[Accident and injuries situations in accidents at school and on the way to and from school]. / Das Unfall- und Verletzungsgeschehen bei Schulunfällen und Schulwegeunfällen.

In the Federal Republic of Germany, where accidents to schoolchildren are covered by the statutory accident insurance, a total of 991,947 accidents of this kind occurred in 1987, 133 of which were fatal. In this study, the accidents and injuries sustained by 1059 schoolboys and schoolgirls who received medical treatment in our clinics are analysed. We are concerned here with 887 accidents actually at school and 172 accidents on the way to or from school. In the case of accidents at school, the proportion of 6-, 7- and 8-year-olds affected was below 3% for each of these age groups. The percentage of children involved in accidents at school increased steeply with increasing age, reaching a peak in girls at 12 years of age, with 15.4%, and in boys at 13 years, with 14.5%. After this, the proportion in each individual age group lay between 10% and 12% up to 17 years of age and decreased to 7% in 19-year-olds. The proportion of accidents among 20- and 21-year-olds was less than 2%. Of the 887 accidents at school, 53% occurred during sports lessons, 28% during break times, 11% in the course of the general coming and going involved in attendance on the school premises, 3% during instruction in academic subjects and 3% during extracurricular activities, e.g. school outings. Each of these accident areas has its typical accident risks, and often its characteristic accident pattern in addition. Furthermore, there are age-specific and sex-specific features. The frequency of injuries to the upper extremities, including the hand, was 11% higher in girls than in boys.(ABSTRACT TRUNCATED AT 250 WORDS)

[Thoracic injuries in traffic accidents and non-traffic accidents]. / Thoraxverletzungen bei Verkehrsunfällen und Nichtverkehrsunfällen.

Traffic accidents differ from non-traffic accidents where the injuries are concerned. With the males two thirds of the thoracic injuries happened in non-traffic accidents and one third in road accidents; with the females, the relation was reversed. In thirteen per cent of the traffic accidents and in twenty-five per cent of the non-traffic accidents there were only thoracic injuries, in the other cases there were multiple injuries. Blunt damages of the thorax occurred in the majority of both kinds of accidents, penetrating injuries were less common. Closed rib fractures happened twice as often in traffic accidents as in accidents at work. Compound fractures of the ribs were three times as frequent in non-traffic accidents as in traffic accidents. In thirty-five per cent of road accidents and in twenty-two per cent of non-traffic accidents the injuries were of an intrathoracal kind. Of all the three hundred and thirty thorax injured patients thirty-four did not survive their injuries, twenty-nine due to traffic accidents, and five due to non-traffic accidents.

[Injuries in occupational accidents]. / Verletzungen bei Arbeitsunfällen.

Evaluation of 3,096 accidents occurred during occupational activity in industry reveals the following results: most of the injuries of men are more serious than these of women. Ranking the injured parts of the body shows that injuries of the hand are most frequent. Moreover ranking the injured parts of the body as well as the nature of injuries reveals that there are notable differences between the two sexes.

[Prolonged functional times of xenogenic kidney transplants by means of anti-donor brain globulin (ADBG)]. / Verlängerte Funktionszeiten xenogener Nierentransplantate durch Anwendung von Anti-Spender-Hirn-Globulin (ADBG).

This paper reports about experimental xenografting of kidneys in closely related species (fox-dog) modifying primary graft rejection by treatment of the recipients with anti-donor brain globulin (ADBG). ADBG, produced by immunisation of rabbits with fox brain tissue, in vitro demonstrates cytotoxicity against fox lymphocytes as well as versus dog lymphocytes. In respect of the phylogenetic constellations, the erythrocytes of both species, too, are influenced in hemagglutinating test. However, kidney tissue is said to be unable to adsorb thymocytolytic antibodies of anti brain sera, thus the way of immunosuppression is directed mostly against the lymphocytes of the recipients, causing here twofold survival time compared to untreated controls. MST is 11.2 +/- 2.4 days (n = 5). Cytotoxic antibodies appear on the 8th day after surgery, that means 4 days later than in the controls. Histological findings correspond to those of untreated recipients.

[Effect of azathioprine and prednisolone on recipients of xenografts presensitized with donor species-specific antigen (author's transl)]. / Beeinflussung einer durch Antigenvorbehandlung induzierten Sensibilisierung xenogener Transplantatempfänger durch Azathioprin und Prednisolon.

Presensitization induced by pretreatment of the recipients with donor species-specific spleen antigen cannot be completely reversed by immunosuppressive drugs. However, there is a suppressive influence of the combined administration of azathioprine and prednisolone on hemagglutinating antibody production after transplantation as well as an effect on function and survival time of renal xenografts.

