Kaonic hydrogen and K(-)p scattering

Chiral SU(3) effective field theory in combination with a relativistic coupled-channels approach is used to perform a novel analysis of the strong-interaction shift and width in kaonic hydrogen in view of the new accurate DEAR measurements. Questions of consistency with previous K(-)p data are examined. Coulomb and isospin breaking effects turn out to be important and are both taken into account in this work.

Chiral dynamics of deeply bound pionic atoms

We present and discuss a systematic calculation, based on two-loop chiral perturbation theory, of the pion-nuclear s-wave optical potential. A proper treatment of the explicit energy dependence of the off-shell pion self-energy together with (electromagnetic) gauge invariance of the Klein-Gordon equation turns out to be crucial. Accurate data for the binding energies and widths of the 1s and 2p levels in pionic 205Pb and 207Pb are well reproduced without need for a notorious "missing repulsion" in the pion-nuclear s-wave optical potential. The connection with the in-medium change of the pion decay constant is clarified.

[Identification and characterisation of immune cells in the ejaculate of infertile and fertile men]

Using the immunoperoxidase technique with monoclonal antibodies the ejaculates of 20 infertile and 15 fertile men were examined for lymphocyte subsets and activation markers to know more about the cellular mucosal immunity in the male genital tract. The results have shown that there are small differences of T-helper (CD4), T-suppressor (CD8), B- (CD19) and Natural Killer cells (CD57) between both groups. The number of monocytes (CD14), activated T- and B-cells and macrophages (CD25), the LCA-positive cells (CD45) and the HLA-DR-positive cells were remarkably increased in fertile patients. It has been established that the number of NK-cells (CD57) correlated with mycoplasma infection and the B-cells (CD19) correlated with the testosterone level. It seems that the increased testosterone value improved the cellular immunity. Infertile men have a disturbed mucosal immunity and a higher rate of genital infections.

[Peripheral blood lymphocyte subpopulations of postmenopausal women with hormone replacement therapy]

The effect of hormone replacement therapy on cellular immunity of postmenopausal women was studied by flow cytometry (FACS). Lymphocyte subsets in peripheral blood before and after hormonal replacement therapy (HRT) were measured. After 6 months of HRT with the sequential combined drug Klimonorm(R) (2 mg estradiol valerate and 0,15 mg levonorgestrel) the cytotoxic T-cells (CD8) were reduced and the CD4/CD8 ratio was increased significantly (p < 0,05).

Carney complex--an unexpected finding during puerperium

Carney complex is an extremely rare, autosomal dominant, multi-system disorder characterized by multiple neoplasias and lentiginosis. The genetic defect responsible for this complex has been localized to the short arm of chromosome 2 (2p16). The most prevalent clinical manifestations in patients with Carney complex are spotty skin pigmentation, skin and cardiac myxomas, Cushing's syndrome and acromegaly. Here we report the case of a 31-year-old woman with a spontaneous pregnancy. At 32 weeks of gestation, she was admitted to our Department of Obstetrics with hypertension and severe back pain. In addition, she had unusual pigmentation and typical cushingoid features. One day after admission, the pregnancy was terminated by emergency cesarian section because of preeclampsia and pathological CTG. During the postoperative period the severe back pain persisted, and radiographic evaluation revealed a collapse of L(2)/L(3) with severe osteopenia. A CT scan showed a mass in the right suprarenal area. Histopathological examination revealed a primary pigmented nodular adrenocortical disease. After biochemical confirmation of the diagnosis of Cushing's syndrome, it was recognized that the patient met the diagnostic criteria for Carney complex.

