[A rare case of isolated prostate metastasis from primary pancreatic cancer]. / Seltener Fall der Metastase eines Pankreaskarzinoms in die Prostata.

An otherwise healthy 66 year old male presented with a suspicious intraprostatic lesion detected by digito-rectal examination. Serum PSA levels were normal. A CT scan of the abdomen revealed a nondistinctive mass within the pancreatic head. A transrectal biopsy confirmed the intraprostatic lesion as a metastatic lesion from pancreatic cancer. Therefore, we report this unusual case of a primary pancreatic carcinoma, clinical stage IV, which led to metastases in the liver and prostate.

[Lichen planus esophagitis without skin, genital or oral mucosa involvement]. / Lichenoide Osophagitis ohne Haut-, Genital- oder Mundschleimhautbeteiligung.

Lichen ruber planus is a common skin and mucosal disease, with very rare involvement of the esophagus. We report on a 68-year-old patient suffering from dysphagia, with a reduced general condition and weight loss of 12 kg in the past 6 months due to lichen planus of the esophagus. Treatment by bougienage was very successful. This case report describes a lichen ruber planus of the esophagus without involvement of skin, genital or oral mucosa.

Quality assurance in mammography: artifact analysis.

Evaluation of mammograms for artifacts is essential for mammographic quality assurance. A variety of mammographic artifacts (i.e., variations in mammographic density not caused by true attenuation differences) can occur and can create pseudolesions or mask true abnormalities. Many artifacts are readily identified, whereas others present a true diagnostic challenge. Factors that create artifacts may be related to the processor (eg, static, dirt or excessive developer buildup on the rollers, excessive roller pressure, damp film, scrapes and scratches, incomplete fixing, power failure, contaminated developer), the technologist (eg, improper film handling and loading, improper use of the mammography unit and related equipment, positioning and darkroom errors), the mammography unit (eg, failure of the collimation mirror to rotate, grid inhomogeneity, failure of the reciprocating grid to move, material in the tube housing, compression failure, improper alignment of the compression paddle with the Bucky tray, defective compression paddle), or the patient (e.g., motion, superimposed objects or substances [jewelry, body parts, clothing, hair, implanted medical devices, foreign bodies, substances on the skin]). Familiarity with the broad range of artifacts and the measures required to eliminate them is vital. Careful attention to darkroom cleanliness, care in film handling, regularly scheduled processor maintenance and chemical replenishment, daily quality assurance activities, and careful attention to detail during patient positioning and mammography can reduce or eliminate most mammographic artifacts.

Relative forefoot abduction and its relationship to foot length in vitro.

BACKGROUND: The human foot is often modelled as a rigid body in gait analysis. A more realistic model separates this segment into a forefoot and rearfoot. However, no three-dimensional data has been published on dynamic relative ab-adduction between these segments, and how this impacts changes in foot shape. OBJECTIVE: The purpose was to quantify three-dimensionally forefoot ab-adduction relative to the rearfoot in vitro, and to determine how forefoot ab-adduction affects foot length. METHODS: Video data were collected from reflective marker triads affixed to the ends of Steinmann pins drilled into the tibia, calcaneus, cuboid, and the first and fifth metatarsal bones. Medial and lateral foot length and forefoot ab-adduction relative to the rearfoot were calculated under two axial tibial loads (200 N, 600 N) and two input motions (dorsi-plantarflexion, internal-external tibial rotation). RESULTS: It was found that patterns of change for each variable were dependent on the degree of rigidity of the foot. Relative forefoot ab-adduction values ranged from 4.4 degrees of adduction to 1.7 degrees of abduction. Medial foot length values changed +/- 0.8 mm (+/- 0.5%) and lateral foot length values changed +/- 0.5 mm (+/- 0.3%). Medial foot length was correlated positively with relative forefoot abduction, and external tibial rotation was correlated positively with relative forefoot adduction.

[Effectiveness of outer stability aids on rotational stability of the ankle joints]. / Die Wirkung von äusseren Stabilisierungshilfen auf die Rotationsstabilität der Sprunggelenke.

The main goal in nonoperative treatment of lateral ankle ligament injuries is the reduction of the possible supination at the ankle joint complex. Complete ligament healing can only be achieved when protected from overstress. There is general agreement that talar tilt should be avoided. Recent reports, however, have shown that instability of the ankle joint is at least in one form an axial rotational one. Therefore, the reduction of tibial rotation should also be taken into consideration. The purpose of this study was to determine the effect of three commonly used ankle braces and ankle taping on rotational stability of the ankle joint complex. The Künzli stabilizing shoe was the only orthosis that stabilized sufficiently the ankle joint complex when the foot was in slight plantarflexion. The reduction of external tibial rotation was in foot flexion of 20 degrees: Künzli stabilizing shoe, 58%; Aircast, 23%; Mikros, 12%; and taping, 10%. This becomes more relevant as this foot position is the most dangerous one where most of the ligament injuries does occur. It could be that the insufficient effect of various ankle braces on rotational stability may be the reason for residual problems after ankle sprain.