[Effect of anti-donor lymphocyte globulin on renal xenograft survived (author's transl)]. / Modifizierung der Primärabstossung xenogener Nierentransplantate durch Anti-Donor-Lymphozyten-Globulin.

This paper reports about experimental xenografting of kidneys in closely related species (fox-dog) modifying primary rejection by treatment of the recipients with anti-donor lymphocyte globulin (ADLG). In respect of the phylogenetic constellations, ADLG contains lymphocytotoxic and hemagglutinating antibodies reactive in vitro with lymphocytes and erythrocytes of foxes as well as of dogs. Furthermore, donor species-specific papain-separated lymphocyte antigen is capable of reducing cytotoxicity of ADLG by adsorption of its lymphocytotoxic antibodies. In vivo ADLG, used as single therapy, has an immunosuppressive effect on kidney graft survival, which results in significant prolongation of mean survival time (9.6 +/- 1.5 days, n = 5).

[Induction of partial immune tolerance in a closely-related species system by a single injection of papain-extracted, donor species specific, lymphocyte membrane antigens]. / Induktion partieller Immunotoleranz im nah verwandten Speziessystem durch einmalige Injektion eines mit Papain gewonnenen, spenderspezies-spezifischen Lylmphozytenmembran-Antigens.

This paper reports of experimental xenografting of kidneys in closely related species (fox-dog) modifying primary graft rejection by single i.v. injection of donorspecies-specific lymphocyte antigen in soluble form. Papain treatment was used to separate histocompatibility antigens from lymphocytes of donors. This antigen, in vitro, is capable of reducing cytotoxicity of xeno-antisera by adsorption of their lymphocytotoxic antibodies. A single intraoperative i.v. injection of this antigen to the transplant recipients results in the subsequent failure of humoral antibody production, thus this antigen-mediated effect is thought to be a state of B-cell tolerance. Survival times are more than doubled in comparison to untreated controls and last in average 14.6 +/- 1.74 days (n = 5). Histological studies demonstrate rather well conserved renal parenchym with sporadic infiltrations of round cells.

[The unaffected primary rejection of xenogeneic kidney transplants in the closely related fox-dog species system]. / Die unbeeinflusste Primärabstossung xenogener Nierentransplantate im nah verwandten Speziessystem Fuchs - Hund.

The present study reports of three kinds of experiments of unaffected primary rejection of xenogenous kidney transplanats in the close-related fox-dog species system. The issue is whether there is a relation between the amount of grafted parenchyma and the immune induced potency, that is whether the course of rejection of transplanted single kidneys (group I a) differs from the course after en-bloc transplantation of both kidneys (group I b). In group II alterations of blood chemism and behavior of humoral antibodies are followed in dogs to which a fox kidney was transplanted, while keeping their own functioning kidneys. This experiment is to give information whether the uremic syndrome influences the development of humoral immunity, and what changes of blood chemism may primarily be related to destruction of the graft, under the condition of absent uremia. Untreated graft recipients survived for 5,4 +/- 0,49 days (n = 5) when single kidneys were transplanted (group I a), and 5,2 +/- 0,75 days (n = 5) when both kidneys were grafted en-bloc (group I b). As to the rejecting reactions, both groups are almost equal: the increasing functional failure causes a fast increase of creatinine and urea nitrogen; alkaline phosphatase and LDH show distinct alterations, related to the progress of the graft's destruction. Decrease of albumin level and loss of cholinesterase activity indicate an impaired hepatic function as reaction to uremic intoxication. Gamma-globulins and leucocytes show alterations that can be related to non-specific inflammatory reactions. The immunologically specific initial lymphopenia suggests that after revascularization these cells migrate to the graft, and later react with antigenic structures of vascular endothelium and still later with those of the organ cells. Cytotoxic antibodies appear on the 4th postoperative day in increasing amount. Post mortem histologic examination shows round cell infiltrates in the vastly necrotic renal parenchyma. When the recipient's kidneys are kept in situ and a fox kidney is transplanted (group II) uremia is avoided and the animals survive. During the 30-days period of observation, that is longer than the term of rejection, the titer of cytotoxic antibodies remains stable or tends to increase. LDH and alkaline phosphatase show characteristic changes that are considered sequels from destructed transplantate. The experiments show, aside from certain reservations, that the donor-host combination fox-dog is suitable to serve as preclinic model for human transplantation using xenogenous donors of organs, i. e. anthropoid primates.

[Prolonged function time of xenogenic kidney transplants caused by the combined use of azathioprin and prednisolone]. / Verlängerte Funktionszeiten xenogener Nierentransplantate durch kombinierte Anwendung von Azathioprin und Prednisolon.