Assessment of prenatal smoke exposure by determining nicotine and its metabolites in maternal and neonatal urine

Urine specimens were collected from 75 pregnant women before childbirth and from their newborns within 48 postnatal hours. A high-performance liquid chromatography (HPLC) method was used to determine urinary nicotine and its metabolites, cotinine and trans-3'-hydroxycotinine (OH-cotinine) to objectivise prenatal smoke exposure. Using the sum of nicotine metabolites as a marker, 34 women were classed as not exposed to smoke ( < 15 nmol/l), 18 as passive smokers (15-400 nmol/l), and 23 as active smokers ( > 400 nmol/1). The newborns of active smokers exhibited significantly (P < 0.001) higher nicotine metabolite concentrations than did those of either non-exposed women or passive smokers. A close correlation was found to exist between maternal and neonatal nicotine and cotinine concentrations (r=0.8968 and r=0.9205, respectively). For OH-cotinine, this correlation was particularly close when maternal, but not neonatal, OH - cotinine was adjusted to creatinine (r=0.9792). The neonatal/maternal urine concentration ratios for cotinine and OH-cotinine were noted to not significantly depend on the time of postpartal urine collection. Within the first two postnatal days, the extent of current prenatal smoke exposure attributable to active smoking of the mother was best reflected by the urinary concentrations of cotinine plus OH-cotinine without adjustment to creatinine.

[Electrophysiological studies in breast carcinoma patients with tamoxifen retinopathy]

PURPOSE

Crystalline plaques in the cornea or the retinal nerve fiber layer are well-known side effects of tamoxifen therapy. We investigated whether electrophysiological methods for determining the function of the retinal nerve fiber layer and retinal pigment epithelium demonstrate changes in tamoxifen retinopathy.

PATIENTS AND METHODS

We compared the right eyes of four women with breast cancer and mono- or bilateral tamoxifen retinopathy to ten right eyes of age-matched, eyehealthy patients who had not received tamoxifen by means of electrophysiological investigations (e.g., pattern-reversal electroretinography, flash electroretinography for the maximal combined response, electrooculography; ISCEV standard conditions).

RESULTS

No significant differences were observed between patients with tamoxifen retinopathy and controls regarding mean visual acuity, basal level of the electro-oculographic standing potential, basal level on the Arden index, or any of the other electrophysiological potentials.

CONCLUSIONS

Pattern-reversal electroretinographic measurements revealed no damage of retinal ganglion cells in the presence of crystalline plaques in the retinal nerve fiber layer. Electro-oculography did reveal differences, but these were not statistically significant, possibly due to the small number of cases.

Hormonal regulation of neonatal weight: placental leptin and leptin receptors

OBJECTIVE

To examine whether umbilical and maternal leptin levels correlate with birthweight, placental weight, and maternal weight; and to detect membrane-bound leptin receptors in placental tissue as well as soluble leptin receptors in umbilical and maternal blood.

DESIGN

Prospective observational study.

SETTING

University teaching hospital.

METHODS

Serum levels of leptin and soluble leptin receptors were analysed in 31 randomly selected mother/newborn pairs at delivery. In addition, placental tissue was assayed for leptin receptors using immunocytochemistry and Western blot.

RESULTS

The mean [SD] leptin level in umbilical cord venous blood (7.1 ng/mL [4.0]) was significantly lower (P<0.001) than in maternal blood (22.5 ng/mL [10.8]). Umbilical cord leptin concentrations correlated significantly with birthweight (P<0.001), placental weight (P<0.005) but not with maternal leptin. Maternal leptin concentrations correlated only with maternal weight (P<0.001). In chorionic villous tissue, trophoblasts stained strongly positive for leptin receptor-like immunoreactivity. Two membrane-bound isoforms of the leptin receptor were also detected in placental tissue. In both umbilical and maternal serum, a soluble leptin receptor was found migrating as broad band at Mr 97,000 D.

CONCLUSION

The present data strongly reinforce the idea that circulating leptin levels may provide a growth-promoting signal for fetal development during late pregnancy. While membrane-bound leptin receptors may be involved in autocrine regulation of placental leptin production, the soluble receptor form may serve as a transport vehicle for leptin to fetal tissues.

[Life situation of parents of twins and triplets: a qualitative study]

BACKGROUND

Starting in the middle of the 1980s, an increasing incidence of multiple pregnancies in Germany has been reported, with assisted reproduction mainly contributing to this increase. In the management of multiple pregnancies, the main focus is on optimising the obstetric care. The difficult socio-economic and psychosocial situation of parents of multiples, however, is often underestimated.

