[Pacemaker's twiddler syndrome (author's transl)]. / Funktionelle Schweregrade des Pacemaker's-Twiddler-Syndrom.

This report demonstrates the results of five observation of the Pacemaker's-twiddler-syndrome, which will not necessarily end in the complete malfunction of the pacemaker unit. Therefore we classify the Pacemaker's-twiddler-syndrome as a partial and a complete form. The partial form is characterized by still effective cardiac stimulation, whereas the complete form can not stimulate the heart muscle because of the retracted electrode. Also methods of early detection and prevention of the Pacemaker's-twiddler-syndrome are discussed.

[Pharmacological treatment of chronic arterial occlusive disease (author's transl)]. / Rationelle Pharmakotherapie chronischer peripherer arterieller Durchblutungsstörungen.

Two thirds of the patients with peripheral arterial occlusive disease have to be treated conservatively, for only up to 30% can be revascularized by operative methods. Using the pharmacological differential treatment the grade of compensation and localization of the obliterative process has to be considered. Ignoring the usual basic therapy (elimination of heart failure and pathological bradycardia, systemic walking-exercise, anticoagulation etc.) intrafemoral long-term application of energetic phosphate (i.e. nucleotid-nucleosid-mixtures) leads to a positive result in nearly two thirds (n = 97 legs) with a degree of II to IV of Fontaine. Whereas the snakes' encyme Ancrod with the effect of defibrination was successful in almost 70% of the patients with arterial insufficiency (n = 45) including the degree II B (painless walking-distance under 100 meters). Energetic phosphates, applied to the arteria femoralis, are most successful in degree II with claudication intermittens. Ancrod should be used respectively for patients with pain during rest. These results are discussed with respect to compensation and localization of arterial occlusive disease, acute and chronic measurements of the hemodynamics by use of Doppler ultrasound and strain gauge plethysmography and with respect to variation of the concentration of the metabolic parameters lactate and pyruvate--the latter when defibrination was performed.

Hormone-sensitive adenylate cyclase in human colonic mucosa.

Human colonic adenylate cyclase has been shown to be sensitive to vasoactive intestinal polypeptide (VIP) and prostaglandins of the E- and F-type. Maximal activation of enzyme activity averaged 200% for VIP and 300-350% for the E-prostaglandins. Both classes of hormones had an additive effect on enzyme activity indicating the existence of two distinct hormone-sensitive adenylate cyclases in human colonic mucosa.

[Acquired isolated ventricular septal defects]. / Erworbene isolierte Ventrikelseptum-Defekte.

Among the acquired defects of ventricular septum the rupture of the septum are known to occur as a rare complication following penetrating and non-penetrating injuries of the chest and more common as sequel of myocardial infarction. A left to right shunt usually follows the acute rupture of the interventricular septum, and is usually lethal. Only a few patients survive for several months under conventional therapy. Early diagnostic procedures using heart catheterization are crucial to determine whether surgical maneuvers are necessary. We present patients who experienced acute rupture of the ventricular septum. We discuss their pathological and clinical findings as well as the problems related to prognosis and therapy.