Proceedings of an interdisciplinary meeting, sponsored by the Commission of the European Communities, as advised by the Committee on Medical and Public Health Research

Proceedings of a NATO ARW held in Cargese, France, October 9-13, 1989

The contact between the human blood and foreign technical apparatus (circulatory) and respiratory assist devices, arti ficial kidneys) leads to changes in the plasmatic and cel lular components of the blood, which have often only been taken as signs of gross but passive blood destruction. There is much evidence to support this notion in parts (mechanical cellolysis of erythrocytes and thrombocytes), however, these changes have to be seen in a broader bio logical context as an organ-specific reaction of the blood. It is an unjustified oversimplification to simply treat the blood as transport organ for respiratory gases (02 and CO ) and metabolites. The blood is rather also an organ 2 system for specific and unspecific defense mechanisms, di rected against the hazards of mechanical, microbiological and toxicological risks posed to multicellular macro-orga nisms in an environment in which trauma and other distur bances of the physical integrity are common. The two defense systems of the blood are based on humural and cellular constituents; the latter have to be considered as "excitable cells," capable of responding in a predictable and automatic fashion to adequate stimuli. The response of the cellular constituents in controlled and coordinated by chemical mediators. The immunological research of the last century has distinguished two separate defense systems of the blood: I. The highly specific defense system (immune system sen sustrictori) which is phylogenetically new and is ontogenetically learned."

The edition of Nietzsche's correspondence is concluded with the commentary on the letters from and to Nietzsche in the crisis-ridden period from 1887 to 1889. The effort required for the commentary is particularly great for this time, as nearly every document from the period has been subjected to intense comment and interpretation. Renate MA1/4ller-Buck, who has proved her worth in editing the letters from the very beginnning of the project, has not only been involved in collating and accessing the manuscript resources (particularly the drafts of letters) but has over and above this devoted her attention to unravelling difficult personal connections, personal and literary allusions and the complicated networks in this wide-ranging correspondence. The comprehensive index to Section III, to which Holger Schmid has made an equal contribution, now provides access to the final and most complex episode in Friedrich Nietzsche's life and work.

Un sere Vorstellungen iiber die Pathogenese der chronis chen arteriellen VerschluB- krankheit haben sich in den vergangenen fiinfzehn Jahren gewandelt. Dies muBte auch unsere Konzepte iiber die Wirkungen von Substanzen fUr die Therapie dieses komplexen Krankheitsprozesses beriihren. Gegeniiber den bisher bekannten Re- zeptor-Wechselwirkungen und muskulotropen Effekten treten in der jiingsten Zeit Wirkungen auf Membranen in den Vordergrund. Angriffspunkte dieser Art kon- nen mit neuenTestsystemen aufgezeigt werden. In der hier vorliegenden Dokumentation zur Pharmakologie von Ginkgo biloba sind erste Untersuchungen in dieser Richtung beschrieben. Sie werfen Licht auf das differenzierte pharmakologische Wirkprofil einer Substanz, die in den ver- schiedenen Fachrichtungen bei der Therapie der chronischen arteriellen Ver- schluBkrankheit breite Anwendung gefunden hat. Das iiberraschende Ergebnis dieser Experimente war, daB das Verhalten der Zellen in StreBsituationen, die fUr die aktive Atherosklerose charakteristisch sind wie Storungen des Ionen- und pH-Gleichgewichts, Einwirkung reaktiver Sauerstoff-Radikale sowie Austausch von Mediatoren zwischen Blutzellen untereinander und mit Endothelzellen, unter Ginkgo biloba in beeindruckenderWeise verbessert wurde. Diese Beobachtungen fiihrten zu dem SchluB, daB ginkgospezifische Terpenoide und Flavonoide in die Lipidphase von Membranen inkorporiert werden und dadurch die mechanischen und biochemischen Eigenschaften der Membran positiv beeinflussen. Neuere rheologische Befunde deuten darauf hin, daB die Inkorporation von Ginkgo biloba in Membranen ein ProzeB ist, der sich iiber einen langeren Zeitraum vollzieht. Moglicherweise werden die Komponenten bereits im Rahmen der Membranbio- synthese eingebaut. Die Beobachtungen zeigen auch, daB kiinftig neue Langzeit- strategien bei der Erforschung derWirkung von Phytopharmaka eingesetzt werden miissen.