METHODS

The present study examines the life situation of parents of twins and triplets using focus groups as a qualitative research method. Nineteen mothers and fathers of twins and triplets were interviewed in four focus groups. Main topics were the parental reaction to the diagnosis of multiple pregnancy, the first time at home with the multiples, special situations and wishes and ideas for a better care during multiple pregnancy.

RESULTS

The diagnosis of multiple pregnancy was made at early gestational age, with the parental reactions being described between "happiness" and "shock". With this diagnosis, however, the future parents feel alone. Caring for the babies is leading to the limits of parent's ability to take stress. Marital problems and social isolation are discussed controversially. Exceptional situations such as illness of the mother require fast and un-bureaucratic solutions.

CONCLUSIONS

The interviews suggest that special problems of multiple parenthood such as social isolation, marital and psychic problems are not necessarily related to higher order multiples or handicapped children. It appears to be essential to offer a more individual care for women expecting multiples, whereas the main resource for improving care is in providing contact and information possibilities.

[Incidence of neural tube defects in the Magdeburg administrative district]

The Magdeburg Register of birth defects includes information on the incidence rate of neural tube defects (NTD) in the city of Magdeburg since 1980, and in the Regierungsbezirk (administrational district) since 1987. The average prevalence of NTD was 16.4 per 10,000 births in the city of Magdeburg, and 12 per 10,000 births in the surrounding counties. Besides of this significant difference between the city and counties, there are conspicuous variations from one year to the next. In 1987 the prevalence of NTD was about 27 per 10,000 births in the city of Magdeburg whereas the observed prevalence in the countryside was about 19 per 10,000 births. Different eating habits and/or increased teratogenic influences in the city may be considered as causes. In 1997 there was also a high rate of incidence of NTD in the city of Magdeburg--16.4 per 10,000 births. The incidence rate of NTD in the counties (about 10 per 10,000) births) is again lower than in the city. Because of these incidence rates, we may assume that the examined population is insufficiently protected by folic acid in the preconceptional stage.

Immunocytochemical detection of somatostatin receptors sst1, sst2A, sst2B, and sst3 in paraffin-embedded breast cancer tissue using subtype-specific antibodies

The long-acting somatostatin analogue octreotide (SMS 201-995) inhibits growth of certain breast cancer cell lines in vivo and in vitro. Because the antiproliferative action of octreotide depends on at least the presence of somatostatin receptors, it is crucial to determine the pattern of somatostatin receptor protein expression on the tumor cells. In the present study, we have raised polyclonal antibodies to somatostatin receptor subtypes (ssts) sst1, sst2A, sst2B, and sst3 using peptides corresponding to their COOH-terminal sequences. These antisera were used for immunocytochemical staining of paraffin sections of 33 primary breast cancers. Somatostatin receptor-like immunoreactivity (Li) was predominantly localized to the plasma membrane of the tumor cells. In the vast majority of positively stained tumors, somatostatin receptor-Li was uniformly present on nearly all tumor cells. Both the level and the pattern of expression of ssts varied greatly between individual carcinomas. sst2A-Li and/or sst2B-Li was detectable in 28 tumors (85%); among these, 14 tumors (42%) showed particularly high levels of sst2-Li. sst1-Li was found in 17 (52%) cases and sst3-Li in 16 (48%) cases. The expression of ssts was independent of patient age, menopausal status, diagnosis, histological grade, and levels of estrogen and progesterone receptors. The immunocytochemical determination of somatostatin receptor status allows direct detection of receptor protein on the tumor cells and, hence, may provide more precise information than reverse transcription-PCR for predicting response to octreotide therapy in breast cancer.

