Search

Zur Normenanalyse und Normenkritik der gegenwartigen Verbraucherpolitik lassen sich Beitrage der folgenden Arten erarbeiten

The effect of HSV (controls: sham), which induces hypergastrinemia, on duodenal Ca absorption was studied in "intact", TPTX, PTX, and TX rats. Ca absorption was estimated by an in vivo loop technique. As this technique increased serum gastrin by the duodenal Ca load, gastrin was also measured in rats not subjected to evaluation of Ca absorption. Following vagotomy gastrin rose significantly in "intact" as well as in TPTX, PTX, and TX rats. Further, intraduodenal Ca increased gastrin both after sham and vagotomy. However, gastrin in vagotomized rats was significantly higher than in sham rats, too. Although duodenal Ca absorption was not altered by vagotomy in "intact" and in TX rats, it was significantly lowered in vagotomized TPTX and PTX rats. Pretreatment of TPTX rats by pentagastrin for 10 days or immediately preceding experiments did not change Ca absorption. In addition, serum parathyroid hormone was unchanged by vagotomy in "intact" rats as compared to sham controls. We conclude that (1) vagotomy does not influence the rate of duodenal Ca absorption in "intact" rats, (2) Ca absorption is lower after vagotomy only in the absence of parathyroid glands, and (3) this vagotomy effect is not mimicked by exogenous pentagastrin and therefore appears unrelated to endogenous postvagotomy gastrinemia.

Binding of aggregated human immunoglobulin G (IgG) on diploid human fibroblasts leads to a rapid depolarization of the cells within 1-2 min. We resolved this membrane potential change into its plasma membrane and mitochondrial membrane components by measuring the transmembrane distribution of the lipophilic tritium-labelled cation tetraphenylphosphonium, [3H]Ph4P+. The responsibility of the plasma membrane for the membrane potential change, induced by binding of IgGs, is demonstrated. The IgG-induced membrane depolarization leads to the induction of prostaglandin E2 synthesis. Aggregated immunoglobulins (IgG) are specifically bound via the Fc portion because only binding of Fc fragments, in contrast to (Fab')2 fragments, leads to a stimulation of prostaglandin E2 synthesis comparable to that mediated by IgGs. Depolarization of the plasma membrane by short incubation of the fibroblasts in high-K+ buffer (5 min) results in a stimulation of prostaglandin E2 synthesis comparable to that mediated by either aggregated human IgGs or Fc fragments. Our previous results on Fc gamma-receptor-mediated antigen-IgG-antibody complex internalization showed that a maximum uptake of these complexes could be detected 60-90 min after binding. Therefore, we conclude that not internalisation but binding of aggregated IgGs to the Fc gamma receptors on human fibroblasts is the stimulus for plasma membrane depolarization leading to an enhanced prostaglandin E2 release.

A monoclonal antibody, FR51, raised against the IgG Fc receptor (Fc gamma R) of the human monoblast cell line U937 was used to analyze the distribution of this antigen on various human cells. This antibody inhibited the binding of human IgG to the Fc gamma R on U937 cells, HL-60 cells and human peripheral blood monocytes. In contrast, the Fc gamma R on human granulocytes (neutrophil cells) and on an Epstein-Barr virus-transformed human lymphoblastoid cell line (Raji) were not recognized, indicated by the failure of blocking the binding of human IgG ligand to the Fc gamma R on these cells. By affinity chromatography of detergent-containing cell free lysates of surface-iodinated U937 cells, HL-60 cells and monocytes, a protein of 70-kDa was isolated. This protein was identified as the Fc gamma R by rebinding the isolated protein to immobilized human IgG. Removal of the carbohydrate moiety with endo-beta-N-acetylglucosaminidase F demonstrated that the receptors consist of a 40-kDa polypeptide. Analysis of the polypeptide patterns obtained by proteolytic digestion of either mature (70-kDa) or deglycosylated (40-kDa) receptors isolated from monocytes, U937 cells and HL-60 cells strongly suggests that the Fc gamma R are identical. The monoclonal antibody FR51 specifically reacts with Fc gamma R on human monocytes, a myeloblast and a monoblast cell line but not with the receptors on a B cell line and neutrophil cells.

