[Traffic accidents of senior citizen car drivers]. / Unfälle älterer Kraftfahrer.

The number of accidents caused by older car drivers increases annually in Germany. Typical errors of older drivers concern the right of way, changes of direction and conflicts with pedestrians at cross walks. These errors are attributed to deficient information gathering and processing caused by old age and illness. In many cases these deficiencies can be countered by appropriate strategies of compensation. The physician's task is to advise the older patient whose obligation it is to check his own ability to drive. In certain cases the physician's task is also to report to the traffic authorities on the patient's ability to drive a car. The physician is aided in this task by the "Guidelines Concerning Disease and Motorized Traffic" published by the German Transport Ministry.

[Empirical studies of automobile driving fitness of patients treated with methadone-substitution]. / Empirische Untersuchungen zur Fahreignung von Methadon-Substitutionspatienten.

The aim of this experimental study was to gain an impression on the driver fitness of heroin addicts which were at the moment substituted by methadone especially within a methadone program sponsored by the government of NRW. 21 out of 34 patients investigated were unfit to drive because they were at the time the tests were conducted under the effect of at least one additional psychotropic substance other than methadone or because at prior blood tests within 3 months they had been found at least twice under the effect of psychotropic drugs or they were known as concomitant drug users. The remaining 13 methadone patients were matched with 13 control subjects of the same sex, education and-within a range of +/- 2 years-also the same age. Testing short term memory, tracking, decision and reaction behavior, perception, sustained attention, speed estimation, peripheral attention with simultaneous central task, reactive loading, personality questionnaires including traffic specific questions and psychopathologic characteristics the patients yielded significant poorer results compared with the control group. When selecting 6 very good patients according to the decision of the physicians the significant differences concerning performance measures vanished but some differences concerning personality traits still remained. The results confirm the expert's opinion-called "disease and motor traffic"-that in general methadone substituted patients are unfit to drive. The driver fitness of the very few optimal patients depends on the amount of the personality disorders.

[Prosthetic management of rotation-plasties according to Borggreve]. / Prothetische Versorgung von Rotationsplastiken nach Borggreve.

Two patients, suffering from Osteosarcoma of the distal femur, were operated in 1987. A Rotatoryplasty with resecting the half of the femur and the knee joint was performed. We would like to demonstrate our experiences in the prosthetic fitting in these patients. The Rotatoryplasty improves the prosthetic comfort in these patients cured by above knee amputation in former time.

Seat belt legislation and seat belt effectiveness in the Federal Republic of Germany.

In 1976 belt usage was made compulsory for front seat passengers in the Federal Republic of Germany. Since 1984, noncompliance incurs a fine of DM 40. In 1984 belt usage was also made compulsory for back seat passengers (noncompliance not being fined). Following the introduction of the fines, the usage rates both for drivers and front seat passengers increased from about 60% to more than 90%. The number of car occupant fatalities has lowered considerably since the introduction of the fine (by about 25%). Approximately 15 to 20 percentage points of this change are probably due to this measure. Major injuries decreased noticeably as well, in particular injuries to the eyes. Belt usage on back seats is still unsatisfactory (20%), although here too, the effect on injuries of the belt is incontestable, taking into consideration occupant interaction.

[A new special form of enchondromatosis]. / Eine neue Sonderform der Enchondromatose.

A case of enchondromatosis with an unusual course was observed. The enchondromas originated in the patellae, subsequently with rapidly spreading metaepiphyseal growth on the knee joints and distally on the medial side of the right tibia. Cold-sensitive exanthema, pigment spots, drumstick fingers, watch glass nails, dentition disorders. Since radical surgery on the right femur 8 years ago there has been no recurrence.

[Course and differential diagnosis of McCune-Albright syndrome]. / Verlauf und Differentialdiagnostik des McCune-Albright-Syndroms.

The McCune-Albright syndrome consists of a combination of fibrous dysplasia of bone and endocrine lesions with abnormalities of pigmentation. The condition is rare and may be missed, as happened in our case. The case showed extreme skeletal deformities, menarche at one year and peculiar histological appearances.

[Long-lasting EEG abnormalities in alkylphosphat intoxication (author's transl)]. / Langandauernde EEG-Veränderung bei einer E 605-Vergiftung.

In the reported case of a severe alkylphosphate poisoning the first EEG-observation at the twentieth day after intake showed marked abnormalities although there was a complete physical and humoral recovery. Progressive normalization of the EEG occured in the following six weeks. Psychopathological symptoms of a mild apathy and slowening of reactions disappeared gradually.

[The seat belt: effect on the consequences of traffic accidents (author's transl)]. / Bisherige Erfahrungen mit dem Sicherheitsgurt in seiner Auswirkung auf die Unfallfolgen im Strassenverkehr.

At the present time, more than 90% of the motor vehicles in the Federal Republic of Germany are equipped with seat belts. On the average, however, only one out of two drivers uses his belt. It has been established that the seat belt, considering the present rate of use, annually protects about 1700 car occupants from fatality and about 30,000 from injuries (resulting in economic savings of approx. DM 1.8 X 10(9)). If all car occupants were to observe seat-belt regulations, this gain in safety might be doubled. Experience of other countries indicates that the introduction of the fine would result in much better compliance with the regulation than has been observed thus far.

[The effect of tramadol on the EEG and the electronystagmogram (author's transl)]. / Die Wirkung von Tramadol auf das Elektroenzephalogramm und Elektronystagmogramm.

1-(m-Methoxyphenyl)-2-(dimethylaminomethyl)-cyclohexan-1-ol (tramadol; Tramal) in oral doses of 150 mg/kg caused no essential changes in the EEG pattern in man. Only the alpha-rhythm of the occipital leads was more synchronized and the amplitude somewhat higher. beta-Waves increased slightly, but the delta-waves were not significantly changed. Tramadol induced no measurable alterations in the electronystagmographic recordings of quick voluntary eye movements or follow-up to-and-fro eye movements. In the optokinetic and postrotatory nystagmus, however, there was a moderate decrease in the total amplitude and maximal angular velocity of the slow nystagmic stage. The results of EEG and electronystagmographic investigations indicate that tramadol has a moderate relaxant (central depressant) effect.