[The ether inhaler of Louis Ombrédanne. Remarks on his career outside France and his invention]. / Der Atherinhalator nach Louis Ombrédanne. Anmerkungen zu seiner Karriere ausserhalb Frankreichs und zu seinem Erfinder.

The adoption of the Ombrédanne inhaler in Germany is surveyed mainly using the circumstances surrounding its acceptance and distribution. In addition, the figure of Louis Ombrédanne is brought into recollection and expanded. For this purpose historical literature was drawn upon, correspondence with companies was initiated, interviews were carried out and important localities in his life as well as the Académie de Chirurgie itself (Paris) were visited. The "Ombrédanne" reached Germany indirectly via Lithuania and Argentina 19 years after its introduction in France. In the time following, however, it was highly acclaimed in publications and extensively used in civilian and military areas up until World War II. With regard to its adoption and diffusion the question of possible influencing factors arises pertaining to the impediment or furtherance of acceptance outside France. Louis Ombrédanne, the inventor of the apparatus, was a great surgeon, a fascinating personality even today but not an active trailblazer of modern anaesthesiology.

[Epidural abscess following delivery with peridural analgesia. The question of prevention]. / Epiduralabszess nach geburtshilflicher Periduralanalgesie. Zur Frage der Vermeidbarkeit.

A 35-year-old healthy gravida 2 para 2 developed a spinal epidural abscess after uneventful obstetric epidural analgesia. The diagnosis was confirmed by gadolinium-enhanced MRI; immediate surgical drainage combined with long-term antibiotic treatment led to complete recovery. The symptoms and possible contributing factors (e.g. immunological impairment of the patient, duration of the catheterization, violation of hygienic standards, type of disinfectant and dressing) are discussed. Vigilance is essential to avoid complications in patients with epidural catheters, even after it has been removed, in order to introduce appropriate diagnostic and therapeutic measures without delay. Immediate treatment is decisive for long term prognosis which should be introduced before neurological dysfunction appears.

Microscopic anatomy of the eye of the deep-diving Antarctic Weddell seal (Leptonychotes weddellii).

The microscopic anatomy of the eye of the Weddell seal was studied with various light and electron microscopic methods with a view to correlating morphological findings with the biology of this seal which is adapted to the extremes of the Antarctic environment and to extreme diving excursions into the lightless depths of the sea. In the retina an area centralis was found but no fovea centralis. The densely packed photoreceptors consist exclusively of highly differentiated rods, which in primates detect light at low intensity but have rather poor image discrimination. The ganglion cells are relatively scarce, suggesting a high degree of convergence of the light-sensitive cells on the ganglion cells. The pigment epithelium is almost devoid of pigment granules. The extensive tapetum lucidum is about 400-500 microm thick and is composed of about 30 layers of specialized cells. The cornea is 650 (center) to 800-900 (periphery) microm thick. Its structure and glycosaminoglycan histochemistry correspond to that of other mammals. The iridocorneal angle is unusually deep and pervaded by an elaborate trabecular meshwork, which together with a complex canal of Schlemm can be correlated with the ability to absorb large amounts of fluid. The ciliary muscle and its antagonist, the membrane of Bruch, are poorly developed, suggesting relatively poor abilities of accommodation. The combination of a well-developed tapetum lucidum, an unpigmented pigment epithelium, well-developed rods, and a high number of rods converging on only few ganglion cells is obviously an adaptation to an extreme light sensitivity, enabling the animals to make use of the little light available in the deep sea.

[Aloys Martin (1818-1891) "Trailblazer of anesthesia". An addendum to his life and influence]. / Aloys Martin (1818-1891), "Wegbereiter der Anästhesie". Nachträge zu seinem Leben und Wirken.