[Detection of abnormalities in Magdeburg according to the Mainz model]

Between 09/01/92 and 08/31/95 the Mainz model to register birth defects had been tested in the city of Magdeburg at the same time when the regional register instituted in 1980 was continued. The aim of this hospital-based model for the thorough registry of malformations in neonates is to examine all newborns born in hospitals using clinical and sonographical methods by experienced physicians according to a standardized scheme. Additional medical and social data were recorded. Data on live-and stillborn as well as spontaneous abortions older than the 16th gestational week and induced abortions following prenatal diagnosis were included. During the survey 5255 neonates were examined. The calculated percentage of major birth defects (by definition) was 7.8% and therefore higher than reported before. The experience with the Mainz model in the city of Magdeburg demonstrates, that this model is basically applicable to other centres. It is possible to obtain valid data on malformation frequencies in a defined population. Special attention has to be paid to certain conditions in the composition of hospital populations.

Examination of the two-dimensional pupil function in coherent scanning microscopes using spherical particles

The determination of the modulus of the pupil function in reflection acoustic and optical microscopy with the help of spherical particles is demonstrated. The theoretical examination shows that this method can give good results if the pupil function drops smoothly towards the edge. For a pupil with a sharp edge this technique can give the accurate pupil function only by imaging large spheres. The dependence of the accuracy of the method on the size of the spherical particle is analyzed. Numerical and experimental results obtained for the confocal scanning optical microscope and the scanning acoustic microscope are examined.

Investigations on Selected Red Cell Concentrates for Toxoplasma and Toxoplasma DNA

<i>Background: </i>The aim of the present study was to detect the occurrence of viable Toxoplasms or the presence of their DNA. Red blood cell concentrates of specific IgM-positive donors were tested in order to estimate if such blood products may have an infectious potential when transfused. <i>Material and Methods: </i>Aliquots of 1,000 red cell concentrates were used to inoculate in vitro cell cultures which were examined microscopically 6-7 days later with fluorescent staining for <i>Toxoplasma gondii. </i>Additionally, after a DNA isolation procedure, a polymerase chain reaction (PCR) was performed using a part of the sequence of the toxoplasma B1 gene as a target. Dilutions of <i>T. gondii </i>tachyzoites with the red cell concentrate were used as positive controls. <i>Results: </i>Tachyzoites could be detected by in vitro culture even when the inoculum statistically contained only one parasite. About 3 tachyzoites yielded a positive result with the PCR method. All red cell samples investigated gave negative results both in cell culture and PCR. <i>Conclusion: </i>The risk of transmission of Toxoplasms by transfusing red cell concentrates from specific IgM-positive donors can be considered unlikely.

Imaging of spheres with the confocal scanning optical microscope

The scalar theory of image formation for a strongly spherical object in ref lection confocal optical microscopy is considered. The image contrast is derived from the far-field scattering amplitude. Experimentally obtained images of the sphere are seen to be in good agreement with the theoretical prediction.

-Cytokine level in malignant ascites and peripheral blood of patients with advanced ovarian carcinoma-

The concentrations of various cytokines were examined by ELISA in blood and in ascites from 14 patients with advanced ovarian cancer (stage IV). The control group consisted of 6 patients with benign gynaecological disorders. Compared with patients with benign gynaecological disorders, ascites and/or plasma of patients with ovarian cancer showed significantly higher levels of IL-6, IL-8, IL-10, TNF-alpha, and sIL-2R. There were no increases of IL-1 alpha, IL-1 beta, IL-2, IFN-gamma, and sCD14 levels. The possible pathogenetic significance of cytokines in ovarian cancer is discussed.

Bacterial contamination of single-donor blood components

An analysis was performed of the microbiological laboratory quality control data for the past 9 years (1985-1993). Bacterial contamination was detected in 100 of 25,171 tested blood components. Single-donor platelet concentrates had a contamination incidence of 25 in 5889 (0.42%); whole blood samples were contaminated at a rate of 1 in 2973 (0.03%) and red cell concentrates at a rate of 73 in 15,317 (0.48%); of 992 samples of fresh frozen plasma only 1 was contaminated (0.1%). Gram-positive staphylococci comprised 75% of cases and Gram-negative rods 10%. This frequency of laboratory-detected bacterial contamination contrasts with the low rate of transfusion-associated septicaemic events.

