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The aim of this paper is to describe the secular changes of selected demographic parameters and to investigate the possible causes for such changes as well as the biological relevance. We took into account the following parameters: population density, mean live expectancy, average age at marriage of until then unmarried persons, rate of live births, and number of children per woman. The results show that the population density (global and in Germany) especially in the twentieth century increased dramatically. We found a striking increase of life expectancy in Germany. Essential causes are rapid decreases in infant and maternal mortality. Since the 80s of the twentieth century the average age at marriage of until then unmarried persons as well as the number of single mothers show a permanent increase. Generally, the average age of mothers increased (for live and legitimate births). In the past 150 years we found a decrease in fertility rates in Germany. The registered demographic parameters show temporal and regional variations. These differences, especially between East Germany and West Germany, are emphasized.

In contrast to motivational accounts of the personal-group discrepancy, results from this article suggest that the discrepancy is explained by aggregating different sets of comparison outcomes for either personal or group ratings. Results from a longitudinal study with East German (the minority group) and West German (the majority group) samples confirm the personal-group discrepancy and support our approach. First, social comparisons influenced evaluations of economic situation at both group and personal levels. Second, ratings of group versus personal economic situation were based on different sets of comparisons. Third, the mean structure of both sets of comparison outcomes mirrored the personal-group discrepancy. Fourth, an interaction between personal-group discrepancy and group status supported the authors' suggestions-concerning the direction of the discrepancy.

Predictions by social identity theory (SIT) and relative deprivation theory (RDT) concerning preferences for strategies to cope with a negative in-group status position were tested. The focus of the present research was a comparison of the theories regarding their differential patterns of prediction. For this purpose, a natural sample within a specific historical situation was investigated: East Germans after the German unification. First, the predictive power of SIT and RDT variables was tested separately. In a second step, a possible integration of the theories was addressed. Combining the SIT variables and RDT variables led to an integrated model indicating a differential pattern of prediction for intergroup strategies. The RDT components explained the collective responses, whereas SIT constructs were related to individual strategies.

This article reports results of an anthropological investigation on pre-school children from 1994. The body height and weight are presented and compared with results of the Jena Longitudinal Study and results of the investigations of school children which are carried out in Jena in relatively regular intervals since 1880. For the increase of the body weight since 1985/86 changes in the nutritional situation of the people from East-Germany are discussed. Other changes in the living conditions influencing the somatic development are analysed.

The quality of diabetes care in the former GDR 1989/90 and in former West Germany 1990/91 was compared in a case control study. The study group consisted of 83% of the diabetic patients registered in the local diabetes care unit in Jena who were on insulin. The patients (86 women, 104 men; 131 Type-I and 59 Type-II, aged 16-60 years) were in the care of the local diabetes care unit. The control group consisted of randomly selected diabetic patients of the outpatient department of the university of Düsseldorf (matched pairs). Despite a different strategy of therapy the HbA1c (Jena/Düsseldorf) was the same: 154%/153% of the mean normal value in type-I and 178%/175% in type-II. The prevalence of retinopathy in type-I and type-II and proteinuria in type-I was not different, whereas the prevalence of proteinuria in type II- and of hypertension in both types of diabetes was higher in Jena.

The efficacy of care in the centralized diabetes care system in the former German Democratic Republic was evaluated on the basis of the recommendations of the St. Vincent Declaration. Eighty-three per cent (n = 190, 46% women) of all insulin-treated diabetic patients aged 16-60 years who were registered in one district diabetes care unit were examined. Of these, 131 patients had type 1 (insulin-dependent) diabetes (69%) and 59 type 2 (non-insulin-dependent) diabetes (31%). All patients were on animal insulin and 96% (n = 187) had conventional therapy consisting of fixed insulin dose and a fixed diet. Levels of glycosylated haemoglobin (normal 4.15%, SD 0.54) were 6.3 +/- 1.3% in type 1 and 7.4 +/- 1.7% in type 2 diabetics. Retinopathy was found in 35% of type 1 (proliferative 3.8%) and 23% of type 2 patients (proliferative 3.4%). No patient was blind. Screening for nephropathy identified 29% of type 1 and 47% of type 2 diabetics as having albuminuria > 20 mg/l in early-morning urine. The prevalence of hypertension was 31% and 69% for type 1 and type 2 patients respectively. Foot ulcers were found in 2.1% and lower limb amputations in 2.1%. The incidence of severe hypoglycaemia (except in pregnancy) was 0.07 per patient per year. This study shows that the diabetes care system was effective and the winding up of this system with the reunification of Germany was not a medical necessity. However, the system failed to establish an integrated regime with regional general practitioners for the effective treatment of hypertension.

