[Current roentgenologic delay in bronchial carcinoma]. / Die gegenwärtige röntgenologische Verschleppung beim Bronchialkarzinom.

The actual delaying of findings in roentgenograms is represented in 1000 cases of resected bronchial carcinoma from 1957 to 1972 and in 800 unresectable patients from 1973 to 1976. The delaying is analysed using the criteria as localization, site, diameter, histology, clinical delaying of symptoms, manner of discovering the tumour, original finding in the roentgenogram, prognosis, and sex-distribution of the tumours. 1. In 40% of the 1000 resected patients a delay of findings in roentgenograms may be pointed out. 2. Lung cancer is the best discovered by x-ray examination. 69% of 1000 resectable patients, suffering from lung cancer, were discovered by the people's x-ray screening (VRRU). Nevertheless 45-50% of these VRRU-cases are showing a delaying of findings in roentgenograms by more than 6 months. Even in patients, discovered by clinical symptoms, a delaying of findings after x-ray examinations was found, 26% of these patients showing abnormal x-ray findings at the time of diagnosis existing but unheeded already for 6 or more than 24 months. 3. In 10-15% of the cases resection could not be done to delaying of findings in roentgenograms. 4. In most cases the focus of peripheral tumours in roentgenograms is delayed (in 50% for 6 to more than 24 months). 5. In 74% of cases in women a roentgenographic delay was found by 6 to more than 24 months. As a matter of fact, only 10% of all patients were women. 6. Among the central tumours with plain densities the squamous cell carcinomata had findings markedly longer before diagnosis than small cell carcinomata. Among the peripheral tumours alveolar cell carcinoma and adenocell carcinoma are the longest delayed, followed by small (oat) cell carcinoma, polymorph cell carcinoma and squamous cell carcinoma. 7. Positive unheeded x-ray screening series under 6 months remained unregarded in our analysis. But even these series might be still improved. As a conclusion is stated: the detection and prognosis of lung cancer might be improved a) by increasing the quality of reading and interpretation of the VRRU, b) by differentiating the x-ray-intervals according to the risk of lung cancer in each person, c) by a constant algorithm in the diagnosis of suspect findings in roentgenograms.

[Social aspects in fighting against tuberculosis]. / Soziale Aspekte der Tuberkulosebekämpfung.

In 1884 Robert Koch postulated in his essay on "The Etiology of Tuberculosis" favouring moments for the settling of tubercle bacilli to explain the predisposition and diversified course of tuberculosis in grown-up persons. Under the conception "disposition" he also subsumised exogen factors beside the internal conditions and proclaimed that all steps undertaken against tuberculosis should take into account the social conditions. Only to effect the treatment in a sanatorium for such patients, it is also necessary to care for their families and for the patients themselves after they left the sanatorium. Complex fighting programmes developed according to the thorough analysis of the social surroundings, including the influences of occupation, income, expenses for food, housing and clothing, the legislation with regard to the health law and education to health duty as well as the level of medical science. Briefly, there was stated that the tuberculosis mortality depends on the standard of life. From the war-epidemiology of tuberculosis at least 3 parallel curves resulted, decisively influencing the mortality, the curves of infection and charging with work as well as the curve of nourishment. So the tuberculosis was characterised as a social disease. No wonder that social appearances--and war is one of them--stamp the special picture. As a model of applied knowledge, the strategy of fighting tuberculosis in the GDR and its outstanding results are discussed. After the antituberculosis chemotherapy was introduced, which shortens the duration of the disease and removes its chronic relapsing course, the significance of the social factors, however, decreased, but concerning the situation in the Third World, their knowledge is of great importance and not only of historical interest.

[Roentgenologically wasted time in bronchial carcinoma -a review (author's transl)]. / Röntgenologische Verschleppungszeiten beim Bronchialkarzinom -Eine Literaturanalyse.

The importance of roentgenologically wasted time, its frequency, causes and relation to specific characteristics of bronchial carcinoma are discussed in details along the literature. A short casuistic will show the actuality of the problem. There may be gained some important conclusions from the literature, but the differences in methods and the missing security in some definitions don't allow reliable answers to some detailproblems. The following conclusion could be derived from literature: 1. The roentgenologically protracted rate amounts to more than 30% on average. It decreases with increasing in experience of the readers of fluorographies. But even among them in the part of protracted cases amounts up to 10%. 2. Late protracted roentgenologic roentgenologic diagnosis is caused by -overlooking minimal lesions, -false algorithm in diagnostic procedure, -false diagnosis, -inadequate techniques, -the misinterpretation of developing malign lesion on the basis of existing alterations aetiologically known, -the delay on the patient's part. 3. The most important cause of all protracted x-ray findings is misinterpreted obstructive pneumonitis; it is followed by parenchymal cloudy densities, by striped atelectasis, old tuberculous processes, peripheral coin lesions and hilus alterations. 4. The time roentgenologically wasted is differing in wide range up to some years. 5. With increasing wasted time the portion of central tumors is also rising. 6. Even in patients considered as radically resected there exists still a negative correlation between the roentgenologically wasted time and prognosis. 7. The average of wasted time in x-ray lesions is running parallel to the screening intervals. 8. There seem to exist some differences between the different histological types in view of the roentgenologically wasted time. 9. There are no correlations between the age of the patients and the roentgenologically wasted time.