In healthy controls (n=34) and in the various metabolically defined subgroups of urolithiasis patients, including primary hyperparathyroidism (pHPT), parathyroid hormone (PTH) was studied using two different antisera, as were the cyclic nucleotides (cAMP; cGMP) and related variables in both urine and plasma; in addition, the nephrogenous components of the cyclic nucleotides were also determined. In nonpHPT (so-called idiopathic) stone disease, nephrogenous cAMP (2-h fasting urine) was significantly lower than normal in the normo-calciuric majority (n=60), and also lower than normal (medians) in all the other subgroups (absorptive hypercalciuria,n=15; renal hypercalciuria,n=23; uric acid lithiasis,n=17; uric/calcium oxalate lithiasis,n=12). In contrast, it was significantly elevated in pHPT (n=20), and only in this latter condition was nephrogenous cGMP (2-h urine) elevated. The total nucleotide production (sum of nephrogenous cAMP + nephrogenous cGMP) is again significantly lower only in normo-calciuric calcium stone disease. Except for high values in pHPT, no differences in plasma nucleotides are observed. Stone patients (idiopathic and pHPT) have significantly lower-than-normal serum phosphate and phosphate threshold in common. With the exception of pHPT, the differences in serum calcium are only minute, while ionised calcium is moderately elevated within the normal range in the serum of renal hypercalciuria patients.

Glucose tolerance test (oral standard glucose tolerance test) was carried out--before starting radiotherapy--in 99 female patients suffering from inoperable cancer of the genitals. 47 of these patients were administered gestonoroncapronate (600 mg/week) during radiotherapy. Glucose tolerance was tested anew after the last irradiation. During the first hour after the second glucose tolerance test, an improvement of glucose tolerance was stated in the patients' group treated with gestonoroncapronate, whereas during the second hour a deterioration of glucose tolerance was found. The patients' collective treated without gestonoroncapronate demonstrated an improved glucose tolerance during the entire second course of the test. A decrease of capacity of the islet cell organ, induced by gestonoroncapronate, is discussed.

Description of the course of disease concerning an intraligamentous pregnancy carried to full term, but diagnosed only during operation. Subsequent evaluation of the ultrasonic and cardiotocologic graphs. Constantly rectilinear pressure curves without uterine activities are interpreted as characteristic tocographic criteria of an advanced ectopic gravidity.

Nitrate wie Glyceryltrinitrat (GTN), Isosorbiddinitrat (ISDN) werden in verschiedenen Darreichungsformen als Tablette, Salbe, Pflaster, Spray und auch intravenos angewendet. Ihre Anwendung hat in den letzten Jahren eine deutliche Ausweitung erfahren. ISDN, oral verabreicht, galt lange Zeit als Standardtherapeutikum zur Prophylaxe der stabilen Angina pectoris, GTN als Zerbeiskapsel oder Spray zur Therapie des akuten Angina pectoris-Anfalls. Nachdem verschiedene klinische Studien positive Wirkungen intravenos zugefuhrter Nitrate beim akuten Myocardinfarkt im Sinne einer Verkleinerung der infarktbedingten Nekrosezone ergaben, wurde GTN zunehmend in der internistischen Intensivtherapie eingesetzt. Weitere Indikation zur intravenosen Applikation sind die akute Linksherz-Insuffizienz, allein oder in Kombination mit Furosemid. In der Anastesiologie und operativen Intensivmedizin werden intravenos applizierte Nitrate zur kontrollierten Blutdrucksenkung, sowie bei Zustanden, die mit einer Druckerhohung im kleinen Kreislauf einhergehen, eingesetzt.

We have searched for elevated basal plasma somatostatin in patients with documented cholelithiasis (n = 37) and compared the data with healthy control subjects (n = 27). Using an acidic assay system for measuring somatostatin in unprocessed plasma, we could not find deviations from normal values in biliary stone patients. Also basal blood levels of other islet cell hormones (insulin, glucagon) and minerals (calcium, magnesium) are unchanged. Further studies are needed to find out whether an abnormal response of plasma somatostatin to appropriate stimuli can play a role in the etiology of biliary stones.

In patients with urolithiasis, stones composed of uric acid are the second most frequent stone species following calcium-containing stones. In our outpatient clinic about 17 percent of all urolithiasis patients have uric acid stones (1). Whereas calcium-containing stones are most frequent between the ages of 36 to 55 years, the maximum frequency of uric acid stones occurs between 56 and 65 years. Males are predominant in this group and comprise about 70 percent of all patients examined.

Isoflurane is the only routine volatile anesthetic which leads to a burst-suppression EEG in nontoxic concentrations and for which no memory impairments can be expected subsequent to anesthesia. After electrically induced spike-wave activity in electroconvulsive therapy (ECT), a brief period of a very flat EEG can be observed. This phenomenon may be closely related to the therapeutic effects of ECT. The results which have been achieved up to now in comparing ECT to anesthetic therapy with isoflurane, without seizures being induced, are presented.

