We analyzed the postmortem blood of a total of 100 fatal cases for beta-hydroxybutyric acid (BHBA). In 25 cases of sudden and unexpected death of alcoholics we found pathologically increased levels of BHBA of 1260 to 47 200 (median 8000) µmol/L. This led us to the diagnosis of an alcoholic ketoacidosis (AKA) as cause of death in these cases. The control group of 69 postmortem cases revealed that BHBA concentrations below 500 can be regarded as normal, and values up to 2500 µmol/L as elevated. Our study shows that BHBA values over 2500 µmol/L could lead to death, if no medical attention is sought. During storage we did not find any indication of postmortem formation or decomposition of BHBA in blood in vitro or in the corpses. In our opinion, BHBA should be considered the diagnostic marker of choice for the postmortem determination of alcoholic ketoacidosis (AKA) as the cause of death. The classical indications of such deaths are: unexpected death of a chronic alcoholic; none or only traces of ethanol in the blood; increased acetone blood concentration; and neither autopsy, histology, microbiology, nor toxicology reveal the cause of death. In six further cases a diabetic ketoacidosis (DKA) was diagnosed as the cause of death.

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Objective To compare the effects of drinking white wine or black tea with Swiss cheese fondue followed by a shot of cherry schnapps on gastric emptying, appetite, and abdominal symptoms. Design Randomised controlled crossover study. Participants 20 healthy adults (14 men) aged 23-58. Interventions Cheese fondue (3260 kJ, 32% fat) labelled with 150 mg sodium 13Carbon-octanoate was consumed with 300 ml of white wine (13%, 40 g alcohol) or black tea in randomised order, followed by 20 ml schnapps (40%, 8 g alcohol) or water in randomised order. Main outcome measures Cumulative percentage dose of 13C substrate recovered over four hours (higher values indicate faster gastric emptying) and appetite and dyspeptic symptoms (visual analogue scales). Results Gastric emptying was significantly faster when fondue was consumed with tea or water than with wine or schnapps (cumulative percentage dose of 13C recovered 18.1%, 95% confidence interval 15.2% to 20.9% v 7.4%, 4.6% to 10.3%; P<0.001). An inverse dose-response relation between alcohol intake and gastric emptying was evident. Appetite was similar with consumption of wine or tea (difference 0.11, −0.12 to 0.34; P=0.35), but reduced if both wine and schnapps were consumed (difference −0.40, −0.01 to −0.79; P<0.046). No difference in dyspeptic symptoms was present. Conclusions Gastric emptying after a Swiss cheese fondue is noticeably slower and appetite suppressed if consumed with higher doses of alcohol. This effect was not associated with dyspeptic symptoms. Trial registration ClinicalTrials.gov NCT00943696.

A method of matching skulls with photographic portraits or impressions of the face in clay by video superimposition is described. Two different practical cases are presented. The first one deals with the identification of a skull of a six-year-old girl, the second with the identification of the skull of the famous Swiss Pedagogue Johann Heinrich Pestalozzi, who died about 160 years ago. The advantages and versatility of this method are shown; also the setup of the equipment and the working technique.

In memoriam Prof. H. Lubhart(1 1 .x1.77) 3,4-Dimethoxyfuran: Properties, Calculations and some Substitution Reactions Summary 3,4-D6methoxyfuran (3,4-DF) is much more reactive than furan itself. We present experimental details €or the synthesis of this useful compound in 50-100 g batches. 3,4-Dibenzyloxyfuran has also been prepared. Quantum mechanical calculations by PPP-and CNDO-methods analogous to furan itself gave the following inforimation (compared with furan): enhanced negative partial charge at C (2) and c(5), higher acidity at a-positions, a stronger and at the same time inverted dipol moment. In accordance with the calculations, 3,4-DF can easily be substituted by weak electrophilic reagents, e.g. in a typical Mannich reaction. The bis-amino compound 8 is produced in good yields. Lithiation by butyl-Li leads to mono-or di-substituted products. The mono-and di-Li-3,CDF have been used for the preparation of various acylated and alkylated 3,4-DF derivatives.By acid hydrolysis of 3,4-DF crystalline 4-methoxy-3 (2 H)-furanone has been prepared.3,4-Diimethoxyfuran ( = 3,4-DF) wurde von uns gelegentlich zu Reaktionen mit Chinonen und anderen Dienophilen benutzt [3-91. Die dabei zu Tage getretene, gegenuber Furan deutlich erhohte Reaktivitat veranlasste uns, die chemischen und physikalischen Eigenschaften naher zu untersuchen, woruber in dieser und in spateren Arbeiten berichtet werden s0113).