Hepatitissicherheit von Blutkonserven

Presented are current results of blood donor screening for hepatitis markers and of retrospective investigations of these blood donors, whose blood units were reported as a possible cause of transfusion-associated hepatitis. In 1993 517,120 donations of 260,559 donors were investigated by routine. Only 8 of the samples (0.049%) were found positive for HBs-Ag and negative for anti-HBc, thus showing markers for early hepatitis-B infection.This means 1 of 65,000 samples. 1,251 samples (0.48 %) were found repeatedly reactive for Anti-HCV. From January 01,1989 until December 31,1993,107 cases (100%) of possible transfusion-associated hepatitis by a total number of 1,365 transfused blood units were reported. In 88 (82%) of these cases we were able to exclude any connection between the reported blood units and receivers’ hepatitis infection. Only one case (1 %) of reported hepatitis-B was found to be probably caused by one of the mentioned units. In 14 (13 %) cases we were not able to make a follow-up examination of all donors, and in 4 cases we found questionable results. The results of these investigations refer to a very low risk of hepatitis transmission by single blood units, screened for HBs-Ag, anti-HBc, anti-HCV and ALT.

[Leukocyte and lymphocyte populations in peripheral blood and malignant ascites in patients with ovarian carcinoma]

Ascites and peripheral blood of 12 patients with advanced ovarian cancer (stage IV) have been investigated by two-color flow cytometry for leukocytes and lymphocyte subsets with monoclonal antibodies, against CD3, CD4, CD8, CD14, CD16/56, CD19, CD25, CD45, CD57, and HLA-DR. Ascites compared with blood showed a significant raise of CD3-positive lymphocytes (80 +/- 14% vs. 69 +/- 8%) and a significant reduction of CD57-positive lymphocytes (13.6 +/- 13% vs 24 +/- 21%). There was an increased expression of HLA-DR on CD3-positive lymphocytes in malignant ascites. The results are discussed with regard to a supposedly defective local immune defense against the tumor.

[HIV retrospective study of the German Red Cross blood donation service in Germany]

OBJECTIVE

It was tried to retrospectively identify HIV infections in recipients of transfusions from donors who were tested HIV positive at a subsequent donation. These lookback data were traced back to answer the following questions: 1. How many transfusion recipients were infected before the start of the routine HIV testing in 1985? 2. How great is the risk of HIV infections from infected but not yet HIV antibody-positive donors? 3. Furthermore, the transfusion of HIV-infected transfusion recipients was traced back to the involved donor to establish causality.

DESIGN

Retrospective ('lookback') study.

SETTING

HIV Study Group of the Red Cross Blood Banks of the Federal Republic of Germany.

PARTICIPANTS

Preceding donations of HIV antibody-positive repeat donors were traced back to the transfusion recipients in order to establish their HIV antibody status. In a second lookback study, HIV-infected transfusion recipients and their corresponding donors were investigated after they had been reported to the blood bank as infected by transfusion-associated HIV.

INTERVENTIONS

None.

RESULTS

Recipients of 156 respectively 133 transfusions from repeat donors found to be Western blot-positive were investigated from 1985 to 1987 and from 1987 to 1992, respectively. About 50% of the recipients had died. About 40% of the recipients could not be examined, because they either were not available for testing or refused to be tested or because it was impossible to clarify the fate of the blood products. 25 HIV recipients were identified from 1981 to 1985, when routine HIV testing began. Nine transfusion-associated HIV infections were identified from 1985 to 1992. 25 million units of blood were prepared during this period.

CONCLUSIONS

The risk of HIV transmission by tested transfusions is extremely rare (in the order of 1:1 million). The second lookback study suggests that in more than 50% of the blood recipients in whom HIV infection was attributed to transfusion, a causal relationship to an infected donor could not be established.

