A new sarcomatoid variant of multiple myeloma in a 20-year-old male.

We present a 20-year-old man with a rare variant of multiple myeloma with peculiar spindle cell morphology and sarcomatoid growth. The diagnosis of multiple myeloma was substantiated by clinical examinations. The patient was treated with several therapeutic trials including autologous stem cell support. Unfortunately, he developed a disseminated aspergillosis of the lungs and died of fatal lung bleeding. We recommended that "sarcomatous" multiple myeloma be considered in cases of "unclassifiable" sarcomatous tumors of the bone marrow.

[Abscess-forming and necrotizing aspergillus myocarditis in a surgical intensive care patient--a rare occurrence]. / Abszedierende und nekrotisierende Aspergillusmyokarditis bei einem chirurgischen Intensivpatienten--ein seltenes Ereignis.

The case of an 89 year old patient is reported, in whom an aspergillus myocarditis was unexpectedly found at autopsy. Preoperatively, the patient showed no risk factors for an invasive mycosis. 5 days after uncomplicated surgery he developed septic shock due to peritonitis. After surgery and intensive care therapy the patient recovered initially. 23 days after the first operation the patient suddenly developed catecholamin-resistant myocardial failure and died. Ten days before, aspergillus spec. was found in a specimen of bronchial secretion. This finding was interpreted as colonisation and not treated.

[An interuniversity comparison of the supervision of doctoral candidates--should the promotion procedures be changed?]. / Betreuung medizinischer Doktoranden im interuniversitären Vergleich--Sollte das Promotionsverfahren geändert werden?

BACKGROUND AND OBJECTIVE: There are only few investigations on supervision of medical dissertations that allow a comparison between different universities. This article discusses how the medical dissertation can be incorporated into a new medical curriculum. METHODS: A questionnaire was sent to all medical students in Lübeck who wrote dissertations in 1998. It contained 28 questions on duration, supervision, impact on medical studies and possible changes in the dissertation process. The data were compared statistically to previous studies. RESULTS: 70 questionnaires could be evaluated (63%) which allowed a comparison with studies in Hannover and Erlangen-Nürnberg. The Lübeck students assessed their supervision to be significantly better, they worked more frequently on experimental topics and data of their research were published more often than was the case in the other two institutions. The students regularly needed one extra semester for their dissertation, especially those working on experimental topics. Those who wrote dissertations expressed criticism of the dissertation process: only one third were in favour of making no change in the process. When asked to suggest possible improvements they proposed having a central facility for the announcement of dissertation subjects and one free semester to work solely on the dissertation. CONCLUSION: In order to evaluate and compare supervision of dissertations, a comparable questionnaire should be used by all medical universities. If the medical curriculum is changed, the dissertation either has to be firmly integrated in the curriculum or it should be undertaken after completion of the studies.