After various types of sympathectomy (surgical, chemical, isolated adrenodemedullation; AMX, combined procedures) in the rat, basal gastric secretion, gastric mucosal blood flow (MBF), associated glucose and a variety of hormones in the blood were measured. With the exception of the ineffective surgical sympathectomy, all the other forms variously influence gastric secretion qualitatively (volume, acidity, pepsin) and quantitatively (output per unit time). Chemical sympathectomy has an augmenting effect both on acid (volume, acidity, output) and on pepsin. In general the MBF parallels acid, but the MBF is decreased after AMX despite stable or increased gastric secretion. Sympathectomy, except procedures involving AMX or AMX + surgical sympathectomy, increases spontaneous gastric mucosal lesions. With AMX glucose is diminished, but is elevated following surgical and chemical sympathectomy. Gastrin, insulin and somatostatin are always higher than in sham-operated controls, glucagon after surgical sympathectomy only. It is concluded that (1) the sympathoadrenal system in the rat modulates both basal gastric secretion and blood hormones; (2) the adrenal medulla may participate in the control of gastric MBF, and (3) gastric mucosal lesions are not correctly reflected by the ration MBF/acidity.

The indication for wedge angiograms in intensive-care patients within the scope of X-ray chest examination is outlined. The obligatory wedge angiogram in patients with Swan-Ganz catheter is redundant. 4 indications for this special examination are specified. As a new possibility for differentiating between the ventral or dorsal course of pulmonary vessels, an inverse ratio of arborization angles is outlined for the first time.

In a short-term (14 days) and a long-term (84 days) experiment after pancreatic duct occlusion in the rat, we measured the insulin, glucagon and somatostatin content of the pancreas; in the short-term experiment, in addition, we performed an oral glucose tolerance test on the 14th day. Exocrine pancreatic function in the short-term study was monitored on the 9th day - in the long-term study on the 21st day. In the long-term study, the pancreatic organ was also examined histologically. Occlusion of the pancreatic duct considerably reduces exocrine function. This accords with the histologically observed atrophy of the exocrine parenchyma, above all in the body and tail (after 84 days). 14 days after occlusion, basal plasma glucose and insulin was about the same as in the sham-operated rats. Incremental insulin after the glucose load in occluded rats was delayed for about 30 min, but the pattern of plasma glucose was only insignificantly altered as compared with the sham-operated controls. The insulin content of the pancreas on days 14 and 84 after occlusion was increased, glucagon and somatostatin unchanged. We conclude, that (a) intraductal occlusion of the pancreas is a suitable tool for inducing an atrophy of the exocrine pancreas; (b) in the short-term, after the duct occlusion, oral glucose tolerance is preserved, but the passage of insulin into the blood is delayed and is associated with a high level of insulin in the pancreas; the cause or causes of this coincidence is/are unknown.

Carbohydrate metabolism was examined--by means of the 100-gm-glucose standard tolerance test--in 23 patients showing a decrease in glucose tolerance during pregnancy; the examinations were carried out postpartum and after a three months' intake of a hormonal contraceptive (compound preparation: mestranol 0.1 mg, lynestrenol 1.0 mg). The peak values and the two-hour-values, being statistically significant, showed a normalization after delivery, and furthermore again a deterioration of glucose tolerance during the intake of the preparation. A remarkable increase in weight, as a possible cause for the dysbolism during contraception, was not observed.Carbohydrate metabolism was examined (100-gm-glucose standard tolerance test) in 23 patients showing a decrease in glucose tolerance during pregnancy; the examinations were carried out postpartum and after a 3 months' intake of a hormonal contraceptive (compound preparation; mestranol .1 mg, lynestrenol 1.0 mg). The peak values and the 2-hour values, being statistically significant, showed a normalization after delivery, and then a deterioration of glucose tolerance during the intake of the preparation. A remarkable increase in weight, as a possible cause for the dysbolism during contraception, was not observed.

