Studies on the endometrial cycle depend upon the precise dating of the cycle stage. In the present paper the generally applied method of vaginal smear was carefully verified through the measurement of the hormones relevant to the endometrial cycle. From rats predated through vaginal smear cytology, the hormone levels of estradiol-17-beta (E2) and progesterone (P), luteinizing hormone (LH), and follicle stimulating hormone (FSH) were measured. The values obtained were then compared to the standardized values of our reference curve. Animals with values that did not fit within the standard deviation of our reference curve were excluded from this investigation. Thus, for the first time exactly dated rat endometrial morphology was studied with electron microscopy. The morphology of the surface epithelium of rat endometrium from all four stages of the cycle is described in detail. In addition a semiquantitative morphometric analysis of the following parameters was performed: cell volume, nuclear volume, the volume density of secretory granules, digestive vacuoles, mitochondria, Golgi apparatus, rough endoplasmic reticulum, and lipid vacuoles as well as the size of lipid vacuoles. With the cellular content of lipid vacuoles and their diameter, it is possible to differentiate between proestrus/estrus and diestrus I/diestrus II, the latter possessing definitely more and larger lipid vacuoles. During estrus the greatest cytoplasmic volume develops. In addition to this, secretory granules are only present during estrus. Finally, diestrus I can be well differentiated from diestrus II, because diestrus I exhibits more digestive vacuoles and during diestrus II a high percentage of free ribosomes is present. On the basis of distinct morphological features, described in this paper, it is now clearly possible to distinguish between the four different cycle stages.

Bloodstream infections are life-threatening conditions which require timely initiation of appropriate antimicrobial therapy. The accuracy of direct disk diffusion susceptibility testing of positive blood cultures was investigated, including for the first time b-lactam/b-lactam-inhibitor combination antibiotics. Results of direct testing, following the guidelines of the Clinical and Laboratory Standards Institute, were compared to standard microtitre broth dilution susceptibility testing of the subcultured isolate on the Merlin MICRONAUT system. Altogether, 758 isolates and 4930 organism/antibiotic combinations from 590 patients were evaluated. With regard to Gram-positive cocci (n=532), agreement between both methods was found in 93.9 % of cases, with 1.6 % very major, 1.1 % major and 2.6 % minor errors. For Gram-negative rods (n=226), agreement was found in 91.9 % of cases, with 1.2 % very major, 0.7 % major and 6.3 % minor errors. When applying the breakpoints of the Deutsches Institut fü r Normung for interpretation of MICRONAUT tests, agreement of direct disk diffusion with standard testing decreased to 82.4 % in Gram-negative rods, with 3.6 % very major, 0.5 % major and 13.4 % minor errors. A high rate of disagreement was observed with oxacillin and gentamicin in Gram-positive cocci, and with cefuroxime, amoxycillin/ clavulanate and piperacillin/tazobactam in Gram-negative rods. In conclusion, the limitations of direct disk diffusion testing of positive blood cultures must be kept in mind by the clinical microbiologist and should, where necessary, be communicated to the clinician to ensure adequate treatment of severely ill patients.

The arotinoid Ro 14-9706, though devoid of any teratogenic potential, was found to reduce dose dependently the survival of pups when their mothers were treated with toxic doses during days 6-15 of gestation. The increased mortality was primarily seen during early lactation. When pups derived from treated mothers were nursed by control foster mothers unexposed to the drug, their survival was significantly improved indicating that the increased mortality was not solely due to fetal drug exposure. When pups derived from untreated mothers were fostered by dams that were exposed to the arotinoid during pregnancy, a significant pup mortality (p < 0.01) was observed, suggesting that the nursing behaviour of lactating dams was seriously affected. This impairment could be linked to a prolactin-suppressive activity of the arotinoid during lactation which was also seen during pregnancy. Other pituitary hormones, however, were not affected by the compound. Although the drug induced pronounced structural alterations in mitochondria of adrenocortical cells, visualized by light microscopy as extended vacuolization in the zona fasciculata and reticularis, this pathological finding did not translate into functional impairment of steroidogenesis. Thus, the arotinoid Ro 14-9706 exhibits in rats a prolactin-suppressive activity which affects lactation and subsequently pup survival. This particular endocrinological interference is a new phenomenon and uncommon for retinoids.

ZusammenfassungPsychische Einflüsse auf Entstehung und Verlauf obstruktiver Atemwegserkrankungen werden heutzutage wenig beachtet und in den neuesten Leitlinien nur noch beiläufig erwähnt, obwohl zahlreiche wissenschaftliche Studien diese Komorbidität eindrucksvoll belegen. Um auf die emotionale Befindlichkeit des Patienten angemessen einzugehen, werden bewährte Formen einer patientenzentrierten Gesprächsführung zwischen Arzt und Patient vorgestellt. Dazu eignen sich sowohl verbale, strukturierte Fragebögen als auch nonverbale, auf Farbwahlen basierende Verfahren, um die emotionale Struktur und den affektiven Zustand des Patienten zu erfassen. Diese orientierende Vorinformation erweist sich als hilfreich für einen von Anteilnahme und Respekt gekennzeichneten ärztlichen Dialog.

877 pain or extrapancreatic complications. A long pancreojejunostomy was combined with transduodenal papilloplasty of the duct of Wirsung. Early mortality was 5.3%; late mortality 7.9%. Fifty-nine patients were free of pain; 7 patients underwent reoperation for pain (0% mortality). At present, 61 patients are free of pain. Thirty-two are diabetic; 13 are treated with insulin. The operation did not significantly influence the endocrine status. Long-term endocrine function is stable in nondiabetics. The resuits show the feasibility of nonresection operations for chronic pancreatitis to preserve the remaining exocrine and endocrine function. Key words: Chronic pancreatitis -Transduodenal papilloplasty -Diabetes mellitus. Zusammenfassung. Residual Endocrine Pancreatic Reserve After Subtotal Pancreatectomy Due to Chronic PancreatitisSummary. In patients with chronic pancreatitis and organ complications, subtotal resection (Whipple procedure, tail resection) is indicated. Postoperative insufficiency may be influenced by the mode of surgery. To assess the reserve of the residual pancreas, a follow-up study was carried out on 20 patients -10 with a tail resection and 10 with a head resection. Normal or slightly disturbed responses were observed in the patients after head resection. The disturbance was obvious in cases with duct occlusion, but there was less alteration in patients who had undergone the modified Whipple operation. In cases of head resection, an organ-sparing surgical procedure should be favored.