OBJECTIVES: Alloys Martin has recently been called "a pioneer of surgical anaesthesia in Germany" [41]. This gave rise to an investigation into further aspects of his professional and private biography and the social as well as political context. METHODS: Documents in archives and relevant medical and historical literature relating to the objectives were surveyed and analyzed. RESULTS: In 1848 the anaesthesiological articles Martin had been contributing came to an end. He then worked as a university lecturer and professor at the University of Munich, as an official forensic and charity physician as well as in medical practice in Munich. Among other things, he published diverse articles on the schematism of Bavarian civilian and military physicians, on infectious diseases and edited scientific journals. As a founder and editor of the Bayerisches ärztliches intelligenzblatt (Bavarian Medical Information Newspaper), renamed the Münchner Medizinische Wochenschrift (Munich Medical Weekly Journal) in 1886, he guided the publication to a central position in a medical community just developing professional status. Martin was also the founder and for many years the chairman of societies for voluntary medical assistance to the poor and the Froebel kindergartens in Munich. Although he himself was of lower class origin and under pressure from conservative circles at the university and ministry due to his liberal political views, his life and works bear witness to his own effective emancipation and rise into the "Bildungsbürgertum" (educated class) of the 19th century. CONCLUSIONS: Alloys Martin is a historical figure in anaesthesiology. In his function of promoting the professionalization of the whole Bavarian medical community, he also ranks highly. In view of his self-abnegating medical service devoted to the common good, he may still today be considered an example.

[News of ether anesthesia in the local press in the 1847 in Bamburg] 449 -1 [How much blood flow is required by the myocardium?]. / Die Kunde von der Athernarkose in der Lokalpresse des Jahres 1847 am Beispiel von Bamberg.

The news of success in ether anesthesia on 16 October 1846 in Boston spread like wildfire through Europe. In the German-speaking countries, the national newspapers as conveyers of the development played a prominent role; this was especially the case for the Augsburger Allgemeine Zeitung whose correspondent, Aloys Martin [1], was a medical professional. The function of local newspapers has not yet been investigated. This was to be remedied by examining both of Bamberg's local papers. All issues from 01.01. to 31.04.1847 were surveyed with respect to relevant announcements. These were then catalogued according to date, extent and contents. Starting on 22.01.1847, the events outside of and in Bamberg were reported on in 26 notices and articles of just a few lines to half a page and in advertisements; Aloys Martin also appears on the scene. Thus, the local press in Bamberg also informed its readers early and regularly on the discovery of ether and the succeeding events.

Levels and enantiomeric ratios of alpha-HCH, oxychlordane, and PCB 149 in blubber of harbour seals (Phoca vitulina) and grey seals (Halichoerus grypus) from Iceland and further species.

The chiral stationary phase beta-TBDM (35% heptakis(6-O-tert.-butyldimethylsilyl-2,3-di-O-methyl)-beta-cyc lod extrin in OV-1701) was applied to study the enantioenrichment of alpha-HCH, oxychlordane, and PCB 149 in blubber of two seal species from Iceland by gas chromatography with electron capture detection. The examined harbour seals (Phoca vitulina) and grey seals (Halichoerus grypus) showed alpha-HCH enantiomeric ratios (ER) > 1. The ER of PCB 149 was comparable in the two species from Iceland but for oxychlordane ER < 1 was observed in harbour seals while the oxychlordane ER in grey seals was > 1. In blubber of Weddell seals (Leptonychotes Weddelli) from the Antarctic we determined an alpha-HCH ER < 1 which is in contrast to the Icelandic seal species and a sample from Lake Baikal.

[Autonomic hyperreflexia, pregnancy and delivery in para-tetraplegia. The obstetric anesthesiologic viewpoint on a case]. / Autonome Hyperreflexie, Schwangerschaft und Entbindung bei Para-/Tetraplegie. Geburtshilflich-anästhesiologische Gesichtspunkte anhand einer Kasuistik.

Although still rare, pregnancy and delivery in women with spinal cord injuries is becoming more frequent (Table 2). In 85%-90% of patients with lesions above T6 symptoms of autonomic hyperreflexia (Table 1), especially paroxysmal and excessive increases in arterial blood pressure, may occur. In anaesthetising a 31-year-old paraplegic primigravida with a complete transverse spinal lesion at T4 for an elective caesarean section, no indication of hypertonic cardiovascular dysregulation either intra- or postoperatively was observed after repeated epidural administration of bupivacaine. Distinct intraoperative spasticity of the abdominal wall muscles was, however, not influenced by the dosages selected.

Histological, histochemical, and ultrastructural investigations on the gastrointestinal system of Antarctic seals: Weddell seal (Leptonychotes weddellii) and crabeater seal (Lobodon carcinophagus).

