[Reanimation and pathology (author's transl)]. / Reanimation und Pathologie

Reanimation and "intensive treatment", by means of which the modern hospital is able to control the critical states on the borderline between life and death, have also opened up new aspects for pathology. The life-threatening phases of the illness have laws of their own for the course and other phenomena under the influence of intensive therapy. This will give expression to the term "vita reducta" purposely suggested for it. The intensive measures are briefly illustrated with regard to their possible general pathological effects and treated in detail, taking into consideration the constitutional basis of acute collapse of the cardio-vascular system and cerebral coma. Also, a critical attitude is taken on the often wrongly used term "clinical death" and especially to the problem of "intravital cerebral death".

[Focal lipodystrophy in the bone marrow]. / Fokale Lipodystophie im Knochenmark

Small areas of slowly progressive disseminated osteolytic disease of unknown clinical, radiological and biochemical aertiology developed over three years in a 59-year-old man with exercise-induced pain in the left leg as the only symptom. Several bone biopsies merely revealed circumscribed primary dystrophy of the univacuolar medullary fat tissue with destruction and new formation of bone. The process, which is restricted to fat tissue of the bone marrow, has been termed "focal liposystrophy". It was also found in a briefly described second case. The pathogenesis is largely identical with comparable changes in extra-osseous fatty tissue which are also of unknown aetiology and usually termed "idiopathic".

[Idiopathic necrosis in the marrow of the distal femur. A contribution to aseptic necrosis of the bone (author's transl)]. / Idiopathische Nekrosen im Mark des distalen Femur. Ein Beitrag zur aseptischen Knochennekrose

Symmetrical aseptic necrosis in the marrow of the distal femur was systematically examined in 4 autopsies. According to formal analysis, the self reliant process, with a tendency toward relapse begins with two forms of destruction of the medullary fatty tissue. The consequences are fundamentally the same as those present after necrosis of the extra-medullary fatty tissue; there are only modifications caused location. These modifications include the regular calcification of non-liquifying by fatty-tissue necrosis that fibroses in a net-like manner, and of subsequent bone formation. Spongiosis in incorporated secondarily into necrosis. Medullary necrosis are not caused by vascular lesions and differ therefore from infarct-like necrosis of the bone. The etiology of the medullary steatonecrosis, which probably begins dystrophically, cannot be cleared up morphologically, and is unknown up to now. There are no definite indications for a causal relationship with cortico-steroid therapy. This form of necrosis of the marrow is therefore termed "idiopathic".