation of the thyreoideal activity and of the monodejodinase-system as well and they show also a greater decomposition rate of the binding proteins. An influence of the course of parturition on the T3 level p.n. and the T4/T3 ratio in the first 24 hours could be disclosed. The hormone concentrations p.n. showed correlations to the pH and pCO2 of the neonatal calves. For T4 and T3 a strong influence of maternal levels on the hormone levels of the calves p.n. could be ascertained. Effects of breed, surrounding temperatures and type of husbandry on the investigated parameters could be established.

Microinjection of foreign DNA is currently the only successful procedure to achieve gene transfer in farm animals, though at low efficiency (1-3% transgenic offspring). Integration of the transgene occurs random, expression is normally independent from the number of integrated copies, but can be affected by the site of integration. In most cases, the transgene is inherited according to the Mendelian rules. To achieve xenotransplantation complement regulating gene constructs have been integrated and expressed in transgenic pigs. Upon transfer of hearts from such transgenic pigs to primates the hyperacute rejection response was overcome and an average survival of approximately 40 days was obtained. It is expected that organs from transgenic pigs will be clinically available within the next 5 to 10 years after open questions in particular on the potential transmission of pathogens have been clarified.

In vitro production of transferable pig embryos is the key technology for an optimized utilization of high yielding farm animals, for the development of recent agricultural products and for the maintenance of genetic variability. Here we present research results of a recent larger study. Emphasis is on techniques to prepare sperm cells for IVF and to culture IVF-embryos in vitro up to blastocyst stages.

The conservation of endangered breeds as live animals is at present the main national strategy of the government and breeding organizations to maintain genetic diversity. Fourty-three breeds and some old strains of cattle, pig, sheep, goat and horses are currently involved. Cryopreservation and banks for sperm, embryos or DNA are another type of genetic material which could subsequently be used for breeding and production in agriculture. Present semen banks involve 9 endangered cattle breeds and also a small amount of deep-frozen sperm of some endangered sheep and horse breeds. Only 2 embryo banks are established in government projects for cattle breeds Murnau-Werdenfelser and the old type German black-white cattle.

The production of monozygotic twins/multiplets in livestock animal can be achieved either by microsurgical bisection of embryos at the morular- or blastocyst stage, isolation and proliferation of blastomeres from early cleavage stages or nuclear transfer. While the success rates of micro-surgical bisection are high in ruminants (pregnancy rates approximately 50%, twinning rates 20-40%) in polyovulatory species such as swine, the efficiency is low with an average of 20% embryonic survival and 2% monozygotic twins that can positively identified via DNA-fingerprinting. Isolated blastomeres from multicellular embryos still possess great developmental capacity in vitro to progress to the blastocyst stage. However, their development in vivo is markedly reduced. This article summarizes the results obtained by the authors during several years of investigation. The results show for the first time that identical twins can be obtained in pigs which have been demonstrated to be a useful tool in biomedical research.

The technique of microinjection is so far the only successful method of gene transfer in farm animals. Fertilized oocytes are collected from superovulated donors by flushing the oviducts and the exogenous gene construct is injected into the male pronucleus of zygotes before transfer into the oviducts or uteri of synchronized recipients. The resulting pups have to be tested for integration and expression of the foreign gene. Potential applications of gene transfer in farm animals are the improvement of growth parameters, the increase of disease resistance, the enhancement of reproduction rates, the increase of wool production of sheep, the alteration of metabolic pathways, the production of human hemoglobin in the blood of transgenic animals, the generation of transgenic animals as organ donors and the proteins in the milk of transgenic animals. Many studies showed, that farm animals are able to direct the expression of partially large amounts of foreign proteins for biomedical purposes into their milk. Therefore transgenic livestock could be an attractive alternative for conventional production methods.

Colonic duplication is a rare, congenital anomaly. A case is presented in order to show the etiology, pathology and clinical importance of colonic duplication.

Normally colonic diverticulitis presents itself clinically with symptoms. In our presentation pyogenic liver abscess was the primary finding of a concealed perforation of sigma colon diverticulitis. Investigations, diagnostic procedures and therapy are presented.

Ultrasound, ERC and computed tomography are the main preoperative diagnostic procedures of common bile duct cysts. In individual cases the definitive diagnosis can be confirmed only intraoperatively. The high rate of complications and the risk of carcinoma requires a radical surgical treatment.

96 patients were operated on for diffuse peritonitis from January 1986 to June 1990. They underwent a differentiated therapeutical concept according to the severity of the underlying peritonitis. Mild forms were handled with the standard approach, while mid-severe cases were treated by continuous postoperative peritoneal lavage. Patients with severe peritonitis were operated on by open abdomen management. Mortality was 32% (31/96) and with that obviously better than the statistically expected mortality, based on the Mannheim-Peritonitis-Score (49%). The same findings could be demonstrated in the therapeutic subgroups. The management of diffuse peritonitis using such a differentiated surgical concept seems to be an effective approach to reduce mortality rates.

The tone depressing effect on deglutition peristaltic processes in the esophagus by i.v. application of 4,4-diphenyl-N-isopropyl-cyclohexylamine hydrochloride (pramiverine, Sistalgin) (0.03 and 0.045 mg/kg body weight), atropine (0.5 mg) and hyoscine-N-butylbromide (scopolamine-butylbromide, SBB) (20 mg) was tested on trained subjects. During the first 30 min following the larger dose of pramiverine, the effect is not quite so pronounced as it is seen after the usual atropine dose; from the 30th to the 60th min, however, the tone depressing effect of pramiverine is superior to that of atropine, 1 h after application of pyramiverine the pressure amplitude is still reduced to 54.3% of the initial value, while after atropine the effect has returned to 70.9% of the initial value by this time. Neither atropine nor pramiverine were able to exert a tone depressing effect as pronounced as that of SSB. But 30 min after application of the effect of SBB was not statistically significant any longer and after 40 min it could not be measured at all. Following atropine and SBB, the side effect of tachycardia was correlated exactly to the main effect tested. Further side effects, such as dryness of mouth and disturbed accomodation, were most pronounced after atropine. With pramiverine at the effective doses of 0.03 and 0.045 mg/kg, the side effects were not appreciable; neither objective measuring nor subjective reports of the subjects indicated any conspicuous deviations.