The morphology of the principal sections of the gastrointestinal system of two Antarctic seals with different dietary habits, namely, the Weddell seal (Leptonychotes weddellii) and the crabeater seal (Lobodon carcinophagus), has been investigated. Histologically examined by light microscopy, the tissue layers of the gastrointestinal tract of both seals are almost identical to those observed in most other mammals and no major differences in principle organization could be found between the two seal species. The ultrastructure of the gastric and intestinal epithelial cells has been examined and is also closely comparable to that of these cells in other mammals; however, Paneth cells have not been found in our material. In general, therefore, adaptations of the gastrointestinal tract to the aquatic environment or the diet are not obvious at the morphological levels of organization studied. Histochemical differences are found between the two closely related species; mucins of the surface epithelium in the stomach of Weddell seals are highly sulfated, while those in the crabeater seal are not. Mucous neck cells in Weddell seals contain acid mucosubstances, while those of crabeater seals contain neutral ones. Goblet cells in the small and large intestine in Weddell seals contain both neutral and acid mucosubstances. Both mucin types are detected in the crabeater seal; however, the mucins of the colon in the crabeater seal are more highly sulfated than those in the Weddell seal. The ratio of goblet cells to enterocytes in the large intestine of crabeater seals is higher than that in Weddell seals.

[The Kartagener syndrome]. / Das Kartagenersyndrom.

A 25-year-old woman with Kartagener's syndrome was admitted to hospital for laparoscopy because of sterility. Kartagener's syndrome is a rare disorder involving the combination of situs inversus, bronchiectasis and sinusitis. A dynein deficiency leads to ciliary dyskinesia. When general anaesthesia is to be induced in a patient with Kartagener's syndrome the following points must be borne in mind: ascertainment of the preoperative pulmonary status, antibiotic coverage, recognition of dextrocardia, necessity for aseptic techniques because of the possibility of abnormal neutrophil chemotaxis. Anticholinergic and antitussive medications are relatively contraindicated, as are nasal tubes. In the present case an intubation anaesthesia with thiopental, nitrous oxide, enflurane and succinylcholine was carried out; cefoxitin was administered for antibiotic treatment, and the patient made an uneventful recovery.

Two new members in the Contracaecum osculatum complex (Nematoda, Ascaridoidea) from the Antarctic.

The genetic structure of adults and larvae of Contracaecum osculatum (sensu lato) from the Antarctic is analyzed on the basis of 24 enzyme loci. Significant deviations of genotype frequencies from the Hardy-Weinberg equilibrium were found, even in samples recovered from the same host. These data indicate that two distinct, reproductively isolated species coexist in C. osculatum (sensu lato) samples from the Antarctic. They were provisionally designated C. osculatum D and E, as they do not correspond to any of the three species previously detected in this complex from the Atlantic Arctic Boreal region (C. osculatum A, B and C). An allozyme diagnostic key for the identification of the five members of the C. osculatum complex, at the larval and adult stage and in both sexes, is given. Species D and E were found to be genetically quite variable: average P99 = 84.3, A = 3.3 and He = 0.23. Both showed high values of intraspecific gene flow: Nm = 4.6 and 6.1 respectively; similar values were found for the Arctic-Boreal C. osculatum A, B and C. The most related members of the complex are the Antarctic species E and the Arctic-Boreal species A (DNei = 0.21), while the most differentiated ones are the Arctic-Boreal species B and C (DNei = 0.76). The evolutionary divergence of C. osculatum C started more than 3 million years ago, in a Pliocene refugium (Baltic Sea). As to the other C. osculatum species, their evolutionary divergence took place during Pleistocene, when this complex achieved a bipolar distribution. This process involved two distinct colonizations of the marine Antarctic region by ancestors of the northern hemisphere, about 1.5 and 1 million years ago, giving origin to C. osculatum D and E respectively.

[Hereditary prolonged QT interval (Romano Ward syndrome) in obstetric management]. / Hereditär verlängertes QT-Intervall (Romano Ward Syndrom) im geburtshilflichen Management.

In the Romano-Ward syndrome, an inherited form of abnormally prolonged QT duration is a matter for concern. The frequency-corrected QTc value in the ECG amounts to more than 0.44 s. Persons suffering from Romano-Ward syndrome are vitally endangered by attacks of arrhythmia, syncope and cardiac arrest which are triggered or aggravated by stress or certain drugs. In obstetrical anaesthesia, attention should be paid to the foetus, which, due to the genetic dominance, will have a 50% probability of suffering from the disorder. A 28-year-old para I was admitted with cervical dilation on her predetermined date of delivery. Romano-Ward syndrome had been diagnosed 10 years earlier. The patient had been free of complaints and had received no treatment. Due to cephalopelvic disproportion and the cardiac syndrome, a primary Caesarean section was performed. The QTc values were pathologically prolonged (0.47 s; 0.48-0.63 s) during the pre- and intraoperative period. Haemodynamic irregularities did not occur in the perioperative period. The newborn was vital (3.830 g; 50 cm; Apgar scores 10/10/10; umbilical cord pH 7.29). Directly postpartum isolated supraventricular extra systoles occurred, and the QTc duration increased to 0.51 s.