[Effect of granulocyte colony stimulating factor (G-CSF) on peripheral blood leukocytes and lymphocytes in patients with chemotherapy-induced leukopenia]

In patients with extensive chemotherapy, G-CSF abrogated leukopenia following administration of cytotoxic agents. Six women with ovarian cancer and chemotherapy-induced leukopenia received 300 micrograms Filgrastrim (r-metHuG-CSF, Neupogen 30; AMGEN, Germany) daily for 10 days. Leukocytes and lymphocyte subsets of peripheral blood were determined before, throughout and after subcutaneous injections of G-CSF by flow cytometry using monoclonal antibodies to CD3, CD4, CD8, CD14, CD16/56, CD19 and CD45. It could be observed that not only neutrophils (23 fold) but also lymphocytes (6 fold) and monocytes (10 fold) showed a dramatic increase in cell counts throughout and after G-CSF administration. This is in contrast to previous reports, where only effects on neutrophils were described. In spite of the increase in lymphocytes the relative percentage of CD3+, CD19+, CD3-CD16/CD56+, CD3+, CD8+ and CD3+ CD4+ lymphocyte subsets did not change throughout and after therapy, except for an increased expression of HLA-DR on CD3+ lymphocytes.

Prevalence of human T-cell lymphotropic virus infections in Germany

The extent of human T-cell lymphotropic retrovirus HTLV-I and HTLV-II infections in the general population in central Europe has not been investigated fully. Two hundred forty-eight thousand blood donors from southern Germany were examined serologically for antibodies to the human lymphotropic retroviruses HTLV-I and HTLV-II: 0.021% were confirmed positive and 0.056% were "indeterminate". A limited number of seropositives and "indeterminate" samples were analyzed by polymerase chain reaction (PCR): the seropositives were confirmed as positive and 43% of the "indeterminate" samples were PCR-positive. The range of 0.021% HTLV-positives in 248,000 donors, i.e. about two in 10,000 individuals, mirrors closely the published data for the United States.

HIV-Lookback-Studie der DRK Blutspendedienste in der BRD

<i>Ziel:</i> Ziel der vorliegenden Untersuchung war es, durch eine Lookback-Studie 1. die Zahl der HIV-Infektionen durch Bluttransfusionen vor Beginn der routinemäßigen HIV-Testung abzuschätzen, 2. auf die Zahl der HIV-Übertragungen durch HIV-negativ getestete Blutspenden nach der Anti-HIV-Testung zu schließen, 3. den Infektionsmodus bei HIV-positiv gemeldeten Transfusionsempfängern durch Rück-verfolgung der Präparate zum Spender abzuklären. <i>Design:</i> Retrospektive («Lookback»-)Untersuchung. <i>Rahmen</i>: HIV-Studiengruppe der DRK-Blutspendedienste in Deutschland, die 80% der Gesamtblutversorgung leisten. <i>Teilnehmer:</i> Die Blutpräparate der Spenden von HIV-Antikörperpositiven Mehrfachspendern wurden, soweit möglich, zum Empfänger zurückverfolgt und diese auf ihren HIV-Antikörperstatus untersucht. In dem Untersuchungszeitraum von 1981 bis 1992 wurden etwa 25 Mio. Blutspenden auf HIV-Antikörper untersucht. <i>Interventionen:</i> Keine. <i>Ergebnisse</i>: Von 289 HIV-Western-blot-positiven Mehrfachspendern wurde versucht, Spenderserien zum Empfänger zurückzuverfolgen. Etwa 50% der Transfusionsempfänger waren an ihrer Grundkrankheit verstorben. Etwa 40% der Spenderserien konnten nicht vollständig abgeklärt werden, da entweder die Empfänger nicht zur Verfügung standen oder eine HIV-Testung verweigerten, oder die Blutpräparate nicht bis zum Empfänger verfolgt werden konnten. Aus den Lookback-Serien von 289 positiven Mehrfachspendern wurden 25 HIV-positive Empfänger vor Beginn der Testung (1982-1985) und 9 HIV-positive Empfänger von HIV-negativ getesteten Blutpräparaten nach Beginn der Testung (1985-1992) identifiziert. Beim empfänger-bezogenen Lookback wurden die transfundierten Blutpräparate von 135 HIV-positiv gemeldeten Transfusionsempfängern zum involvierten Spender zurückverfolgt. Bei mehr als 50% konnte keine Kausalität hergestellt werden, d.h., die benannten Blutpräparate waren nicht Ursache der Infektion, wobei 40% der Fälle nicht vollständig abgeklärt werden konnten. <i>Schlußfolgerungen:</i> Die Übertragung von HIV-Infektionen durch getestete Bluttransfusionen ist extrem selten (1:1 Mio.) und war auch vor der HIV-Testung in

