[Vertebral metastases of urogenital carcinomas: Diagnosis and conservative therapy]. / Wirbelsäulenmetastasen urologischer Tumoren : Diagnostik und konservative Therapie.

The high incidence of bone metastases of urologic neoplasms and their morbidity, especially of vertebral metastases, requires exact diagnosis and consequent therapy. Conventional radiography plays an important role in the diagnosis of symptomatic bone lesions. Computed tomography can evaluate the stability of metastatic lesions and is indispensable for therapy planning. MRI and PET-CT have the highest diagnostic accuracy for the detection of bone metastases and MRI can evaluate their intra- and extraosseus components. PET-CT, PET-MRI, or SPECT-CT in combination with specific tracers - due to their high specificity and sensitivity - have the potential to replace conventional methods in the future. Conservative treatment basically consists of analgesic therapy, the administration of calcium and vitamin D3 and bisphosphonates or inhibitors of RANKL (denosumab). Moreover radium-223-dichloride can improve overall survival and the time to the first symptomatic skeletal event in castration-resistant prostate cancer patients with bone metastases.

[Operative therapy of spinal metastases from urological tumors]. / Operative Therapie von Wirbelsäulenmetastasen urologischer Tumoren.

The treatment of bone metastases from urological tumors represents a palliative form of therapy, apart from the resection of solitary metastases from renal cell carcinomas. Due to the high incidence of spinal metastases this can result in clinically significant symptoms and possible complications for patients, such as pain, spinal instability and compression of the spinal canal with corresponding neurological deficits. By the use of targeted diagnostics and induction of radiotherapeutic and/or surgical treatment, for the majority of patients an immediate reduction in pain as well as early mobilization and sometimes even regression of existing neurological deficits and therefore an improved quality of life can be achieved.

[Planning of family planning]. / Planung der Familienplanung.

PIP: Effective propaganda by official and private organizations is 1 of the necessary 1st steps in a family planning program. The large number of artificial abortions in Switzerland indicates a need for more family planning counseling, and the poor response to the 1 center in a Bern women's clinic suggests that the services must be improved and intensified. These centers should provide contraceptives and birth control counseling, and training for doctors, midwives, and social workers. Scientific investigations (e.g., comparative studies of various oral contraceptives, thorough clinical investigations of observed side effects) should be planned and coordinated in advance. Furthermore, professionally trained and politically neutral doctors and family planning workers should be sent to aid or develop family planning programs in the less developed nations.^ieng

[Saw injury of the hand--an accident with grave sequelae]. / Die Sägeverletzung der Hand--ein folgenreiches Unfallgeschehen.

Besides bruises saw injuries of the hand are the most common severe hand injuries. A total of 294 of 400 patients who had a saw injury between 1982 and 1986 were monitored in the course of a followup examination spanning the time of the accident up to re-entry into professional life. Causes of accidents as well as injury patterns, surgical treatment and aftereffects were analysed. The high number of injuries (70.8%) sustained while not working was remarkable as well as the fact that despite the seriousness of the injury 64.6% of the patients were content with the cosmetic results of treatment and 65% satisfied with the recovered function of the injured hand.

Peripheral bone metastasis of a rare lung cancer.

This article describes the case of a 54 year-old man with a rare large cell cancer of the lung who presented with a metastasis to the right hand. Radiography showed destruction of the phalanx, and histology study confirmed a metastasis of the lung cancer. Metastatic spread is discussed and compared to other metastatic diseases of the hand.

[Hip dislocation without fracture--a trauma surgery emergency]. / Die Hüftluxation ohne Fraktur--ein unfallchirurgischer Notfall.

Between 1968 and 1990, 26 patients (medium age 24.2 years) with a traumatic hip dislocation without fracture were treated at the Dept. of Trauma Surgery of the University Erlangen-Nuremberg. Only 26.9% of the patients had no further injuries beside the hip dislocation. An early closed reduction was carried out whenever possible. In 96.0% of the cases, radiological acceptable results have been achieved with the closed reduction. In 4.0% an open reduction became necessary. After a period of three to four weeks of extension, the patients had been mobilized to nonweight bearing status. Stress on the injured leg was increased progressively, that full weight bearing capacity was achieved after three months. It was possible to examine 12 of the 26 patients. Good and very good results based on the Merle d'Aubigné score and on the Thompson and Epstein score were obtained in 11 of the 12 patients. The complication seen most often was posttraumatic coxarthritis of the hip. We have not seen any necroses of the head of femur in our patients to date. All our results indicate, that the immediate and careful reposition under anaesthesia seems to be the most important factor in preventing a necrosis of the head of femur.

[Spontaneous splenic rupture in metastatic malignant melanoma]. / Spontane Milzruptur bei metastasierendem malignem Melanom - Kurzbericht -

Spontaneous splenic rupture is a rare cause of non-traumatic haemorrhage and is of infectious origin in most instances. We present a patient under treatment for abdominal manifestations of metastatic malignant melanoma who developed signs of haemorrhagic shock and where, upon emergency laparotomy, metastases were found to have caused rupture of the spleen. The patient recovered after splenectomy and was continued on systemic chemoimmunotherapy. One year after the incident he died of cerebral metastases.

[Experience with three minipills preparations with low dose progestagens for oral contraception]. / Erfahrungen mit drei minipillen Praparate mit niedrig dosierten Progestagenen zur oralen Kontrazeption.

PIP: 208 Swiss and Finnish women took the progestagen-only minipills megestrol acetate .5 mg, chlormadinone acetate .5 mg, or D-norgestrel .03 mg for an average of 5 months. Withdrawal bleeding lasted longer, 5.2-5.3 days (mean) than with conventional pills, 4.6 days. Nausea occurred less frequently, 8.5% in the 1st cycle compared with 25%. Loss of libido was reported about as often as with sequential pills. Breakthrough bleeding at intervals of 21 days or less happened in 225 wi th chlormadinone, 28% with norgestrel, and 8% with megestrol. Spotting was reported in 27% of the cycles on megestrol, 18% on chlormadinone, and 14.5% on norgestrel. The time interval from 1 withdrawal bleeding to the next averaged 29.1 days with megestrol, 25.6 days with chlormadinone, and 24.5 days with norgestrel. The variance of this interval was comparable to the 3 progestagens, but about half as large in Finnish women as in Swiss, indicating that the dose used was too high in the Swiss population.^ieng