[Transthoracic lung-biopsy in diffuse lung diseases (author's transl)]. / Uber die transthorakale Lungenbiopsie bei diffusen Lungenerkrankungen.

A report is given about 360 percutaneous transthoracic lung biopsies in diffuse affections of the lung framework. By means of a good cooperation between skilled lung physician and experienced lung pathologist it was able to get a definitive diagnosis in 88.3% of the cases. The expense concerning this diagnostic procedure is small. As for complications there occurred pneumothoraces (15.8%), lung haemorrhage (5.3%) and haemothorax (1 case).

[Contribution of the medical-scientific association for bronchopneumonology of the GDR and of its sections to development of bronchopneumonology (author's transl)]. / Beitrag der medizinisch-wissenschaftlichen Gesselschaft für Bronchopneumonologie der DDR und ihrer Sektionen zur Entwicklung des Fachgebietes Bronchopneumonologie.

Report on the historical development of the medical-scientific associations in GDR, engaged in tuberculosis and pulmonary diseases. Important tasks of the Association for Bronchopneumonology and Tuberculosis of the GDR are promoting and propagating scientific knowledge and progress, arranging national and international conferences in GDR and taking part in conferences in other countries. The association takes influence on the profile of the speciality, and on its future development. The Zeitschrift für Erkrankungen der Atmungsorgane is the scientific organ of the association. Sections, working- and study groups are essential parts of the association dealing with special problems of the discipline. There exists good relations to medical associations of other countries; the association of bronchopneumonology and tuberculosis is member of the International Union against Tuberculosis.

[Respiratory tract diseases, their health-political importance and trends]. / Erkrankungen der Atmungsorgane, ihre gesundheitspolitische Bedeutung und Trends.

The diseases of the respiratory organs are defined and classified according to the 8th revision of the international classification of the diseases. The acute forms are above all represented by the infections of the respiratory tract. They are the problem No. 1 in health politics, since the most frequent exemptions from work are given on their account. A transition into chronic diseases of the respiratory tract is not infrequent. Among the causes of death the diseases of the respiratory system occupy the 3rd place, the chronic forms are an essential cause of early invalidity. Among the chronic diseases of the respiratory organs considerable shifts to the unspecific side took place. The tuberculosis is vastly reduced. The methods practised in its combat and the graduated, well functioning system of specialised outpatient institutions and hospitals proved as a very suitable instrumentarium also for the combat against the unspecific diseases of the respiratory organs. Three main groups increasingly demand our attention: bronchial carcinoma, chronic obstructive lung disease and the professionally conditioned diseases of the respiratory organs. Their combat demands a broad partnership with the physicians of the "first line", the factory health service and the internists. For this purpose the description of the own possibilities is necessary.

[BCG-vaccination in GDR (author's transl)]. / Die BCG-Impfung in der DDR.

Report on the development of BCG-vaccination in GDR, appreciating the initiative and the contribution of Prof. Hans Knöll. BCG-vaccination has a great portion of the steady reduction of tuberculosis morbidity among children and young adults and the practical disappearance of mortality in these age groups.

[New methods of chemotherapy also for extrapulmonary tuberculosis?]. / Neue Wege der Chemotherapie auch für die extrapulmonale Tuberkulose?

The chemotherapy of all forms of tuberculosis is basically performed according to homogeneous principles. Different opinions exist within the extrapulmonary forms particularly with regard to the duration of the treatment. Here, the so-called long-term therapy is frequently still postulated with 18--24 months. But newly developed, highly effective antituberculotic medicaments do not only allow but actually demand a shortening of the time of treatment in interest of the patient. Apparantly rifampicin and also pyrazin amide are able to effect on the germs in rest -- the persisters. Up to now the last mentioned gave the actual rise for the long-term application. Under the notion short-term therapy on the one hand by the application of the preparations mentioned and on the other hand basing on the experiences in the medicamentous treatment of the pulmonary tuberculosis now in the same measure the possiblity of a total duration of the therapy of on an average twelve months develops for the extrapulmonary manifestations of tuberculosis. Here, the two-phase regime is preferred with a continuous application of medicaments lasting for three months and following controlled phase with intermitting application of antituberculotics twice a week. The duration of application for rifampicin in these cases should neither trandgress nor be below three months.