[Mydriasis, tachycardia]. / Mydriasis, Tachykardie.

We report a case of plant poisoning with atropa belladonna. A student took the berries because of the hallucinogen effects. In this case report we describe the symptoms and the therapy of poisoning with atropa belladonna. Another part informs about the historic and cultural importance of this nightshade. Since antiquity, the lethal as well as the hallucinogenic effects of poisoning with atropa belladonna are well known; therefore, they are an important part of orgies and rituals.

[Contrast media-enhanced duplex ultrasonography of liver tumors]. / Kontrastmittelverstärkte Duplexsonographie von Lebertumoren.

The differentiation of focal liver processes is a daily clinical problem. A new option in addition to magnetic resonance tomography has been created with the development of new stable sonographic contrast agents. In this paper, Levovist was studied as a sonographic contrast agent in the detection of specific tumour perfusion patterns. All focal liver processes were proven by cytology or histology. In 19 of 22 cases there was a pathological diagnosis. In 5 of 7 haemangiomas a feeding vessel was visualised. In 3 focal nodular hyperplasias intense intratumoural enhancement was visible shortly after injection. In 2 cases of hepatocellular carcinomas tumoural neovascularisations were visualised which were not seen before the injection of Levovist. The new sonographic contrast agents provide better differentiation of specific perfusion patterns of liver tumours than normal duplex sonography.

[Abdominal pain]. / Abdominalschmerzen.

A 37-year-old female patient was admitted to our outpatient clinic because of abdominal pain and absence of stool for five days. A diagnosis of acute intermittent porphyria was made by determination of porphyrins in the urine and the stool, the absence of skin symptoms and the measurement of urosynthase activity. As triggering event we suspect a viral infection. Neurological and neuropsychiatric symptoms were absent.

[Castleman's disease--a rare cause of a febrile state with lymphadenopathy]. / "Castleman's Disease"--seltene Ursache eines Status febrilis mit Lymphadenopathie.

HISTORY AND CLINICAL FINDINGS: A 26-year-old man had a prolonged fever, 10 kg weight loss and generalized lymphadenopathy, first diagnosed as a malignant lymphoma. On admission he was febrile and in a markedly reduced physical condition. Submandibular, angular, cubital and inguinal lymph nodes were slightly enlarged bilaterally. INVESTIGATIONS: Serology and blood cultures were negative. Sonography and computed tomography showed enlarged lymph nodes in the neck, mediastinum, axillae, retroperitoneum and mesentery. Biopsies of lymph nodes and bone marrow revealed changes characteristic of Castleman's disease. TREATMENT AND COURSE: Prednisone was administered, 20 mg daily for 20 days, the dose gradually reduced over 4 months. The fever ceased after 14 days and the patients's working capacity was fully restored after 7 weeks. CONCLUSION: In a case of prolonged fever of unknown cause Castleman's disease should be included in the differential diagnosis. It at first consists of polyclonal lymphatic proliferation. But transformation to malignant lymphoma and systemic Kaposi's sarcoma have been described in the disease's generalized form.