The present publication reports about the delay of the rejection by unspecific medicamentous immuno suppression. This is the continuation of our earlier publication about the unaffected primary rejection of xenogenic kidney transplants in the closely related system fox - dog. The combined application of azathioprine and prednisolone leads to elongated function times of the kidney transplants and to the duplication of survival times of the recipients. Lymphocytotoxins, which are immuno-electrophoretic Ig G antibodies, appear two days later than in untreated recipients by hindrance of immunological reactivity. These obtain however then in consequence of the injured formation of antigen-antibody complexes a concentration increase which widely exceeds the increase of the control groups. The influence of azathioprin and prednisolone on the humoral respectively cellular immunity is talked about in the discussion. Morphological differences in the transplants are not observed in comparison with untreated recipients.

[Hyperacute rejection of renal xenografts after presensitization of the recipients induced by treatment with donor species-specific spleen antigen (author's transl)]. / Hyperakute Abstossung xenogener Nierentransplantate durch Vorsensibilisierung der Empfänger mit spenderspeziesspezifischem Milzantigen.

This paper reports about experimental xenografting of kidneys in closely related species (fox/dog) modifying primary graft rejection by pretreatment of the recipients with semisoluble donor species-specific spleen antigen. This kind of pretreatment does not induce immunological enhancement which protects the graft from damage, but causes presensitization of the recipients and subsequently the hyperacute rejection of the transplants. Arteriovenous gradients of platelets and leukocytes as well as those of fibrinogen and clotting factors II, V, VIII, and IX suggest a greater degree of intravascular coagulation within the first minutes after revascularization. Hemagglutinating antibodies induced by pretreatment of the recipients with donor species-specific spleen extract seem to be responsible for the rapidity of rejection and for the reduction of survival time.

[Immunobiological fundamentals of primary graft rejection (author's transl)]. / Immunbiologische Grundlagen der primären Transplantatabstossung.

Graft rejection caused by genetic differences between donor and recipient is an immunological reaction of transplantation antigens with mechanisms of primarily cellular immunity, and later on even of humoral immunity. For initiating the immune response of the recipient three stages have to be distinguished: 1. Recognition of determinant groups of transplantation antigens by menbrame receptors at the surface of immunologically competent lymphocytes. 2. Differentiation and proliferation of immunologically activated lymphoid cells into cellular antibodies and plasma cells, the receptor molecules of which could be identified as immunoglobulins and which are sent into the blood as circulating humoral antibodies, , partially as complement fixing ones. 3. Effector phase, in the course of which the lysis of the graft is caused by target cell destruction. Many problems still remain unsolved, but now as ever, the basis of most experimental studies is still formed by Burnet's clonal selection theory.

[About the comparison of closely related species chimpanzee-man and fox-dog in respect of the possibility of xenotransplantation (author's transl)]. / Uber die Vergleichbarkeit der Spezieskombinationen Schimpanse-Mensch und Fuchs-Hund im Hinblick auf xenogene Transplantationen.

Although the transplant combinations chimpanzee-man on one hand and fox-dog on the other hand have nearly the same phylogenetic development within their zoological family, it is not quite correct to compare the immunological reactions and patterns of rejection of xenogeneic transplants within these systems. The differences in immunochemistry of serum proteins between these two systems confirm that chimpanzee and man are more closely related than fox and dog concerning their genetic disparity. This and other mentioned examples demonstrate the possibility of obtaining qualitative informations of genetic constellations between xenogeneic species combinations by comparing immunochemistry of serum proteins.

[Available methods to modify primary graft rejection (author's transl)]. / Möglichkeiten zur Beeinflussung der primären Transplantatabstossung.

Primary graft rejection is an immunological reaction. Many modes of preventing, or at least, delaying rejection have already been tested. The present study deals with experiences and possible mechanisms of action of nonspecific immunosuppression caused by different drugs or antilymphocytic sera; furthermore, an account is given of the latest stand of knowledge gained from experimental studies to induce immunological enhancement, as well as immunological tolerance to transplantation antigens.

[Diagnosis and therapy of liver echinococcus (author's transl)]. / Diagnostik und Chirurgie der Leberechinococcen

From 1970 to April 1975 42 patients were treated for Echinococcus of the liver at the Bonn University Dept. of Surgery. There were 33 cases of E. cysticus and 9 cases of E. alveolaris. These two types of Echinococcus, different in parasitology and epidemiology present different clinical manifestation of disease with different course and prognosis. Angiography with celiaco- and superselective hepaticography are decisive for diagnosis. Therapy can only be surgical with total removal of the parasites. In E. cysticus this is almost always possible by enucleation-resection or pericystectomie following evacuation of the cyst and instillation of 20% sodium-chloride or formaldehyde. Such radicality is the exception in E. alveolaris. Here partial resections, biliodigestive and hepatodigestive anastomoses as palliative measures are carried out predominantly to ensure bile passage.