[A 28-year-old patient with exanthema on hands and feet]. / 28-jährige Patientin mit Exanthemen an Händen und Füssen.

We report on a case of papular-purpuric gloves and socks syndrome (PPGSS). Our 28-year-old female patient showed a typical exanthema on hands and feet followed by high fever, cervical swelling of lymph nodes and general symptoms. Clinical and paraclinical tests led to a diagnosis of PPGSS. This is, in most cases, caused by viral infections, in particular by the parvovirus B19. After recovering, the daughter of our patient suffered from erythema infectiosum, a typical infection caused by parvovirus B19.

[Significance of situational increase in blood pressure as a result of psychoneural stress relative to recovery for long-term stress sequelae]. / Die Bedeutung situativer Blutdrucksteigerungen unter psychonervaler Belastung in Abhängigkeit vom Erholungsverhalten für längerfristige Beanspruchungsfolgen.

3 regulation types of blood pressure under psychic load (examinations) depending on the level of blood pressure during examination and the recovery time were investigated with a complex programme before and after an examination period of 3 months. Only in the group with elevated blood pressure and delayed recovery time we have found after the period of 14 examinations and increased risk of fat metabolism (HDL-cholesterol, LDL/HDL), an elevated diastolic blood pressure and a decreased physical performance.

Physiological and psychological response to a three-month mental strain period in students.

Biochemical and immunological parameters, physical and mental performance, subjective complaints and behavioural characteristics were compared before and after 14 final examinations undertaken by 64 students during a three-month examination period. A decrease in cholesterol, triglycerides, HDL-cholesterol, physical performance and an increase in LDL/HDL cholesterol quotient, lactate level, mental performance were accompanied by a lower frequency of mental complaints and higher frequency of physical complaints. From the multidimensional variance and discriminant analysis 17 of the 44 variables discriminated between the state prior to and after the examination period. The results are interpreted in terms of the psychophysiological adaptation to adequate mental stress.

[Modification of psychic, autonomic and metabolic reactions during examinations by a single dose of beta-receptor blockers]. / Beeinflussung von psychischen, vegetativen und Stoffwechselreaktionen unter Examina durch einmalige Gabe von beta-Rezeptorenblockern.

18 students of human medicine were checked during their state examinations when they were or were not administered the beta-receptor blocker Propranolol. In the present examinations under psychic stress Propranolol has no ascertaining influence on the experience parameters, but on somatic reactions in the cardio-circulatory system, the haematological system as well as in the influence on a series of laboratory-chemical parameters. While slighter heart rate, lower blood pressure, a slighter decrease of the absolute number of lymphocytes and a lower plasma cortisol level refer to less distinct reactions of demand under influence of Propranolol, in the region of the lipid parameters HDL-cholesterol and LDL-cholesterol changes develop in the sense of an at least situational increased atherogenic risk.

[HDL and LDL cholesterol changes in psychological stress in relation to stress experience]. / HDL- und LDL-Cholesterolveränderungen bei psychischen Belastungen in Abhängigkeit vom Stresserleben.

During examinations and after a three-month examination period the changes of the parameters of fat metabolism were investigated depending upon stress experience before examinations. Students with a distinct stress experience showed a higher total cholesterol and LDL-cholesterol as well as a higher LDL/HDL-cholesterol quotient within a concrete examination. After the examination period in this group a higher LDL/HDL-cholesterol quotient and a lower HDL-cholesterol level was established in comparison to the group with an insignificant stress experience. A positive dependence on the initial value of the parameters of fat metabolism consists only in the group with distinct stress experience. According to these results also stress has an influence on the reactions of the fractions of cholesterol.

[Changes in physical endurance following a 3-months' exam period]. / Veränderungen der physischen Leistungsfähigkeit nach einer dreimonatigen Prüfungsperiode.

The question was raised to what extent in the course of a three-month examination period as a time of increased psychic stress, depending upon the distinction of the personal peculiarity "fear of examinations" of the students, reductions of the physical efficiency develop. On the basis of the lactate efficiency curves a significant decrease in vitality after a three-month examination period was proved. The determination of the efficiency in the aerobic-anaerobic transitional zone renders possible an exact evidence, independent upon motivation. According to the results the formation of the curriculum has a determining influence on the physical efficiency, however, not the personal peculiarity "fear of examinations".

