[Atypical mycobacterial infection due to Mycobacterium fortuitum]. / Atypische Mykobakteriose, hervorgerufen durch Mycobacterium fortuitum.

The case is presented of a 48-year-old woman who, in association with repeated septic temperatures, developed abscesses in the region of the right shoulder and in the right ankly. Histological examination from excisates revealed caseous tuberculoid granulomas. Mycobacterium fortuitum was isolated from the pus of both abscesses. Although the Mycobacterium fortuitum was resistant to nine commonly used tuberculostatics, it was found to be sensitive to ethionamide and capreomycine. The use of these two drugs in combination with local measures proved successful.

[Radiotherapy results in brain metastases (118 cases)]. / Ergebnisse der Strahlentherapie bei Hirnmetastasen (118 Fälle)

Results of palliative radiation therapy in cerebral metastases of various primary tumors are reported. The radiation therapy consisted in a large-volume irradiation which encompassed the whole cerebrum, using single dose of 200 rd (calculated for the center of the skull) five times a week, amounting to a total dose of 4000 rd, sometimes up to 5000 rd. In some cases, a saturating irradiation of a small volume reached 5000 or 6000 rd. A significant improvement in symptomatics was obtained in about 70% of the patients. The average time of survival after accomplishment of the radiation therapy amounted to six months. Own results and the summarized results of the other authors justify the irradiation of cerebral metastases as a rewarding palliative indication.

[Laxative induced diarrhea- -a form of self-mutilation]. / Laxantieninduzierte diarrhöe- eine form von selbstmutilation

In the differential diagnosis of gastrointestinal disturbances the possibility of laxative abuse is considered either too late or not at all. The sequel is a protracted course of illness with a series of expensive and fruitless investigations. On the basis of three recently observed cases of laxative-induced diarrhea the problems of diagnosis and management are discussed. Methods of securing early diagnosis are mentioned. The overall prognosis must be considered unfavorable. The importance is stressed of long-term follow-up of these patients at community level, to ensure timely intervention should complications arise and to prevent further unnecessary investigations.

[Chorea minor under ovulation inhibitors]. / Chorea minor unter Ovulationshemmern

Three weeks after commencing oral contraception for the first time, a 26-year-old woman with a history of rheumatic carditis and chorea minor presented with sudden recurrence of hyperkinesis. Withdrawal of the contraceptive agent was followed by rapid remission of the hyperkinesis, which suggests a casual relationship between the contraceptive and this condition and an analogy between this case and so-called chorea gravidarum. A young non-pregnant woman presenting with chorea minor should be specifically questioned by ingestion of oral contraceptives. If there is a past history of rheumatic fever with or without chorea, oral contraceptives are contraindicated.

PIP: 3 weeks after commencing oral contraception (Ovulen) for the 1st time, a 26-year-old woman with a history of rheumatic carditis and chorea minor presented with sudden recurrence of hyperkinesis. Withdrawal of the contraceptive agent was followed by rapid remission of the hyperkinesis, which suggests a causal relationship between the contraceptive and this condition and an analogy between this case and so-called chorea gravidarum. A young nonpregnant woman presenting with chorea minor should be specifically questioned about ingestion of oral contraceptives. If there is a past history of rheumatic fever with or without chorea, oral contraceptives are contraindicated.