First report of hepatic lobectomy for metastatic carotid body tumor.

Hepatic lobectomy for metastatic colon cancer is well accepted, yielding a 30-35% five-year survival with a low mortality of less than 5%. Less commonly is hepatic resection for selected metastasis from other organs. We report here what we believe is the first hepatic lobectomy for a metastatic carotid body tumor. The patient was a 41-year-old white female who presented with a large incapacitating hepatic metastasis and an incidental lung metastasis from a carotid body tumor resected 12 years earlier. The patient underwent left hemihepatectomy and local lymph node dissection at our university. Twenty-one months after the operation the patient is asymptomatic and has no sign of tumor reoccurrence . We discuss here the clinical features, pathophysiology, treatment and the surgical literature of this rare entity. This is yet another example of the effectiveness of hepatic resection for noncolonic metastasis (26 references).

Is ultrasound superior to carcinoembryonic antigen (CEA) measurement in recurrent tumor screening of patients with colorectal carcinoma?

Assuming that in the postoperative recurrent tumor screening CEA levels are as important as imaging techniques in elucidating the spread or the recurrence of a tumor, we examined 61 patients with colonic carcinoma. Those patients were operated curatively and were regularly controlled by clinical examination, laboratory, sonographic, endoscopic or radiological methods. In 3 patients there was a local recurrent, in 3 other patients there was a local recurrent and metastases. 8 patients showed sonographic livermetastases only, proved by computed tomography. In 6 patients CEA-levels rose. In 2 patients with sonographically confirmed metastases of the liver, there were neither clinical nor laboratory hints for metastases and the CEA-levels were normal. No one had elevated CEA-levels before detecting metastases. Our results indicate that ultrasound of the liver can detect metastases of colonic tumors earlier than clinical or laboratory sings do. Because of its greater diagnostic security, ultrasound is superior to CEA-measurement in recurrent tumor screening.

[Psychodrama versus patient club activity (leisure group): effects of a 25 hours group psychotherapy with psychiatric patients (author's transl)]. / Psychodrama-versus-Freizeitgruppe: Effekte einer 25stündigen Gruppenpsychotherapie bei psychiatrischen Patienten.

UNLABELLED: The effects of psychodramatherapy versus patient club activity group is compared in a controlled study with psychiatric patients in a period of two month (8 times a three hour session per week). SAMPLE: 22 patients (11 patients psychodramatherapy (PD); 11 patients patient club activity (PCA)). Diagnoses: neuroses, subacute psychoses. Patients were matched according to age, sex and syndrome (resp. diagnoses). Applied tests: semistandardized interview with formulation of personal therapeutic goals, personality tests (Giessen, MMPI), mood scales (EWL, Bf-S v. Zerssen, 100 mml line), psychopathology (AMP 3/interview), social adjustment (SAF). Testing periods: before beginning with PD and PCA, attendant to therapy, after therapy, follow up (three month after end oftherapy). RESULTS: it was advantageous to have both psychotic and neurotic patients in the same therapy group. In the course of psychodramatherapy and patient club activity there was an improvement with a regressive trend to baseline after end of therapy. PD in comparison to PCA appeared to be more effective in the improvement of some psychiatric relevant personality dimensions, in the improvement of psychopathology, in reaching the personal therapeutic goals and in a positive opinion of therapy. A psychodramatherapy lasting two month seems revealed to be more attractive and to have more therapeutic efficacy than a patient club activity group. Because of the instability of some effects a more prolonged therapy period is suggested.