[Arterial hypertension in university students]. / Arterielle Hypertonie im Studentenalter.

Experiences of a hypertension dispensary during student consulting hours are reported. The dispensary was built up with 106 students who were classified by a screening from a larger group at the beginning of an academic year. It comprised 2 groups which underwent different therapeutic measures, borderline value hypertensives (n = 53) of a general medical therapy, hypertensives in clinical degree of severity I (n = 53) of a medicamentous therapy, i.e. a propranolol medication. After 2 years, medical as well as pedagogical and political problems of higher education were analysed. For particular phases of stress, as there are during study, general measures alone are not estimated as effective therapy in borderline value hypertensives, though several risk factors could be influenced favourably. So the number of smokers decreased from 28 to 7%. The blood pressure values showed a normalisation only in 10.5%, in 55.5% a borderline value area and in 34% an increasing tendency. On the other hand, in all hypertensives under propranolol medication, a clear decrease in blood pressure could be achieved. It is to be recommended that antihypertensive drugs be used in borderline value hypertensives in particular stress situations.

[Comparative biochemical studies in asymptomatic hyperuricemia and manifest gout with special reference to renal change]. / Vergleichende biochemische Untersuchungen bei asymptomatischer Hyperurkämie und manifester Gicht unter besonderer Berücksichtgung renaler Veränderungen.

It is reported on results of comparative biochemical examinations in asymptomatic hyperuricaemia and manifest gout. Restriction of the urate clearance of the kidney, which could be proved also in young patients with asymptomatic hyperuricaemia, and a disturbance of the lipid metabolism which appeared in most cases are discussed from the pathogenetic point of view, in which cases the hyperlipoproteinaemia is regarded as a possible partial pathogenetic factor. For the separation of serum and urine the polyacrylamide gel-pore gradient electrophoresis was used. Using a modifiable concentration gradient this method is superior to the usual disc electrophoresis. The distribution pattern of the types of haptoglobin established by serum separation showed clear deviations from the normal distribution in hyperuricaemia or manifest gout and may be explained as a reference to the influence of genetic factors. By parallel performed electrophoretic separation of serum and urine a microproteinuria could be established and differentiated between glomerular and tubular proteinuria which is regarded as an early symptom of renal changes and was already present in 9 of 20 young patients with asymptomatic hyperuricaemia. These findings emphasize the necessity of an early renal diagnostics.

[Circulatory regulation during orthostatic test in young hypertensive patients]. / Kreislaufregulation unter Orthostasebelastung bei jugendlichen Hypertonikern.

The recognition of orthostatic circulatory dysregulations the usual circulation test were critically analysed concerning their valency. The results of our examinations show that all tests are only a supplementing diagnostics to the comprehensive directed anamnesis and clinical examination. The importance of the orthostasis in the therapy of hypertension is known. Taking into consideration the complex approach, the frequency of orthostatic circulatory dysregulations is also evident in untreated juvenile hypertensive patients. Juvenile hypertensive patients with orthasthenia should be treated with a basis therapy with beta-receptor blockers.

[Heart rate and blood pressure under psychological and physical laboratory stress in young hypertensive patients following long-term therapy with the beta receptor blocker propranolol]. / Herzfrequenz und Blutdruckverhalten unter psychischen und physischen Laborbelastungen bei jugendlichen Hypertonikern nach einer Langzeittherapie mit dem beta-Rezeptorenblocker Propranolol.

16 male hypertensive patients who could be compared according to the behaviour of blood pressure and the heart frequency in the psychophysiological experiment, according to age the characteristic signs of the profession underwent a long-term therapy with propranolol. After an average duration of the therapy of 31 months the patients were exposed to psychical and physical laboratory loads after a three-week interval in therapy. The behaviour of the blood pressure and of the heart frequency under psychical and physical laboratory loads before and after the therapy with propranolol are compared.

[Profile and tasks of a medical university polyclinic in the past and present using as example the Medical Polyclinical Institutes of the Karl Marx University of Leipzig]. / Profil und Aufgabenstellung einer Medizinischen Universitätspoliklinik in Vergangenheit und Gegenwart am Beispiel des Medizinisch-Poliklinischen Institutes der Karl-Marx-Universität Leipzig.

