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History and Admission Findings: Three men, aged 32, 56 and 41 years, respectively, were hospitalized within two weeks because of flu-like symptoms, limb pain and abdominal pain. Being in a febrile, impaired general condition, pressure pains in the upper abdomen and flank pains were particularly noteworthy., Investigations: The results of the examinations, indicating acute renal insufficiency, thrombocytopenia and elevated lactate dehydrogenase were typical of a hantavirus infection, and positive serology for the puumala virus confirmed this suspicion. Ultrasonography indicated nephritic changes in all cases. Striking and unusual, however, was the finding of an acalculous cholecystitis., Treatment and Course: In one of the three cases, antibiotic therapy with ceftriaxone was performed, in the other two cases symptomatic therapy. The cholecystitis was closely monitored sonographically and healed without complications in all cases., Conclusions: Hantavirus infections are common in an endemic area such as the Swabian Alb in Southern Germany, but an acalculous cholecystitis was rarely described in such a context. This accumulation is very remarkable, and the knowledge about it can both help to detect complications at an early stage and prevent unnecessary cases of cholecystectomy., (© Georg Thieme Verlag KG Stuttgart · New York.)

For the resolution of racemic 2 MBF-Lactol (3) was used. After 40 h an excess of 3 gave a new product, the "modified" MBF-Lactol 6. This has a high enantiomeric selectivity and leads to well crystallized derivatives.

Numerous epidemiologic studies have shown that a diet rich in vegetables, fruits and fiber is associated with a decreased risk of cancer, particularly of epithelial tumors. Especially this association is evident for various citrus fruits, carrots, leafy green vegetables, as well as cruciferous-(sorts of cabbage, broccoli) and leak vegetables (garlic, onions, etc.). In the course of investigation of the protective mechanisms exerted by vegetable foodstuffs, a great number of secondary plant products such as carotenoids, sulfides, glucosinolates, plant sterols saponins, terpens, phytoestrogens, flavones, protease inhibitors, or phenolic acids, which are substantial constituents of our daily food, have changed their meaning from a non-nutritive constituent to a probably cancer preventive biological-active substance. But also fermentable, soluble fibers and substances in fermented foods can exert protective effects on development of cancer. Mostly the anticarcinogenic action of biological-active substances is limited to an early stage of carcinogenesis. Therefore it seems to be important to start prevention of cancer by nutrition as early as possible and adhere to it over a long period.

The monophasic action potential (MAP) contains a wealth of information about the stat of the myocardium, which makes it very useful for numerous diagnostic and therapeutic applications in patients with heart disease. The silver-silver chloride electrodes which are currently used for the measurement of MAP have poor long-term stability in contact with biological tissue. This study was therefore undertaken with the aim of investigating the electrochemical behaviour of fractally coated leads in terms of their signal-detection performance. Experience gained with these leads in cardiac pacemakers has already demonstrated the long-term stability and biocompatibility of the fractally coated leads. Present results show that, due to their large electrochemically active surface area, fractally coated leads have a very low impedance over a wide frequency range. The negligible polarization artifact of these leads permits the measurement of cardiac potentials immediately after a stimulus. Fractally coated leads are thus highly suitable for the measurement of MAP, and have clear advantages over Ag/AgCl electrodes. The second part of this study reports on the results of MAP measurements using fractally coated leads.

The monophasic action potential (MAP) represents a summed signal formed by overlapping action potentials of myocardial cells close to the tip of the lead. Analysis of the MAP therefore provides detailed information about the electrophysiological effects of autonomous nervous and pharmacological influences on the myocardium, for example adrenergic or cholinergic stimulation of the heart. All known MAP recordings were obtained with Ag/AgCl electrodes, which, thanks to their low polarization properties, ensure reliable MAP measurement. Owing to their toxicity and inadequate long-term stability, however, Ag/AgCl electrodes cannot be implanted. With the aim of making MAP measurement available for implantable devices, fractally coated leads were therefore developed. The aim of the present study was to evaluate the in vivo measurement of fractally coated leads which are characterized by negligible polarization, low impedance over a wide frequency range, high biocompatibility and good long-term stability. In addition, as a result of their extremely high Helmholtz capacities (up to 50 mF/cm2), fractally coated leads permit stimulation and virtually undisturbed recording of MAP with the same pair of electrodes. For the evaluation of MAP measurements with fractally coated leads, a quadrupolar catheter enabling simultaneous MAP recordings with 2 Ag/AgCl electrodes and 2 fractally coated leads was devised. The stimulation pulses were always applied via the fractally coated leads. With both types of electrode, with spontaneous excitation and stimulation, the well-known MAP morphology, with amplitudes of between 10 and 25 mV in the ventricle, and between 5 and 10 mV in the atrium, was seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Within the period from 1959 to 1984 the development of diagnostic and therapeutic possibilities has been demonstrated in 68 cases of women with a Stein-Leventhal syndrome. In the first group consisting of 11 female patients who were under examination until 1975 the clinical aspects took the leading part in the diagnosis. The ovarian wedge resection meant histological security and therapy at the same time. During the second period until 1980 (26 women) the hormone diagnostics was an essential criterion. The conservative therapy with Clostilbegyt aimed at the correction of these hormonal dysfunction as well. During the last years (31 women) diagnosis has been concentrated on etiological aspects. Correspondingly an individualized therapy was practised. The advances in the medical attendance of infertility become evident in the increase of the pregnancy rate from 9.1 to 61.3%.

In 20 women with marked androgynism or testosterone concentrations being suspected for a tumor blood samples were taken by selective retrograde catheterization of the ovarian and suprarenal veins via vena femoralis. Testosterone, 17 beta-estradiol, and progesterone were determined and the concentration gradients to peripheral blood levels were calculated. In 20% of patients an pure adrenal and in 5% an ovarian hypersecretion of testosterone was established. A combined adrenal-ovarian hypersecretion was found in 50%. In 25% of the cases no final estimation was made because anatomic variations in venous size and drainage made catheterization and bilateral blood sampling impossible. There were no references to an androgen-secreting tumor.