In three groups--patients with recurrent calcium urolithiasis (RCU), patients with primary hyperparathyroidism (pHPT), and healthy controls--citrate was measured enzymatically in 24 and in 2-hr urine after an overnight fast. Citrate excretion per 24 hr was significantly lower in RCU than in age and sex matched controls, whereas there was no significant difference in citrate excretion in urines from the 2-hr morning collection. In pHPT citrate was also lower than in controls and fell within the range of RCU of comparable age. Both categories of urines (24 and 2hr) have in common the characteristic that the actual citrate concentration is lower by 50 per cent in RCU and pHPT than in controls, mainly as a result of the higher urine volume. Correction of citrate for creatinine does not disclose further differences among the populations studied but conversely hampers exact interpretation of urinary citrate in the absence of strict separation of individuals according to sex and age. From these data we conclude that (i) a low excretion and concentration of urinary citrate is detectable in calcium lithiasis and may contribute to a deficiency in inhibitory activity against nucleating processes in stone-forming urine; and (ii) the differences in urinary citrate elicited in samples of 24 and 2-hr morning urine are of unknown origin and merit further investigations.

The response of VIP to either an oral glucose load (OGT) or intravenous glucose (IV glucose), aimed at reproducing the plasma glucose level after OGT, was studied in trained, conscious, sham-operated (Sham; n =6 ) dogs, and dogs having initially (12 months before the glucose experiments) undergone occlusion of the pancreatic duct by the prolamine glue technique (Occ; n =5 ). As a result, prior to glucose studies, the exocrine pancreas function was found subtotally reduced, as indirectly evaluated by the para-aminobenzoic acid (PABA) test, but no signs of diabetes were detected. The two studies with glucose administration designed to demonstrate the release of insulin, VIP, somatostatin into plasma as modified by enteric signals (represented by the difference of plasma peptide concentration during OGT minus peptide concentration during IV glucose) revealed the following: (1) basal plasma glucose, insulin, VIP, somatostatin did not differ between Sham and Occ dogs; (2) after OGT in Occ dogs the plasma glucose was elevated, whereas plasma insulin was markedly reduced, and VIP, somatostatin were largely unchanged; (3) the integrated output of insulin only was impaired when considering the so-called entero-insulin axis, while integrated VIP, somatostatin were unaltered. It was concluded (a) the Occ procedure in the dog has the capacity to subtotal destruction of the pancreatic acinar tissue, and of the entero-insular axis of insulin, the latter through yet unknown pathways, (b) the Occ technique may be a useful tool for investigation of the nature of “incretin”, (c) VIP and somatostatin do not respond to elevated blood glucose and may have no role in the “incretin” concept of enteric modulation of the B-cell.

Sectorsonographic examination was performed in 17 patients with pleural effusion after heart surgery (n = 15) and during bacterial pneumonia (n = 2). When pleural effusion could be diagnosed by chest roentgenogram, it was identified by ultrasound in every patient. On the other hand, it was possible to recognize pleural effusion by ultrasound in 6 patients in whom chest roentgenogram was equivocal or failed the diagnosis. Neither chest roentgenogram nor ultrasound allowed the differentiation between transsudate, exsudate, chylus, and blood in the pleural space. However, localization and mobility of the diaphragm as well as concomitant pericardial effusion and/or ascites can be identified by ultrasound. Sonographic examination, an easily repeatable harmless method without radiation exposure should be performed in pediatric patients whenever pleural effusion is suspected.

In vivo Wechselbeziehungen zwischen exo- und endokrinem Pankreas sind wenig erforscht. Der Grund ist das Fehlen eines reprasentativen Tiermodells fur chronische Pankreatitis. Bei dieser (Mensch) wurden sowohl eine erhebliche Reduktion von Glucosetoleranz und Insulinreserven beobachtet als auch grob normale Befunde (1). Die beim Versuchstier ersatzweise praktizierte Gangunterbindung hat eine Atrophie des exokrinen Drusenanteils ohne nennenswerte entzundliche Nebenreaktion zur Folge, weshalb die Technik als Grundlage fur das Studium von exo-endokrinen Verflechtungen am Pankreas (2), aber auch zur Bewertung des Inkretin-Effekts gastrointestinaler Hormone (sog. entero-insulare Achse) (3) herangezogen wird. Im mikrochirurgisch erstellten Rattenmodell mit Pankreasgang-Occlusion (4) studierten wir die intravenose Glucosetoleranz und die begleitenden Veranderungen der Hormone aus A-, B- und D- Zellen.