After a short survey of the historical development of the Medico-Policlinical Institute of the Karl Marx University Leipzig tasks and developmental tendencies of university medical policlinics are described, evaluating hereby the results of the Vth conference of higher education. They are understood as a university representation of ambulatorily working internists and to a large extent of the specialists for general medicine. Their main tasks consist in education and continued professional training of this group of physicians under integrative description of the whole subject internal medicine, a research oriented to practice as well as a guiding and coordination function for the ambulatory internistic care, taking into particular consideration the early recognition of a disease, in primary and secondary prevention as well as in a scientifically based ambulatory therapy of epidemiologically important diseases.

[Hypertensive regulatory disorders in adolescents after a 10-year therapy-free interval]. / Hypertone Regulationsstörungen bei Jugendlichen nach 10jährigem therapiefreiem Intervall.

After a 10 years' interval 89 of 212 patients with a hypertensive disturbance of the regulation could again be examined. Of the 89 patients only 6 were in dispensary care due to high blood pressure; of the 83 patients who are not in dispensary care 30 showed a normal blood pressure and 18 a hypertension. The factors of influence hereditary disposition, overweight, neurotic personality structure and disturbances of lipometabolism increase in their frequency from normotonics over borderline patients to hypertensives. It is referred to practical consequences.

[Digoxin therapy in the aged under serum level control with special reference to hypertension]. / Zur Digoxinbehandling im Alter unter Serumspiegelkontrolle mit besonderer Berücksichtigung der Hypertonie.

In 125 patients with hypertension in the clinical degree of severity II despite normal concentrations of creatinine and potassium in the serum at the age of more than 65 years significantly higher digoxin serum concentrations of 2.36 +/- 1.19 nmol/l (= 1.84 +/- 0.93 ng/ml) and intoxications than in younger patients with 1.45 +/- 0.55 nmol/l (= 1.13 +/- 0.43 ng/ml) were found. After discussion of the results of other investigators comes the recommendation in patients at an older age (beginning with about 65 years) and in renal insufficiency to apply digitoxin instead of digoxin, taking into consideration the mean maintenance dose of 0.1 mg/die.

[Comparative studies in young hypertensive patients at rest and after standardized physical and sensomotoric exertion]. / Vergleichende Untersuchungen bei jugendlichen Hypertonikern unter Ruhebedingungen und nach standardisierter physischer und sensumotorischer Belastung.

The acknowledged role of central-nervous mechanisms in the etiopathogenesis of the essential arterial hypertension led to the use of a psycho-physiologic test method with the aim of the early recognition of stress-induced permanent changes of physiologic functions. We succeed in proving the chosen sensumotoric stress in a group of patients with essential arterial hypertension which at first appears uniform in clinical respect allows a further differentiation. On the basis of the behaviour of defined physiologic and biochemical parameters after physical and sensumotoric stress it is referred to the necessity of a differentiated therapy of the early form of the essential arterial hypertension.

[Protein-analytical studies on the serum and urine of patients with visceral lupus erythematosus]. / Proteinanalytische Untersuchungen in Serum and Harn bei Patienten mit Lupus erythematodes visceralis

Serum and urine of patients with ascertained lupus erythematodes visceralis were separated by means of the polyacrylamide gel pore gradient electrophoresis on the same experimental conditions. Deviations from the normal electropherogram were found in the serum within the gamma-globulins. For the demonstration of antinuclear factors the loose body test, the LE-cell test as well as the immunofluorescence test were carried out. In the uropherogram a highly molecular protein band could be proved which did not appear in the serum. In this fraction an immune complex which developed in the area of the kidney might be in question. It is referred to the possibility of the use of the PAA-polyacrylamide gel electrophoresis for the early recognition of renal changes.

[Early recognition of adverse effects, especially of kidney lesions, in patients with progressive chronic polyarthritis under D-Penicillamine therapy]. / Früherfassung von Nebenwirkungen, insbesondere Nierensch bei Patienten mit progressiv chronischer Polyarthritis unter D-Penicillamintherapie

A report is given on the control of the course of 36 patients with progressive chronic polyarthritis under treatment of D-penicillamine. Despite the favourable therapeutic effect side effects of various kinds are observed. As the severest complication the development of renal disturbances with proteinuria is to be regarded. With the help of the disc electrophoresis of the urine it is possible to establish the beginning disturbances of the permeability of the basal membrane and to achieve a retrogression by reduction of the dose or finishing of the treatment with the medicament, respectively.