Basic biochemical data on blood from antarctic Weddell seals (Leptonychotes weddelli): ions, lipids, enzymes, serum proteins and thyroid hormones.

1. Standard laboratory values of blood samples taken from Weddell seals in Antarctica were determined. 2. Numerous blood parameters are similar to those observed in man. 3. Comparatively high cholesterol levels but normal triglyceride levels were observed when compared with humans. 4. In comparison to laboratory findings in humans, T4 levels were decreased although T3 levels were normal. 5. The levels of alkaline phosphatase are considerably higher than those in humans. 6. The data obtained indicate different lipid and thyroid hormone metabolism in Weddell seals when compared with humans.

[Recording the feeding behavior of freely moving animals using the example of freely diving Weddell seals (Leptonychotes weddellii)]. / Registrierung des Fressverhaltens beim frei beweglichen Tier am Beispiel der freitauchenden Weddellrobbe (Leptonychotes Weddellii).

During the antarctic summer 1990, the pattern of food intake in comparison to diving-activity was investigated on adult Weddell seals. Diving depths were recorded by a time-depth recorder (TDR). The TDR is a free programmable electronic datalogger, which can store data on up to 5 channels. It was fixed on the fur of the seal, ensuring that no longer lasting irritation of the animal was caused. The pattern of food-intake was monitored by measuring the jaw-movements, using strain gauges for recording the deformation of the muscles by mastication. After electronic amplification and filtering, the frequency of jaw-activity within a measuring period was recorded one channel of the TDR. By simultaneously observing the diving depths, these data may lead to conclusions about chewing patterns of the seal in water depths where they catch prey. The graph of these data and the mathematical evaluation by Fourier analysis and Plexogramme show a close correlation between diving depth and jaw-activity.

[Hereditary prolonged QT interval (Romano-Ward syndrome) in a female patient with non-elective cesarean section]. / Hereditär verlängertes QT-intervall (Romano-Ward-Syndrom) bei einer Patientin mit nicht-elektiver Sectio caesarea.

In the Romano-Ward syndrome, an inherited form of abnormally prolonged QT duration is the matter of concern. The frequency-corrected QTc value in the ECG amounts to more than 0.44 s (upper mean value: 0.44 s). Persons suffering from Romano-Ward syndrome are vitally endangered by attacks of arrhythmia, syncope, and cardiac arrest that are triggered or aggravated by stress or certain drugs. In obstetrical anesthesia, attention should be paid to the fetus, which, due to the genetic dominance, will have a 50% probability of having the disorder. A 28-year-old para I was admitted with cervical dilation on her predetermined date of delivery. Romano-Ward syndrome had been diagnosed 10 years earlier; the patient had been free of complaints and had received no treatment. Due to cephalopelvic disproportion and the cardiac syndrome, a primary cesarean section was performed. Following premedication and provision of a beta-blocker, defibrillator, and drugs for resuscitation, intubation anesthesia with methohexital, nitrous oxide, enflurane, and succinylcholine was carried out. The QTc values were pathologically prolonged (0.47 s; 0.48-063 s) during the pre- and intraoperative period. Hemodynamic irregularities did not occur in the perioperative period. The newborn was vital (3,830 g, 50 cm; Apgar scores 10/10/10; umbilical cord pH 7.29). Directly postpartum isolated supraventricular extrasystoles occurred, and the QTc duration increased to 0.51 s. Simultaneous registration of the ECG and phonocardiogram showed premature occurrence of the second cardiac sound, which is typical of Romano-Ward syndrome.

Antarctic seals carry antibodies against seal herpesvirus.

Weddell seals in the Antarctica had high neutralizing antibody titres to seal- and feline herpesvirus and none against phocine distemper virus. Crab-eater seals were free of antibodies. This suggests an evolutionary wide spread of seal herpesvirus.