The examination of the ITI system in disputed paternities

106 paternity cases with a total of 114 putative fathers were examined in the inter-alpha-trypsin inhibitor (ITI) system. Analysis was performed by isoelectric focusing (IEF) of untreated sera on polyacrylamide gels. From 39 paternity exclusions, determined in other genetic systems, 7 were confirmed in the ITI system. In 75 expertises the alleged man was not excluded from fatherhood; in 68 cases the probability of paternity was W greater than 99.73%. The practical exclusion rate in the ITI system was therefore calculated to be 10.45%. The theoretical exclusion rate was determined to be 19.3%. In one paternity case the alleged father and the child showed inverse homozygosity in the ITI system, while the man was not excluded from fatherhood in 28 additional marker systems. The calculated probability of his paternity was 99.99%. The assumption of an incomplete expression of the ITI phenotypes in infants is supported by a significant deviation between the observed and expected ITI distributions at population equilibrium.

[Regional transfemoral intra-arterial chemotherapy using selective catheter placement. Method and clinical results]

In a retrospective study on 108 arterial transfemoral perfusion treatments with cytostatic drugs, the authors describe the procedure and the response of patients shown by tumor markers, computed tomography, histologic findings, and subjective assessment by the patients. Then follows a critical discussion of the complication rate of a therapy which has proved since 1980 to be a valuable and effective treatment method. The objective remission rate was 67%, and a subjective response was observed in 75% of all cases. Compared to systemic chemotherapy, the tolerance was clearly better. Only in one case we found an arterial embolism which was treated by conservative measures. Intraarterial perfusion of cytostatic drugs is within the scope of palliative measures a very effective and, above all, relatively non-stressful treatment with regard to quality of life and survival time. This interventional therapy method should be offered by the radiologist to the clinical oncologist.

[Microsurgery of the fallopian tube]

9 per cent of all patients with female sterility are indicated to be operated on. After discussing the conditions for microsurgery the indications like salpingolysis, ovariolysis, fimbrioplasty, salpingoneostomia, anastomosis, conservative operations of ectopic pregnancy and endometriosis are argued in detail. Microsurgery improves pregnancy rates about 20 per cent. The principles of microsurgery should have a wider entrance in gynecologic operations.

Introduction of a standardized "paternity index" for the statistical evaluation of blood group findings in paternity testing

The introduction of a standardized paternity index (PI) for the statistical evaluation of blood group findings in cases of disputed paternity is proposed and explained. By using the PI X/Y as parameter, it is not necessary to give the information of the probability of paternity in percent. The PI includes the full information of the blood group findings. In addition to that, by using the suggested standardization based on the probabilities of error according to Schulte Mönting and Walter the test volume is also taken into account. The interpretation of the mathematical result is given by verbal predicates, the limitations of which are orientated by the verbal predicates for the probabilities of error according to Schulte Mönting and Walter, published by us elsewhere. Besides the essential fact that the test volume is taken into account, the most important advantage of this procedure is that the mathematical result is involved in the court decision only by the PI (which is free of any valuation) and its verbal predicate and not by sometimes relatively high percentages, which may be misunderstood by laymen.

[The distinction of elevated alpha-fetoprotein levels in amniotic fluids for antenatal diagnosis of genetic defects]

Among 1017 amniotic fluid samples of 831 patients were 110 cases (10,8%) cases with sanguivolent amniotic fluid in the first portion and a second clear specimen. Contrary to the trend to analyse only the second clear share, we tested both samples. 110 pregnancies are analysed. The abortion risk (1,8%) in this group and the rate of prematurity (8,1%) are not increased. Retrospectively we were able to demonstrate a fetus injury in one case. The different analysis enable us to a conclusion about the fetal risk.