Hyperoxalurie ist ein wichtiger Risikofaktor in der Atiologie der rezidivierenden Kalzium-Urolithiasis (RCU) (1, 2), aber das Vorkommen von Hyperoxalurie bei dieser Stomng wird widerspruchlich beurteilt (3,4, 5). Die Hyperoxalurie-Theorie basiert auf der Vorstellung einer gesteigerten intestinalen Oxalat-Absorption bei koexistierender intestinal-hyperabsorptiver Hyperkalzurie (Einzelheiten s. Lit. 6). Normale intestinale Absorption von 14C-Oxalat bei nichtklassifizierter RCU wurde ebenso gefunden (7) wie erniedrigte Tracer-Absorption bei alien mit RCU vergesellschafteten Kalzurie-Typen (8), wenn der Bewertung auser einer 24-h-Urinperiode auch eine postprandiale Urinperiode von 3 h zugrundegelegt wird. Den meisten fruheren Arbeiten ist gemeinsam, das die Oxalat-Exkretion wahrend der fur die enterale Resorption kritischen Periode von 3 h nach Nahrungszufuhr nicht gemessen wurde. Die Bewertung der fraktionellen intestinalen Absorption von Tracer-Oxalat last theoretisch die Moglichkeit offen, das die Bewegungen von Urin-Oxalat hierbei nicht reflektiert werden: als mogliche Mechanismen einer Hyperoxalurie kommen neben einer enteralen Hyperabsorption vermehrte endogene Synthese, moglicherweise aus Oxalat-Prakursoren, sowie veranderte renale Bearbeitung von Oxalat in Betracht.

Report is made, in a comparative examination, about infant mortality and early morbidity, as well as about several further perinatal criteria in gestational diabetics, 85 of whom were delivered before/on the calculated date and 59 after the term. With the exception of weight and length of the newborn, no significant differences are occurring in any of the symptoms selected. The same situation appears in a control group consisting of people with healthy metabolism. Conclusion is made thereof that gestational diabetes per se does not represent an indication to terminate pregnancy at any rate on the calculated date.

The influence of highly selective vagotomy (HSV) upon mineral metabolism was investigated in patients with duodenal ulcer (DU). Data obtained before HSV were compared with those from healthy control subjects and, additionally, with data from pre- and post-HSV observations. In DU the function of the parathyroid glands is unsettled because of decreased renal phosphate threshold, normal serum parathyroid hormone and decreased nephrogenous urinary cAMP. HSV decreases the phosphate threshold further, but does not change parathyroid hormone, calcitonin, or nephrogenous cAMP. Conversely, besides hypergastrinemia, HSV accounts for a decrease in total calcium in serum in the presence of an increase of the intestinal calcium absorption, while the bone mineral content is stable up to 5 years following HSV. Moreover, HSV normalizes the decreased serum concentration of 25-hydroxyvitamin D found pre-operatively in DU, while that of 24,25-dihydroxyvitamin D, known to be effective upon bone and gut, remains unaltered. A classification according to pre-operative gastric acid secretion (normo- and hypersecretors) does not provide further insights into variables of mineral metabolism encountered in DU pre- and post-HSV.

The chemotherapy of malignant tumors with oxazaphosphorine cytostatics, e.g., cyclophosphamide (CP) and ifosfamide, is limited by their severe urotoxic side effects. As a result of cytotoxic damage, the proliferation of the urinary bladder urothelium is considerably stimulated during an intensive reparative regeneration. The recently developed uroprotector sodium 2-mercaptoethane sulfonate (Mesna) allows regional detoxification limited to the kidneys and lower urinary tract and thus protects against damage by aggressive oxazaphosphorine metabolites. The object of the present quantitative autoradiographic investigation was to study urothelial proliferation in the bladder of rats after administration of CP alone and in combination with Mesna. 20 h after intraperitoneal injection of a single dose of CP alone (100 mg/kg), the urothelium showed a steep rise of the 3H-thymidine (3H-TdR) labeling index which reached a peak of 17.6% at 30 h. Thereafter, the 3H-TdR index rapidly dropped. A second peak of 4.4% was observed after 7 days. With supplementary intravenous administration of a single dose of Mesna (100 mg/kg) 15 min before treatment with CP, the labeling index was substantially lower than after administration of CP alone. Thus, maximal values of only 1.6 and 1.9% were observed at 35 h and 7 days, respectively. Histopathological examination of the bladders showed severe necrotizing and ulcerative cystitis, 10, 20 and 25 h after administration of CP alone whereas with additional treatment with Mesna only slight edema of the lamina propria developed. The results obtained clearly demonstrate the protective action of Mesna on the urothelium of the lower urinary tract against the urotoxic effects of CP.

