[Communication and information in the Danish health services. Laws, regulations and rules for patients and personnel in the Danish health services]. / Kommunikation og informationspligt i det danske sundhedsvaesen. Love, vedtaegter, rettigheder og regler for patienter og personale i det danske sundhedsvaesen.

This article describes communication and information between patients and health staff in the Danish Health Service. A number of laws, regulations, rights, and rules have been passed, and in 1998 a new law came into effect concerning patients' rights in the health service. This law protects the rights of patients and provides the health staff with guidelines on communication and information to patients. An analysis of the law is given here. Each profession in the health service has its own regulations and ethic rules. These regulations and rules are reviewed with respect to communication and information in the Danish Health Service.

[Prognostic factors in soft tissue sarcomas. Experiences from the Sarcoma Center in Aarhus]. / Prognostiske faktorer ved bløddelssarkomer. Erfaringer fra Sarkomcentret i Arhus.

In the present study, the outcome, patterns of local recurrence and survival, as well as prognostic factors, were evaluated in patients surgically treated for soft tissue sarcomas. Between January 1979 and July 1993, 316 consecutive patients were referred to the Sarcoma Centre in Aarhus with localised malignant soft tissue sarcoma of the extremities or trunk. There were 161 men (51%) and 155 women (49%), the median age was 56 years (1-94). Histologically 52 patients (16%) had a grade I, 60 patients (19%) a grade 2 and 204 patients (65%) a grade 3A or 3B tumour. The five-year local recurrence rate was 18% and the five-year survival rate was 75%. Multivariate analysis indicated the following variables as independent unfavourable factors for local recurrence: extracompartmental location, histological high-grade (i.e. histologically highly malignant) local excision, no adjuvant radiotherapy and intralesional/marginal excision. Independent unfavourable factors for survival were advanced age, extracompartmental location, histological high-grade, lower extremity location and large tumour size. Based on these variables, a prognostic model was made.

[Agressive fibromatosis]. / Aggressiv fibromatose.

Aggressive fibromatosis is a rare soft tissue tumour with a high tendency to local recurrence. The patients often present with a deeply sited, firm mass with or without pain. Genetic, physical and endocrine factors seem to be important in the development of the disease. Patients with Gardner's syndrome and familial adenomatous polyposis have a higher risk of developing aggressive fibromatosis and often develop tumours in the mesentery, retroperitoneally or in the abdominal wall. Infantile fibromatosis is a variant of aggressive fibromatosis. The standard treatment of aggressive fibromatosis is surgical resection with wide free margin, in some cases supplemented with radiotherapy. Chemotherapy and hormonal treatment of non-resectable tumours has been described without convincing results and more data from clinical studies are needed.

[Communication with cancer patients in an orthopedic department]. / Kommunikation med kraeftpatienter i en ortopaedkirurgisk afdeling.

The aim of the study was to examine and to compare the level of information and satisfaction among cancer and shoulder-elbow patients in an orthopaedic ward and the development over time. Thirty-eight consecutive patients under suspicion for cancer and 38 consecutive patients with a benign shoulder-elbow disease were included and matched according to age and gender. Three questionnaires were constructed using closed and open-ended questions about level of information and satisfaction in patients' episodes af care. At admission to the ward the patients had a low level of information and satisfaction. After receiving information on the ward, the patients' level of information and satisfaction in both groups improved and were similarly high. Nevertheless, patients in both groups had a desire to receive more information one month after discharge.

[Can magnetic resonance imaging differentiate between benign and malignant conditions in patients with skeletal or soft tissue tumors?]. / Kan magnetisk resonans-undersøgelse adskille benigne tilstande fra maligne hos patienter med skelet- eller bløddelstumorer?

The records of 437 patients referred preoperatively for magnetic resonance imaging (MRI) due to clinical or radiological suspicion of a bone or soft-tissue malignancy were examined retrospectively in order to evaluate how good MRI is at distinguishing malignant from benign lesions. The MR-examination tends to overestimate malignancy. In all cases, the preoperative MR-examination correctly identified all malignant tumours as malignant, but also estimated a number of benign lesions as malignant. Sensitivity, specificity and predictive value was 100%, 71.2% and 76.4% respectively. In case of bursa/ganglion and pseudotumour, MR was able to correctly identify these lesions as benign. MR could not differentiate between the different types of sarcomas.

Unicompartmental arthroplasty of the knee. Cadaver study of the importance of the anterior cruciate ligament.

The tibiofemoral articulation on horizontal and 10 degrees tilted tibial components was examined radiographically in 20 cadaver knees after lateral arthroplasty, and after cutting the anterior cruciate ligament in 10 knees with medial and 10 with lateral arthroplasty. Articulation took place more posteriorly on the horizontal components at any degree of flexion examined; a correlation was found between the operation-induced change in the inclination of the lateral tibial plateau and the point of articulation. Based on the regression equations, the expected point of articulation on an arbitrarily chosen component placement could be calculated for any degree of flexion provided the preoperative inclination was known. Cutting the anterior cruciate ligament caused articulation to move posteriorly on the tibial component at both medial and lateral arthroplasty. We concluded that it was possible to estimate the tilt of the tibial component that was required to avoid marginal articulations when the preoperative slope of the tibial plateau was known. Absence of the anterior cruciate ligament seems to contraindicate unicompartmental arthroplasty.

Unicompartmental arthroplasty of the knee. Cadaver study of tibial component placement.

In 30 knee preparations the median posterior inclination (tilt) of the medial tibial plateau was 10 degrees (5 degrees-15 degrees). Following medial compartmental arthroplasty in 20 knees, 10 with horizontal, and 10 with 10 degrees tilted tibial components, the point of articulation was determined radiographically. For the combinations of tibial angle and knee flexion that represent the initial 60 per cent of the stance phase, articulation took place more posteriorly on the horizontal components; there was a correlation between the operation-induced change of the tibial inclination and articulation. Articulation took place far posterior on horizontal components inserted in knees with a steep posterior tilt. We concluded that both the component placement and the preoperative inclination of the tibial plateau determine where on the tibial component articulation takes place. An optimal, central articulation with this set-up is obtained when the component is inserted with the same posterior tilt as that of the original articular surface.