The functional mu opioid receptor (OPRM1) Asn40Asp variant predicts short-term response to nicotine replacement therapy in a clinical trial.

To determine whether the functional mu-opioid receptor (OPRM1) Asn40Asp variant predicts the comparative efficacy of different forms of NRT, we conducted a clinical trial of transdermal nicotine (TN) vs nicotine nasal spray (NS) in 320 smokers of European ancestry. Smokers carrying the OPRM1 Asp40 variant (n=82) were significantly more likely than those homozygous for the Asn40 variant (n=238) to be abstinent at the end of treatment, and reported less mood disturbance and weight gain. The genotype effect on treatment outcome was most pronounced among smokers receiving TN, particularly during the 21 mg dose phase. Smokers who carry the OPRM1 Asp40 variant are likely to have a favorable response to TN and may benefit from extended therapy with the 21 mg dose.

Myxoma complex associated with transient hyperthyroidism: are diseases of the thyroid part of the complex?

The myxoma complex is a very rare disease. We report on a 31-year-old woman who suffered a hyperthyreosis, which resolved spontaneously. A few months later she developed a Cushing's syndrome, caused by a primary adrenocortical nodular dysplasia. A bilateral adrenalectomy had to be performed. 15 months after this operation she developed a cerebral infarction caused by an embolus from a left atrial myxoma. Our patient is a further case of Carney's syndrome. The aspect of the hyperthyreosis is interesting: Perhaps disease of the thyroid represents a new element of Carney's syndrome.

[Brucellosis with fatal endotoxic shock]. / Bruzellose mit tödlichem Endotoxinschock.

BACKGROUND: Brucellosis is a zoonosis with good prognosis in cases of early diagnosis. To make the diagnosis is still a problem today. CASE REPORT: A 60-year-old butcher was admitted with undulating fever, sweats, arthralgia and weight loss. Further examination revealed hepatosplenomegaly with laboratory findings of a hepatitis and multiple focal liver lesions shown by abdominal ultrasound and CT. Histologically, these lesions corresponded to caseous granulomas. Diagnosis of brucellosis was confirmed by detection of brucella species in prolonged incubation in blood culture. After the beginning of antibiotic resistance-tested therapy with tetracycline and quinolones, an endotoxic shock occurred during the first 24 hours of treatment and the patient died after multiorgan failure with disseminated intravascular coagulation. CONCLUSION: In cases of undulating fever with liver involvement, a brucellosis should be considered. Good teamwork of the internal, pathological and microbiological departments is necessary for early and correct diagnosis. This is the first report of human brucellosis in association with lethal endotoxic shock.

Arthralgia as an early extraintestinal symptom of Whipple's disease. Report of five cases.

Five patients with Whipple's disease all suffered from arthralgia for a long time (15 years in one case) before developing gastrointestinal or other symptoms. In all patients, arthralgia was seronegative, and there was no evidence of joint destruction. Arthralgias were symmetric and migrating. Whipple's disease is part of the differential diagnosis of enteropathic arthralgia. Thereby, the polymerase chain reaction can be a helpful tool to prove Whipple's disease in difficult differential diagnosis.

Congenital posterior laryngotracheoesophageal cleft with subglottic stenosis: a case report.

Posterior cleft larynx is an uncommon congenital anomaly of variable extent representing an incomplete or absent separation of larynx and trachea from the hypopharynx and esophagus. This case report describes the histopathology of a type 2 cleft (classified according to Evans) associated with a subglottic stenosis due to elliptical shape of the cricoid cartilage and redundant submucosal tissue in a premature female infant.

[Stomach wall abscess--endoscopic diagnosis and therapeutic possibilities]. / Der Magenwandabszess--Endoskopische Diagnose und Therapiemöglichkeit.

This is a case report of a rare gastric wall abscess of a 70 year-old woman who came to hospital with non-characteristic pain in the upper abdomen. The diagnosis was made by endoscopy. After endosonography the patient was treated by endoscopic drainage, antibiotics and abstinence of food. Two weeks later the abscess had healed. Subsequently recurrent arterial emboli occurred in the left leg leading to several operations. Two months after hospitalisation the woman died as a result of circulation failure induced by septicaemia. Surprisingly, post mortem examination showed endocarditis of the mitral valve with septical metastases in multiple organs. A review of the literature is given and etiology and pathogenesis of the gastric wall abscess are reviewed. The surgical treatment is compared with endoscopic therapy.

[Caries protective effect of a NaF containing toothpaste with and without calcium carbonate polishing agent]. / Kariesprotektiver Effekt einer NaF-haltigen Zahnpaste bei gleichzeitiger Anwesenheit eines Kalziumkarbonat-Putzkörpers.

A caries preventive effect depending on the free fluoride concentration was registrated on rats using dentifrices with NaF or MFP (alone or in combination) despite the presence of CaCO3 as abrasive material because the composition of these dentifrices was changed. The free fluoride concentration of dentifrices had induced the accumulation of fluoride into enamel. The ionized fluoride content of NaF-dentifrices was unchanged for 3 years. MFP was hydrolized and had continuously released fluoride ions. The caries preventive effect which was increased by HCO3- was reproducible in correspondence with the fluoride concentration after the storage for two years.