A Baker cyst (synovial cyst) in the right knee-joint was demonstrated by ultrasound in a 70-year-old woman with recurrent knee-joint effusions after minimal trauma to the knee. Radiological examination in two planes showed degenerative changes corresponding to age. Needle puncture of the knee-joint demonstrated numerous neutrophil granulocytes. As the effusion recurred after one week, despite rest and avoidance of weight bearing, arthroscopy with removal of the cyst was indicated. But surprisingly histological examination of synovial tissue revealed epithelioid granulomas and Langerhans giant cells. Culture of fluid obtained on repeat puncture finally grew Mycobacterium tuberculosis. There was no evidence of pulmonary tuberculosis. The knee-joint tuberculosis healed completely without residual damage on antituberculosis treatment, initially 600 mg rifampicin daily, 300 mg isoniazid daily and 2.5 g pyrazinamide daily for 3 months, followed by rifampicin and isoniazid for a further 6 months.

Objective: This study assesses the influence of incontinence on quality of life by means of a questionnaire and sets that in relation to urodynamit. c diagnosis and the loss of urine measured by the pad test.Methods: 59 patients received a questionnaire for self-assessment of urinary leakage and influence of urinary loss on different daily activities. The impact score was calculated by 21 questions each with 0 to 3 points.Results: 10.2% of the questionnaires were not completed in spite of thorough revision of the questionnaire for easy appreciation. Our observations indicate a greater impairment of self-perception and daily activities than of social relationships. Patients with stress incontinence had a significantly lower impact score according to the questionnaire compared with patients suffering from detrusor instability (35.4 vs. 49.3). Furthermore, an increase in impact score according to the degree of stress incontinence could be demonstrated. This correlation was not found in patients with detrusor instability. The analysis of correlation between impact score and loss of urine in pad-test did not yield a correlation on the 5% level.Conclusion: A considerable part of patients had a higher degree of impact than would correspond to the degree of objective incontinence. This suggests that subjective experience indicates a higher degree of incontinence than objective clinical methods could prove. The urogynaecological examination considers the patient's situation at a certain point whereas a questionnaire with subjective statements gives a review over a long time of impairment by loss of urine. This emphasises the Value of this additional information, so that it seems advisable to registrate the impact as an independent parameter for the assessment of patients suffering from incontinence.

Fragestellung: Diese Studie untersucht mit Hilfe eines Quality-of -Life -Fragebogens den Einfluß von Inkontinenz auf die Lebensqualität und setzt diese in Beziehung zur urodynämischen Diagnose und dem Ausmaß des Urinverlusts im Pad-Test.

Three cases of a necrotizing fasciitis, a rare but life-and limb-threatening infection, were treated in the Department of Surgery at the University Hospital of the Ruhr University Bochum (MHH) between October 1992 and January 1994. We compare our experiences with regard to bacteriological etiology, risk factors, localization, and place of entry, course, therapy and mortality with those in the literature.

Three cases of a necrotizing fasciitis, a rare but life- and limb-threatening infection, were treated in the Department of Surgery at the University Hospital of the Ruhr University Bochum (MHH) between October 1992 and January 1994. We compare our experiences with regard to bacteriological etiology, risk factors, localization, and place of entry, course, therapy and mortality with those in the literature.

Three cases of a necrotizing fasciitis, a rare but life- and limb-threatening infection, were treated in the Department of Surgery at the University Hospital of the Ruhr University Bochum (MHH) between October 1992 and January 1994. We compare our experiences with regard to bacteriological etiology, risk factors, localization, and place of entry, course, therapy and mortality with those in the literature.

A Baker cyst (synovial cyst) in the right knee-joint was demonstrated by ultrasound in a 70-year-old woman with recurrent knee-joint effusions after minimal trauma to the knee. Radiological examination in two planes showed degenerative changes corresponding to age. Needle puncture of the knee-joint demonstrated numerous neutrophil granulocytes. As the effusion recurred after one week, despite rest and avoidance of weight bearing, arthroscopy with removal of the cyst was indicated. But surprisingly histological examination of synovial tissue revealed epithelioid granulomas and Langerhans giant cells. Culture of fluid obtained on repeat puncture finally grew Mycobacterium tuberculosis. There was no evidence of pulmonary tuberculosis. The knee-joint tuberculosis healed completely without residual damage on antituberculosis treatment, initially 600 mg rifampicin daily, 300 mg isoniazid daily and 2.5 g pyrazinamide daily for 3 months, followed by rifampicin and isoniazid for a further 6 months.