Zerebrale Krampfanfalle und psychomotorische Entwicklungsverzogerung in Verbindung mit den typischen Hautveranderungen sind hinweisend fur die Diagnose tuberose Hirnsklerose. Rhabdomyome des Herzens konnen, wie aus pathologisch-anatomischen Untersuchungen seit langem bekannt ist, assoziiert vorkommen und werden seit Einfuhrung der Echokardiographie haufiger intra vitam beobachtet.

Dose-response-curves for rectal induction of anaesthesia in children with 1%- or 5%-methohexitone-solutions and dosages of 5, 10, 15, 20 and 25 mg/kg body wt. were obtained in 10 groups of 20 children. Methohexitone and hydroxy-methohexitone serum-levels were compared in another 23 children after application of 1%- or 5%-methohexitone-solutions at dosages of 15 and 20 mg/kg body wt. The sleep induction quota after 1%-methohexitone-solution in the 20 and 25 mg/kg body wt.-dosages was significantly higher, 20% and 25% respectively, and the mean sleep induction time shorter, 37% and 45% respectively compared with results after 5%. The change after 15 mg/kg body wt. was not significant. A study of dosages 5 and 10 mg/kg body wt. was discontinued due to insufficient effect. Methohexitone serum-levels ranged from 0.7-8 mg/l. All of the children after the use of 1%-methohexitone-solution, and only 60% after 5%-methohexitone had serum concentrations above the sleep inducing "borderline" concentration of 2 mg/l. The differences between mean methohexitone and hydroxy-methohexitone-serum-levels were not significant due to the small groups and the wide range of results. We conclude that individual dosages of 15 or 20 mg/kg body wt. 1%-methohexitone-solution should be applied according to clinical criteria such as physical and psychic status of the child.

The dose-response relationship of the Vitamine-K-antagonist Phenprocoumon (Marcumar) was studied in a group of 11 children and 10 adults receiving anticoagulation postoperatively after mechanical valve replacement. The dose in children was found to be lineally correlated to the body surface area and similar to that in adults (saturation dose: 16.0 +/- 3.2 mg/m2; maintenance dose: 11.2 +/- 1.6 mg/m2/week). During the follow up period (265 patient months) one child died from mitral valve thrombosis, two children developed traumatic haematomas, and in one child interactions with 2 other drugs were observed. The incidence of thrombembolism or serious bleeding complications was 4.5 and 9.0 instances per 100 patient-years, respectively. The efficiency of prothrombin time control was established over a six months period and showed 70.3% of the values within, 23.% above, and 6.5% below the therapeutic range. During this period, the prothrombin time was measured 2.5 times per patient and month at the average. We conclude from our experience, that an anticoagulation therapy with Phenprocoumon can be performed in children with only mildly elevated risk of bleeding complications as effectively as in adults provided it is monitored closely.

JET tokamak performance has been progressively raised, culminating in operation at the full design level of 5 MA plasma current in a toroidal field at 3.4 T. the plasma current, position, shape and line-average electron density are controlled by feed-back systems. By glow discharge cleaning in H 2/methane mixtures, the interior of the vessel has been coated with carbon. This reduces the fraction of power radiated

