[Benign recurring aseptic meningitis. What requires our attention?]. / Benigne rekurrierende aseptische Meningitis. Worauf muss man achten?

Benign recurrent aseptic meningitis (BRAM) or Mollaret's meningitis is a rare disease characterized by recurrent episodes of aseptic meningitis followed by spontaneous recovery. Disease courses over several years have been reported. In most cases, BRAM is caused by HSV-2, less frequently by other viruses or autoimmune diseases. In up to 10 %, the aetiology remains unclear. We present a case of idiopathic BRAM and discuss clinical findings, diagnosis and therapeutic options of this rare illness.

[A prospective multi-centre study of the response of metastatic gastrointestinal tumours (author's transl)]. / Prospektive kontrollierte Studie bei metastasierten gastrointestinalen Tumoren. Vergleich zwischen 5-Fluorouracil-Carmustin un Ftorafur-Carmustin.

In a prospective, multi-centre, randomized study of 109 patients with metastatic gastro-intestinal adenocarcinomas the response rate, survival time and side-effects of two drug combinations, carmustin +5-fluorouracil and carmustin + ftorafur, were compared (same carmustin dosage in both groups). Response to the treatment was 32.7% in those receiving carmustin +5-fluorouracil, 26.3% in those on carmustin + ftorafur. This difference occurred among the 42 patients with gastric adenocarcinoma (33.3% compared with 25%), as well as in 11 with pancreatic adenocarcinoma, and in 56 with colorectal adenocarcinoma (32.1% and 28.6%). Median survival time for 5-fluorouracil + carmustin was 330 days, double that for ftorafur + carmustin (163 days). Bone-marrow toxicity (leukopenia, thrombopenia) was below 10% for both drug combinations. Alopecia occurred in only a few patients. Gastro-intestinal toxicity was common (20% and 18.5%, respectively), but there was no difference between the two groups. The somewhat lower effectiveness of ftorafur compared with 5-fluorouracil was probably due to the deliberately smaller dosage of the former.

[Lymphocyte stimulation of healthy probands with a "Hodgkin's HL-A type" (author's transl)]. / Die Lymphocytentransformierbarkeit von Gesunden mit einer "Hodgkin-HL-A-Konstellation"

Reported correlations between HL-A type and Hodgkin's disease suggest that genetic factors as HL-A associated immune response genes may play a role in the pathogenesis of Hodgkin's disease. Assuming that healthy individuals having a Hodgkin HL-A constellation may demonstrate impaired immune function mitogen stimulation and mixed lymphocyte reaction were carried out. However, lymphocytes of 12 persons with a Hodgkin-HL-A type did not show any abnormality in the in vitro tests when compared to a control group.

[Clinical course of typhoid in the Heidelberg region (author's transl)]. / Klinischer Verlauf der Typhusinfektionen im Raum Heidelberg

In the course of a typhoid epidemic during the autumn of 1974 in the Heidelberg region 74 persons were treated in hospital. Chloramphenicol was give to 45, ampicillin to 19. The former, in daily doses of 2.0 g, gave worse results if given for only two instead of three weeks. In comparison, ampicillin was less effective. A second course of treatment became necessary in 13 patients, with trimethoprim-sulphamethoxazole (Bactrim) being succesful in all, although the follow-up period is still too short for definitive results. Three complications occurred: one case of massive bleeding from the gut requiring operation and followed some weeks later by a HBS-antigen-negative hepatitis; one case of typhoma (several weeks after the end of antibiotic treatment), requiring operative removal; a case of febrile abortion in the second month of pregnancy.