[Complaint picture and self concept of patients with duodenal ulcer before and 4 years after surgery]. / Beschwerdebild und Selbstkonzept von Patienten mit Ulcus duodeni vor und 4 Jahren nach einer Operation.

In a catamnesis 4 years after surgery for duodenal ulcer the development of the bodily complaints and of the self-concept of 42 patients was investigated. The self-image of the duodenal ulcer patients 4 years after the operation was the same as before! An unsolved problem of aggression and a state of depression could be identified now as before. Characteristics, which describe self-esteem and confidence were found as highly stable--i.e. they were relatively independent of time and rater. The intestinal complaints in average showed a decrease. Nevertheless the total score of complaints--intestinal and nonintestinal --of the ulcer patients in comparison to a representative sample (Federal Republic of Germany and Berlin-West) was much higher. The main postoperative complaints still came from the intestinum . It could be shown, that in a large subgroup of patients had established a shift of the syndrome to pains in the limbs. The results are discussed under psychoanalytical- psychosomatical aspects.

[Termination of pregnancy during or after treatment of carcinoma of the breast. A review (author's transl)]. / Schwangerschaftsabbruch während oder nach Behandlung eines Mammakarzinoms. Eine Ubersicht.

The problems of medical, eugenic and social or psycho-social indication are discussed on the basis of the literature published during the past 40 years. Prognosis is not as unfavourable as generally assumed, especially during the lactation period. The processes of gestation have no clearly identifiable unfavourable influence on prognosis. On the contrary, in cases of completed carcinoma therapy, the survival rates in women who became subsequently pregnant and stood through the entire period of gestation, are distinctly improved. There is no medical indication for an abortion. A eugenic indication may be present especially in early pregnancy, if percutaneous subsequent irradiation and adjuvant chemotherapy are considered necessary. A social or psycho-social indication can be present if the individual prognosis and situation of the patient in question is taken into consideration. The decision becomes particularly difficult if the carcinoma is diagnosed during the second half of the period of gestation. In that case, prognosis deteriorates to the negative side. The fate as such, however, cannot be influenced by performing an abortion. To achieve viability of the child, adjuvant therapy must be delayed for a period of not longer than 12 weeks. Whether such a waiting period is justified or not, can only be decided from case to case by mutual consultation between the mother and the doctor.

Primary carcinoma of the vagina. An analysis of 82 cases of squamous cell carcinoma.

Between 1949 and 1978, 82 patients with primary squamous cell carcinoma of the vagina were treated at the Universitäts-Frauenklinik Münster. The treatment consisted of a combination of intravaginal radium application and external beam radiation. The -5-year survival rate in patients with state I (FIGO) was 68.4%. None of the stage IV patients survived for more than 3 years.

[Carcinoma of the breast and pregnancy (author's transl)]. / Mammakarzinom und Schwangerschaft.

The prognosis of carcinoma of the breast which was detected during pregnancy or during the breast feeding is discussed. Personal cases are described and the literature is reviewed. The prognosis of carcinoma of the breast following complete treatment is investigated when the prognosis may be influenced by a pregnancy. In contra-distinction to the older view the prognosis is only worsened when the axillary lymph nodes show cancer. Without spread to the axillary lymph nodes there is no difference in the survival rates. In cases with complete treatment for carcinoma of the breast the pregnancy appeared to have a favorable influence on the prognosis. In our own few cases axillary lymph nodes in pregnant women worsened the prognosis more than in non-pregnant women.

[Monochemotherapeutic treatment of advanced stage III and IV ovarian cancer]. / Monochemotherapeutische Behandlung des fortgeschrittenen Ovarialkarzinoms Stadium III and IV.

45 patients with ovarian cancer stage III and IV were treated with melphalan, which was injected intravenously over a time period of six hours. None of the patients had been treated previously with chemotherapeutic drugs. 30 of the patients suffered from ovarian cancer stage III, and 17 of this group went into remission which in three cases lasted longer than twelve months. Six of 15 patients suffering from stage IV ovarian cancer went into remission as well. In comparing monochemotherapy with polychemotherapy, which is applied intravenously as well over a much longer time interval we found approximately the same remission rate. Because of the lower toxicity in the treatment with melphalan and the short period of application, there is a significant advantage to using monochemotherapy rather than polychemotherapy for stage III and IV ovarian cancer.

