G. Seifert

Toxoplasmosis is a ubiquitous infection, contracted by at least a third of the population in most areas of the globe. Clinical disease arises rarely, usually unexpectedly, but sometimes with disastrous effects on the patient. Humans, pets, farm and zoo animals may contract toxoplasmosis, possibly involving any clinical laboratory in its diagnosis. Pathologists must ponder the clinical significance of a hyperplastic l. ymph node, a cyst found at autopsy, or a serologic titer. Serving as scientific physicians, pathologists are asked: How is toxoplasmosis diagnosed? 'What is the treatment for ocular toxoplasmosis, for congenital infection, or for toxoplasmosis in the immunologically compromised host? vVhy does disease develop in as diverse areas as the eye, lymph nodes and placenta? How is Toxoplasma transmitted? This review proposes to survey recent advances, providing a scientific background to diagnose and manage the clinical problems of toxoplasmosis. Reviews are available which emphasize other aspects, such as serologic pro- cedures, resistance and immunity (REMINGTON, 1970), the clinical syndromes (DESMONTS, '1969; FELDMAN, 1968) and comprehensive presentations (JACOBS, 1967; FRENI{EL, '1970). Transmission and Prevalence The recent discovery of the coccidian stages of Toxoplasma in the cat intestine and the Toxoplasma oocyst excreted in cat feces, considerably broadens our understanding of Toxoplasma and its transmission (FRENKEL, DUBEY and MILLER, 1970).

The patriarch of experimental pancreas research is REIGNIER DE GRAAF (1641-1673). He carried out the first experiments with dogs in order to ob­ tain fistular secretion (1664). But only few years later, the just arisen interest in the physiology of the pancreas was severely set back by remarks of CONRAD BRUNNER. In 1682, BRUNNER expressed his belief that on the basis of experi­ ments he had carried out the pancreas was a vitally unimportant organ. He overlooked that after ligation of the main duct (discovered in the turkey by HOFMAN in 1641 and in a human cadaver by WIRSUNG in 1642), in the dog an accessory duct (described by SANTORINI in 1724) usually maintains an adequate flow of secretion. EBERLE in his monograph (1834) confirmed the emulsifying capacity of the pancreatic juice which had already been suggested by SYLVIUS (FRAN­ CISCUS DE LE BOE, 1614-1672) and he dealt with the essential enzymatic functions of the pancreatic juice such as amylolysis, lipolysis and proteolysis. Since HEIDENHAIN (1875), we know that for example trypsin (largely isolated by KUHNE in 1867) is situated in the acinar epithelial cells as zymogen in inactive form; it is thought that the action of "acid" on the glandular tissue is needed for inducing the "enzymatic activity". According to what we know now about the central role of acidosis in the activation of zymogen this topic is, of course, of topical interest.

Die Pathologie des Nervensystems wird in drei aufeinanderfolgenden Banden umfassend behandelt. In diesem Band 13/VI. A werden im einzelnen abgehandelt: Epidemiologie, Biomechanik des Stossablaufes mit kurzer Einfuhrung in die physikalischen Grundlagen, Modalitaten der Gewalteinwirkung, Verletzung der Kopfschwarte, verschiedene Formen der Schadelbruche, traumatische epi-, sub- und subarachnoidale Blutungen, Pachymeningeosis haem. int., Schadelprellung, gedeckte Schaden des Gehirns mit Besprechung der Commotio cerebri und der sog. Rindenprellungsherde, offene Verletzungen des Gehirns, die Hirnwunden in ihren verschiedenen Stadien, Schussverletzungen in Kriegs- und Friedenszeiten, Geschossembolie, Geschosswanderung, entzundliche Komplikationen, Suizide durch Kopfschussverletzungen, offene Stich- und Hiebverletzungen und Verletzungen bei Bombenanschlagen."

In 1967 cardiologists in Switzerland were struck by the sudden increase in the number of cases of so-called primary pulmonary hypertensive disease (PPHD). Up untill966, the cardiology centers in Switzerland had not seen more than one or two cases a year, but this number suddenly multiplied by ten or twenty times. At the June 1968 meeting ofthe Swiss Society of Cardiology, Gurtner et al. (1968b) presented a paper which raised the question whether the vascular types of cor pulmonale had increased. They also raised the question about the possible responsibility of environmental factors, such as toxins or drugs, in causing this increase. Krrihenbuhl et al. (1968) first suggested the possible responsibility of anorexigenic drugs, but no proof was provided. Soon after this, the cardiology team in Bem (Gurtner et al., 1968a) published their report, which resumed and completed the above-mentioned prelim- inary communication; 31 cases of PPHD, among which 17 had taken an anorexigenic drug, aminorex fumarate (Menocil, Cilag), were reported. The importance of this work was soon recognized and it was followed by several meetings (in Vienna, Hannover, and Burgenstock) and two round tables sponsored by the Swiss Society of Cardiology (in Montreux and Basel).

Die Speicheldrüsen sind in mannifacher Weise in den Organismus eingebunden, so daß aus der Analyse des Speichels Rückschlüsse auf krankhafte Funktionen anderer Organsysteme gezogen werden können. Wechselwirkungen zwischen Speicheldrüsen und Organismus spielen in der Ätiologie und Pathogenese der verschiedenen Formen der Sialadenitis eine bedeutsame Rolle. Hierzu gehören Immunkrankheiten, metabolische Erkrankungen, hormonale Dysfunktionen, neurologische und auch genetische Erkrankungen. Auf dem Gebiet der Speicheldrüsentumoren sind durch den Einsatz neuer Methoden (Immunhistochemie, Molekularpathologie, Prolifikationsmarker, Chromosomenanalyse) viele neue Erkenntnisse gesammelt worden.