Background: The study was undertaken to evaluate the prognosis and prognostic factors of women with breast cancer under routine conditions. One of the main questions was to show, how prognosis is influenced by the adjuvant systemic therapy (CMF chemotherapy or hormonal therapy) with or without adjuvant radiotherapy in patients with breast cancer and positive axillary nodes (≥4). Patients and Methods: All patients (n =2,802) with primary breast cancer treated at the Oncology Center of Stuttgart, between 1988 and mid 1994, were retrospectively evaluated. Results: Patients with 4 or more nodes involved receiving adjuvant systemic therapy had an equal prognosis, compared to patients with 1–3 axillary nodes. After further analysis, a benefit was observed only among patients with 4–9 nodes involved, but not among patients with 10 or more axillary nodes. Conclusions: In the retrospective evaluation of data of groups not well-matched, the results have to be interpreted carefully. Bearing this in mind, the data nevertheless indicate that the prognosis of patients with 4–9 nodes involved is not so bad as it has been published, when they are treated with adjuvant systemic therapy with radiotherapy. Furthermore, the data indicate that adjuvant systemic treatment helps to prolong survival time in patients aged 80 years or more.

From 1980 to 1989 222 patients were operated for Graves' disease at two institutions. The indication for surgical treatment and the operative procedure were identical (= extended bilobar subtotal resection). 196 women and 26 men were treated, their mean age was 37 years. Perioperative morbidity comprised 4 permanent recurrent laryngeal nerve palsies (1,8%), and 7 cases with hypoparathyroidism (3,3%). 173 patients (75%) could be reexamined in 1990. Mean follow-up was 3,4 years at Essen University Clinics and 13 months at Stuttgart Diakonissen-Hospital. 63% of the patients were euthyroid with substitution therapy and 13% without any medication. 18% were hypothyroid without symptoms. 5% suffered from recurrent hyperthyroidism. 71% of patients with endocrine ophthalmopathy had improved.

Vom 01. 01.1980 bis 31.12. 1988 wurden 149 Patienten mit einem Morbus Basedow weitgehend subtotal reseziert. Die Schilddrüsenreste hatten eine Größe von 2–3 g je Seite.

UNLABELLED:From 01. 01. 1980-31. 12. 1988 149 patients with Graves' disease were subtotally thyreoidectomized with little rests of 2-3 g on each side. The nervi recurrente and the parathyreoids were exposed.RESULTS:There was only one permanent pulsy of the recurrence nerve and no permanent hypoparathyreoidsm. 146 patients could be observed: two had a recidiv and must be treated with radiojodine. 70% of our patients were hypothyreotic, 20% euthyreotic. We think that the operation is the therapy of choice in young patients with Graves' disease.

We report on the case of an 11-year-old boy suffering from juvenile nephronophthisis who developed bilateral inguinal hernia (on the right as a recurrence of the neonatal operation) 5 days and 4 months after starting CAPD treatment. Before the peritoneal dialysis there had been no clinical signs and no history of inguinal hernia.On the basis of this we emphasise some particular features of inguinal hernia under CAPD treatment such as an increased risk of incarceration, the importance of genital and scrotal swelling as an early symptom, the value of peritoneography as a diagnostic aid, and the need for high ligation of the patent processus vaginalis together with reduced postoperative volumes of the peritoneal dialysate.

We report on the case of an 11-year-old boy suffering from juvenile nephronophthisis who developed bilateral inguinal hernia (on the right as a recurrence of the neonatal operation) 5 days and 4 months after starting CAPD treatment. Before the peritoneal dialysis there had been no clinical signs and no history of inguinal hernia. On the basis of this we emphasise some particular features of inguinal hernia under CAPD treatment such as an increased risk of incarceration, the importance of genital and scrotal swelling as an early symptom, the value of peritoneography as a diagnostic aid, and the need for high ligation of the patent processus vaginalis together with reduced postoperative volumes of the peritoneal dialysate.

Summary Hypersplenism (HS) is defined by: (a) splenomegaly, (b) cytopenia of the blood, and (c) hypercellularity of the bone marrow. Seventeen patients were splenectomized from 1971–85, 10 for recurrent bleeding and 7 for infection due to HS. In 4 patients, the possibility of systemic malignancy could be excluded. In all patients, the blood cell morphology returned to normal postoperatively. One patient died from sepsis due to atypical myobacteria. Two patients developed pneumococcal septicemia 1 year later, which was cured by antibiotics. The return to normal blood cells in all patients and the need to confirm the diagnosis justify splenctomy in hypersplenism.

Zwischen 1971 und 1985 wurden 46 Patienten im Alter von 13 bis 69 Jahren wegen einer chronischen idiopathischen thrombocytopenischen Purpura splenektomiert. Eine Vorbehandlung mit Steroiden erfolgte in 91,3% der Fälle. Eine Vollremission wurde nach der Splenektomie in 86% beobachtet (Follow-up von 5 Jahren). Die perioperative Komplikationsrate lag mit 15% gegenüber Splenektomien aus anderer Indikation hoch. Wir können folgendes operative Vorgehen empfehlen: Mediane Oberbauchlaparotomie, präliminäre Unterbindung der A. lienalis, subtile Suche nach Nebenmilzen, perioperative Antibioticagabe, low-dose-Heparinisierung.

The relation between cholecystectomy and colon carcinogenesis has not been fully elucidated. As bacteria may be involved in the carcinogenic process, we investigated the effect of cholecystectomy and dimethylhydrazine (DMH) administration to SPF NMRI mice with regard to tumour genesis and bacterial colonisation of the intestine.