In an epidemiological collaborative international study under the auspices of WHO-Euro the drug use in pregnancy was investigated in 22 countries in 14,778 women and in hospitals of three different levels. The East German state Thuringia took part according to the annual birth rate with 300 women in 3 hospitals (Jena, Gera, Greiz). In the international average, 14% of the enrolled women took no drugs during pregnancy before admission to hospital for delivery. In East Germany 44% of the women taking part in the study had no drug administration during pregnancy. The critical use of iron preparations and vitamins there has to be mentioned. Under delivery, 99% of the Thuringian women received drugs. In the puerperium the administration of ergot derivatives and of laxatives exceeds the international average and has to be critically revised, but the administration of antiinfectives in only 1/5 and of analgetics 1/3 of the international average.

Periodontology is a young department and has developed in Jena in the last 25 years; since 1982 it is a part in state examination. Maintenance of teeth is possible until old age and requires periodontology as a part of therapy. Biochemically, microbiologically and immunologically methods make it possible to differentiate unlike forms of periodontitis and their special therapy.

The data of 240 patients with non-pretreated oral squamous cell carcinoma were analyzed in dependence on the tumor size (T-category), on the histologic checked lymph node status and the histopathologic grade of malignancy. There is a conformity to the results published by the DOSAK regard to the tumor size (T-category). The comparison of the survival of our patients with the estimated survival rate of the TPI shows also conformable results. Differences exist in the prognostic valuation of the lymph node status by the DOSAK. The histologic verificated lymph node status and the malignancy grade will recommend as decisionsive prognostic relevant parameters.

In a longitudinal study consisting of three single examinations dental findings of 89 individuals (40 boys and 49 girls) were recorded. The aim of the study was to check up the process of dental growth and development of 7.6- to 8.6-year-old children. Age- and sex-specific differences could be established in the three occlusal dimensions by means of clinical findings and 3-d-analysis of the plaster casts. The rate of DMF teeth was remarkably low in girls and boys; the presence of malocclusions was surprisingly high.

It was proved some years, if the program of the WHO for the oral healthy of preschool children could be realized through a complex caries prevention in 5 kindergartens of the town Jena. Since 1986 we found in 50 per cents of six years old children dentures free of caries after three years of caries prevention.

In the former GDR, a series of central regulations governed the sanitary and hygienic aspects of town planning and building construction. Special analysis of the hygienic aspects of town planning was of particular importance and was performed by a standardised method by the planning authorities. In such an analysis both the existing hygienic conditions in an area to be built up or reconstructed had be included, as well as the planned hygienic conditions after putting the building measures into practice. The complicated way of planning and the possibility of rejecting hygienic considerations in favour of political decisions proved to be an obstacle to quick and hygienically satisfactory realisation of planned investments.

From 1979 to 1988 in the GDR the number of patients with alcoholic liver cirrhosis increased from 2,387 to 3,958 (61.2%). An evident decrease of patients with acute virus hepatitis was observed (from 7,037 in 1979 to 1,578 in 1989). In future a further increase of alcoholic liver diseases with the resulting complications (e.g. coma, bleeding varices and withdrawal symptoms) has to be expected.

Guidelines for treating rheumatic diseases in the GDR are formulated based on the sociomedical and economic impact of class XIII (International Classification of Diseases, Injuries and Causes of Death (ICD) of WHO, 9th revision: 1975); these consider trends in temporary incapacity of employees and their utilization of hospital services, as well as statistics of disability pensions. The presentation of the organized cure and care programs, with special emphasis on rheumatology practitioners is followed by a discussion of issues in graduate, postgraduate, and continuing rheumatological education. Finally, a cursory review is given of the priorities and tasks of rheumatology research in the GDR.

The reports of 223 haemophiliacs living in the districts Halle, Leipzig, Karl-Marx-Stadt, and Gera had been analyzed for bleeding events in 1986. There were suffering from haemophilia A 185, from haemophilia B 36 and 2 persons from a complex disorder. In each case 73 patients suffer from a severe and a moderate type of haemophilia. In 55 patients the diagnosis was mild form of haemophilia and in 22 subhaemophilia. Altogether 1802 bleeding episodes had been registered with the following locations: elbow joint 21.0%, knee joint 17.9%, ankle 14.2%, shoulder 4.3%. In 5% of all cases multiple joints had been affected at the same time. Soft tissue bleedings occurred in 16.7% of all cases. For substitution treatment of these 1802 bleeding events altogether 9020 transfusion units were needed, appropriate to 40.4 per year and 52.4 per year and bleeding patient respectively. Expense and duration of treatment depend on the bleeding location. Conclusions for the clinics and the transfusion service are possible.