Use of radioactive gold in the treatment of pleural effusions caused by metastatic cancer.

This paper presents a series of 12 patients suffering from advanced gynecological cancer with the occurrence of pleural effusions. All patients received at least one intrapleural dose of radioactive gold (100 m Ci Au198) when the necessity for thoracentesis became more than once every three weeks. Three showed no recurrence of fluid, five a significant slowing down of effusion, and four did not show any response. Severe complications were minimal, and were comparable to those resulting from thoracentesis in general.

[Psychic and medical reactions in patients undergoing open heart surgery in relation to preoperative psychological condition]. / Psychische und körperliche Reaktionen bei Patienten der offenen Herzchirurgie in Abhängigkeit von präoperativen psychischen Befunden.

This study reports some results on the postoperative psychological and medical condition of 72 open-heart surgery patients. Special emphasis is placed on the relationship between the postoperative reactions and the preoperative psychological condition of the patients as assessed by an interview. Patients whose postoperative reactions was of a psychotic paranoid type conceived the operation as a mainly technical event and had optimistic expectations for the future. Patients who reacted in a hostile aggressive manner after the operation were preoperatively emotionally withdrawn and depressive inhibited. As far as the postoperative physical condition is concerned it was found that patients with the best recovery in this respect were preoperatively characterized by alexithymia. The results are discussed under psychonalytical aspects. Special emphasis is placed on the preoperative condition of alexithymia.

[Results of the intraperitoneal application of radioactive gold in cases of ovarian cancer (author's transl)]. / Ergebnisse der intraperitonealen Applikation von radioaktivem Gold beim Ovarialkarzinom.

Radioactive gold was instilled once into the peritoneal cavity of 248 patients with ovarian carcinoma of varying stages. The criterium for the radioactive gold instillation was either for the post-operative treatment in stage 1A or for the treatment of ascites in more advanced stages. The treatment had no clear cut influence on the five year survival rate. The treatment with radioactive gold Au 198 was very effective in the treatment of ascites and had less side effects than other radioactive colloidal materials.

[Results of high-dosage attack treatment with cytostatics in mammary and ovarian cancer (author's transl)]. / Ergebnisse einer hochdosierten Zytostatika-Stosstherapie beim Mamma- und Ovarialkarzinom.

A total of 80 patients was treated using a short-time high-dosage schedule of cytostatic therapy with cyclophosphamide, 5-FU, vincristin and methotrexate. In metastasizing mammary carcinoma and in ovarian cancer, the remission and growth-stagnation rates obtained were in accordance with those resulting from well-known long-term schedules. The effect was less distinct in carcinoma of the cervix, and no effect was seen in adenocarcinoma of the uterine corpus. The possibilities of treatment with cytostatics resulting therefrom offer not only a better quality of the survival time as compared to long-term therapy, but also permit a more thorough control by an oncologic center.

[Compression of the spinal cord secondary to an intradural metastasis from a primary carcinoma of the breast (author's transl)]. / Rückenmark-Kompression als Folge einer intraduralen Metastasierung beim primären Mammakarzinom.

The intradural spinal spread from operated primary carcinomas of the breast is discussed considering our own case and the literature. The identical localization of the intradural spinal metastases at the junction of the cervical to the thoracic spine in all three known cases is striking.

[Pseudomyxoma peritonei. Effect of radiogold therapy]. / Pseudomyxoma peritonei. Effekt der Radio-Gold-Behandlung.

Five female patients with pseudomyxoma peritonaei in various stages of disease received one or more applications of 198Au intraperitoneally. In all cases the origin of the disease was the ovary. In these patients radioactive gold was given four weeks after the diagnosis was made at laparotomy. Results with this group of patients in gratifying since no recurrence has occured in two patients who were treated one year ago and in a third patient treated five years ago. -- In two other cases 198Au was administered after a recurrence after one year, the other patient had no response at all.