Abstract During 1978 a large 4.2 million barrels (0.7 million cubic meters) per day water injection pressure maintenance project in the Ghawar Field in pressure maintenance project in the Ghawar Field in Saudi Arabia was successfully converted from the use of subsurface saline water to the use of treated seawater for injection. New facility design and construction involved equipment selection and installation in a magnitude never before encountered in seawater treatment operations. The known processes of seawater treatment including processes of seawater treatment including filtration, deaeration, and scale stabilization were implemented in this case with improved concepts of high volume filtration, different approaches of inert stripping gas generation, and self-sufficiency for almost all chemical treatment. The planning, manning, organization, and start-up planning, manning, organization, and start-up management to bring this new facility on-stream within constraints of time, budget, and water quality are discussed. The ability to smoothly convert water supplies without loss of injection volumes or prolonged shutdowns evolved from early problem analysis sessions which anticipated problem analysis sessions which anticipated problems, identified causes, and took preventive problems, identified causes, and took preventive action to remove obstruction in advance. Pilot plant operation during construction finalized plant operation during construction finalized filter media design, pinpointed chemicals, trained operators, and served as a focal point on location to build spirit of teamwork among groups related to Operations, Maintenance, Engineering, and Project Management. Test operation of full scale facilities was undertaken at the earliest moment with support and concurrence of the Construction agency to confirm design and installation. Late delivery of critical control panels required extensive field engineering and equipment modification to hold to start-up schedule. Results show that early indepth participation by the ultimate operating proponent and support groups insures knowledge, proponent and support groups insures knowledge, understanding, and competency in operating facilities critical to support of large volume oil withdrawals. Background Oil withdrawals from the North 'Uthmaniyah portion of the Ghawar Field require pressure portion of the Ghawar Field require pressure maintenance by water injection. Peripheral injection along both flanks of this large oilfield was begun in 1966 using gravity injection wells. In 1973, a program was initiated to convert gravity injection wells to power injection. New surface facilities were designed and constructed incorporating a central saline aquifer water gathering station called 'Uthmaniyah Water Supply Station (UWSS) boosting aquifer water to any of five water injection station identified as 'Uthmaniyah Water Injection Pump Stations (UWIPS). Twelve Combustion Gas Turbines (CGT) were used as prime movers in these stations direct driving booster and shipper pumps to provide high pressure water along flanks of oilfield for peripheral injection below the oil-water contact. Figure I shows area of interest and original power injection arrangement. The decision to replace aquifer water was made in 1974 when it became apparent that the design goal of 4.2 million barrels (0.7 million cubic meters) per calendar day could not be supplied from saline aquifer water supply in this area. Treated seawater was selected as the replacement supply. This paper presents a case history of the organization, planning, manning, and start-up management to bring this new facility on-stream. FACILITY DEVELOPMENT The treated seawater system is shown schematically in Figure 2 taken from a previous publications. Completely new facilities were required publications. Completely new facilities were required from the Qurayyah offshore intake and treating plant to the suction side of UWSS. Until 1974 plant to the suction side of UWSS. Until 1974 the Qurayyah site existed as unimproved, sandy beach without habitation, reasonable access, or other improvements. A new 45 Km paved highway was built from Abqaiq headquarters to the selected Qurayyah plant site. Site preparation commenced in January, 1976.

Some workers state that sinus rhythm is essential for electrocardiographic placement of central venous catheters. We performed a prospective study to compare location control by ECG and by chest X-ray in 40 patients with absolute arrhythmia and atrial fibrillation. The criteria accepted as allowing the assumption of an intracardiac position of the catheter tip were: (1) Abrupt appearance of high-voltage P-waves when the right atrium (RA) was entered and their brisk disappearance when pulling the catheter back into the vena cava superior (VCS) and/or (2) a change in configuration and voltage of the QRS complex on withdrawal of the catheter from the right ventricle (RV). After establishment of an intracardiac position, the catheter was withdrawn until the ECG changed to show a trace identical to that seen before it had entered the heart. Then, in this study, the correct central venous position was confirmed by chest X-ray. The intravascular ECG revealed a correct placement of the catheter tip in the VCS in all patients but one. In this patient who had severe dysrhythmia, an intracardiac ECG could not be obtained, although the chest X-ray showed a correct position of the catheter in the VCS. While false-negative results (where an intracardiac catheter position cannot be documented although the catheter is in a central venous position) occasionally do occur, false-positive results (with ECG suggesting an intracardiac location read, though the catheter tip is actually in a peripheral vein) are virtually impossible.(ABSTRACT TRUNCATED AT 250 WORDS)

The high- and Low-Z impurity make-up of the plasma both at Low and high density Tokamak discharges has been investigated. At 4 ms into the discharge the oxygen impurity content is estimated from the OVI (1032 Aring;) Line intensity to be about 3 % of the electron density. Later in the discharge the quantitative estimate of the oxygen content is more difficult to make because only the oxygen flux is measured. At late times the total oxygen flux is found to be 2 × 1014 cm−3s−1 which is 1.3 % of the hydrogen flux. The high-Z impurities come into the plasma either from the stainless steel wall (Fe, Ni, Cr) or from the limiter (Mo). The L-lines of these impurities are observed. Their intensity is found to rise during the first 40 to 50 ms of the discharge, which indicates a continuous accumulation of high-Z impurities in the bulk of the plasma. Utilizing global rate coefficients for the L-lines, one can obtain the temporal evolution and the radial distribution of the high-Z impurities in the plasma. No accumulation of the high-Z impurities in the center of the discharge is observed. On the contrary, one finds for both the low and the high density discharges an inverted high-Z impurity profile with a weak minimum in the center of the discharge. The low density discharge is usually (for clean wall conditions) metal dominated (Zeff≈ 6 to 8), but at high densities the oxygen begins to play a major role (Zff≈ 1.5 to 2). The high density discharges are obtained by allowing the hydrogen gas to flow into the discharge at some chosen time (usually at t = 40 ms). During the fast increase in electron density - typically from 2.5 × 1013 to 1.8 × 1014 cm−3 - one observes that the absolute density of the high-Z impurity decreases by almost a factor of 4. Comparison of these results with the QWAASS measurements show a rough quantitative agreement.