The frequency of chlamydial infections was investigated by means of the McCoy culture technique and a serological procedure using the microimmunofluorescence test in female outpatients showing suspect symptoms; in patients suffering from acute salpingitis, and in women with involuntary infertility. In 18.6% of 290 subjects of the first group, chlamydiae were isolated from cultures. Of 26 patients with acute salpingitis, Chlamydia trachomatis could be detected in 10. The high frequency of positive serological tests suggests chlamydial infection to constitute an important etiological factor in female infertility and extrauterine pregnancies.

The present paper is based upon the results of anthropological examinations of Jena schoolchildren. It gives a statement on the extent and the present level of secular changes in selected characteristics. Over long periods of time a becoming slimmer of today's population of Jena schoolchildren is documented. The secular acceleration in Jena probands has lasted up to the present time (although in part with reduced intensity).

Also after the elimination of certain subjects and after the development of subspecialisations internal medicine has remained the central clinical basic speciality. The synoptic medical thinking and acting with a coordination of all special examinations to a coherent view and treatment of the patients is incumbent on the internal specialist as "general internal specialist" or so-called "generalist". The central point of the intermedical care of the population lies in the work of the internal specialist. This has consequences also for the education and further training. In the auditory and at the patient we must be able to show the students and physicians trustworthy how internal medicine as general internal medicine is organised in its full extent and is practised by a medical superintendent who is qualified to do this.

Hepatitis represents a serious complication in the transfusion of blood and blood products. In examining patients from the haemophilia centre in Jena HBsAg was identified in no case, HBsAK, however, in 80% of them. The rate of hepatitis infection increased here with the increasing frequency of transfusion. It should be determined by regularly checking HBsAG, HBsAK and transferases within the scope of prophylactic examinations.

In the period of 1958-1979 in the files of National Cancer Register (NCR) of GDR 1,313 patients with nasal cancer (ICD 160) were registered in seven districts of the GDR. In collaboration with NCR the occupational history of 1,160 patients with nasal cancer was recorded by a questionnaire. The results suggest an increased number of tumors in several professions. Compared to about 19 expected tumors in male woodworkers the number of the observed was 70. This is a statistical significant risk of 3.6.

In this paper we report about the actual supply of iodine of women in childbred determining iodine levels in serum and milk of the mothers. No significant differences were found between women without, with treated or with untreated goitre. In early childbred and 4 weeks after birth the iodine in milk amounts to about the half of the maternal serum level and does not further increase with continuation of nursing.

By means of statistical methods there will be demanded the increased rate of prematures and mortality of multiple pregnancies. Mortality by birthweight and percentiles by birthweight to gestational age are used at this study. The special position of multiple pregnancies has been discussed and compared with singletons related to the different distribution of birthweight and the associated problems.

It is reported on the department of general internal medicine of the Friedrich Schiller University Jena and its position in the complex of the internal medical basic care. It is particularly dealt with the cooperation with the specialists for general medicine and the subspecialists. At this example the role of the "general" internal specialists and his tasks in care, research and education in a university clinic are discussed and the necessity of a profile determination is made clear.

Concerning 150 patients suffering from acute cerebrovascular insufficiency we asked the following questions: 1. How often did cardiac decompensation occur, 2. How often did hypertension and hypertrophic symptoms occur in the electrocardiogram, and 3. How often did arteriosclerosis of the cerebral and coronary vessels occur together in deceased patients? Among the patients examined were 47.3% who showed symptoms of cardiac decompensation. Hypertension was found in 60.7% of the patients. The combination of symptoms of hypertrophy in the electrocardiogram and cardiac dysrhythmia was registered 39 times (26.0%). Arteriosclerosis was found in 68.2% of the post-mortem examinations. A high correlation was found between the sclerosis of the intracranial cerebral vessels (65.9%) and the sclerosis of the coronaries (75.0%). The possibilities of the prevention and deceleration, resp., of cerebrovascular insufficiency by early therapy of hypertension and of cardiac decompensation are pointed out.

In a retrospective analysis 228 patients suffering from ovarian carcinoma were investigated. They had been treated at the Dept. of Gynecology of Jena from 1974 up to 1983. We determined remission rate, remission time, and 5-year survival. Conclusions of our analysis are the following: The incidence and 5-year survival of patients suffering from ovarian cancer are nearly constant during the time interval obtained in this study. Survival will be determined by 38%. Early stages (I and II) were treated only by operation while patients suffering from higher stages (III and IV) were undergone chemotherapy and/or radiotherapy. We obtained value of the remission rate and the 5-year survival rate, comparable to these reported in literature.