["Myxoma syndrome"--a "benign" disease with "malignant" course]. / "Myxoma-Syndrom"--eine "benigne" Erkrankung mit "malignem" Krankheitsverlauf.

We are reporting on a 36 year-old woman who presented with recurrent cardiac myxomas over a period of nine years. Two of the tumors typically originated in the left atrium and one in the right atrium. Tumor embolization was the presenting symptom twice, leading to reversible cerebral ischemia and minor pulmonary embolism, respectively. The third tumor remained asymptomatic and was detected during routine echocardiographic examination. Based on a positive family history of cardiac tumors, a facially pronounced hyperpigmentation of the skin and the presence of a thyroid adenoma, the diagnosis of a "myxoma syndrome" was established. Patients with "myxoma syndrome" are generally younger than their counterparts with "sporadic myxoma" (mean age at diagnosis 25 vs. 56 years) and have a high frequency of unusual skin freckling (68%). Familial clustering of cardiac myxomas is also frequent (25%). The tumors may be located in any of the cardiac chambers (87% in the atrias, 13% in the ventricles, 50% at multiple sites simultaneously) and have relatively high (18%) 5-year recurrence rate after surgical excision. Since the clinical signs of cardiac tumors are non-specific, diagnosis essentially relies on cardiac imaging by echocardiography, computer tomography, or angiography. The superiority of transesophageal echocardiography is emphasized in this report.

[The aortic arch as source of thromboembolism events--significance of echocardiography diagnosis]. / Der Aortenbogen als Quelle thromboembolischer Ereignisse--Bedeutung der echokardiographischen Diagnostik.

A 43-year-old woman presented with acute embolic occlusion of the left brachial artery. She was immediately treated by surgical embolectomy. After exclusion of other possible embolic sources, the transthoracic and transesophageal echocardiographic examination revealed a floating thrombus in the aortic arch. There-upon an aortotomy and thrombectomy was performed and showed a normal wall structure of the thoracic aorta except for a minimal ulcerated lesion of the intima at the aortic arch. This case confirms that transthoracic and transesophageal echocardiography are the diagnostic methods of choice for detecting thromboembolic sources originating in the heart or thoracic aorta.

[Bicycle accidents--causes and sequelae. An evaluation of the 1986 calendar year]. / Zweiradunfälle--Ursachen und Folgen. Eine Bilanz des Kalenderjahres 1986.

In a population of 402 motorcyclists and bicyclists, which were treated in the Traumatological Department of the University of Freiburg during 1986, we describe the different cause, spectrum and follow-up of the injuries. The special risk factors are discussed. The social implications show the importance of preventive measures to limit the risk of injury. With respect to the 70% of injured bicyclists with severe head injury, the wearing of safety helmets is strongly advocated. The effectiveness of cycle lanes is substantiated by our results.