Gastric stress ulcers were produced by restraint in nonsecretory rats, and the response of the ulcer index to intraduodenal hydrochloric acid (HCl) or sodium chloride (NaCl) was studied in a three-step dose-response trial. Both substances lowered the ulcer index dose-dependently (Km HCl 0.038 +/- Km NaCl 0.089 +/- 0.009 mM/kg/h, respectively) reaching a nadir in rats receiving HCl. The improvement in ulcerations was associated with elevated plasma secretin, glucose, and lowered gastrin in this protocol. In both experimental procedures plasma vasoactive intestinal peptide (VIP) was higher with the low and intermediate doses as compared with the high dose when a slight venous hyperosmolality was present. Glucagon and insulin remained essentially stable. It is concluded that stress ulcers of the restraint type may be prevented by intraduodenal HCl, suggesting that the interplay of gastrointestinal hormones is deranged by stress and partly restored by acid instillation.

Eine Tinea ist nach allgemeiner Meinung abgeheilt, wenn Dermatophyten und klinische Veranderungen nicht mehr nachweisbar sind. Diese Kriterien uberpruften wir unter taglicher Gabe von 200 mg Ketoconazol (zum Fruhstuck, ohne Lokaltherapie). Im einzelnen ergibt sich: 1. Wann ist ein Pilz mikroskopisch und/oder kulturell noch bzw. nicht mehr nachweisbar und 2. wann ist die Tinea klinisch abgeheilt. Uberpruft wurde bei vermutlich rascher Heilung in ca. wochentlichen, bei langer Therapiedauer (Fussohlen — Nagel) in moglichst 4-(spater mehr-)wochigen Abstanden, ofters mit Fotodokumentation.

The external jugular vein can easily be identified in most patients and provides an alternative access to the superior vena cava. Unfortunately, advancement of the catheter may be hampered for anatomical reasons, e.g. the presence of valves. Use of a flexible guide-wire with curved tip (J-wire), as first proposed by Blitt et al., results in a significant increase in the rate of successful cannulations. This method necessitates tedious surgical draping, however, that may not always be practicable. Therefore, a catheter was developed that is wrapped in a protective sleeve and contains a J-wire instead of the common plastic mandrin, thus making contamination during insertion impossible.

Seventeen patients, aged from 2 days to 16 1/2 years, all suffering from acute myocarditis, were observed between 1975 and 1987. At the onset of the acute infection all patients had a severe disfunction of the left ventricle. Two patients died after hospital admission. Death occurred after one day and after five days, respectively. Postmortem examination showed inflammatory reaction within the myocardium with cellular infiltrates in both cases, and a variable degree of myocardial necrosis in one. The remaining 15 patients had follow-up check-ups between 2 months and 8.25 years later. Electrocardiographic abnormalities disappeared within 3 month in all patients, and the reduced fractional shortening of the left ventricle became normal in 80% of the patients after 5.5 months. At the last follow-ups one patient showed dilated cardiomyopathy. The other patients showed complete recovery regarding their functional capacity and regarding other clinical findings even though 50% still had some minor abnormalities in the echocardiogram and on the chest x-ray. Based on the findings of this follow-up investigation, the prognosis of acute myocarditis in childhood seems as being favourable, although some residual myocardial damage may occur. In most cases this residual myocardial damage is clinically and functionally insignificant. However, in some rare cases, significant chronic myocardial damage will be found.

A new operational regime has been observed in neutral-injection-heated ASDEX divertor discharges. This regime is characterized by high ${\ensuremath{\beta}}_{p}$ values comparable to the aspect ratio $A({\ensuremath{\beta}}_{p}l~0.65A)$ and by confinement times close to those of Ohmic discharges. The high-${\ensuremath{\beta}}_{p}$ regime develops at an injection power \ensuremath{\ge}1.9 MW, a mean density ${\overline{n}}_{e}g~3\ifmmode\times\else\texttimes\fi{}{10}^{13}$ ${\mathrm{cm}}^{\ensuremath{-}3}$, and a $q(a)$ value \ensuremath{\ge}2.6. Beyond these limits or in discharges with material limiter, low ${\ensuremath{\beta}}_{p}$ values and reduced particle and energy confinement times are obtained compared to the Ohmic heating phase.