Electronic excitations generated by the deposition of Mg on Mg films.

Nonadiabatic processes are observed during growth of Mg atoms from the gas phase on Mg films. Chemicurrents are measured in thin film Mg/p-Si(001) Schottky diodes which are exposed to thermally evaporated Mg atoms. The photonic and chemical contributions to the observed reverse currents in the devices can be distinguished by varying the Mg atom flux and by independent measurements using an empty evaporator as a source of heat radiation.

Continuous monitoring of Mg oxidation by internal exoemission.

Thin-film Mg/Si(111) Schottky diodes are exposed to oxygen to detect chemicurrents in the devices. The detected charge is created by nonadiabatic energy dissipation and due to either internal exoemission currents or surface chemiluminescence induced photocurrents. Both contributions can be distinguished by changing the metal film thickness of the device. Auger electron spectroscopy to study the oxygen uptake demonstrates that the chemicurrent transients represent truly the time dependent reaction rate at the surface. Model calculations indicate that the current monitors Mg oxide island nucleation and growth.

Chemically induced electronic excitations at metal surfaces.

The energy released in low-energy chemisorption or physisorption of molecules on metal surfaces is usually expected to be dissipated by surface vibrations (phonons). Theoretical descriptions of competing electronic excitations are incomplete, and experimental observation of excited charge carriers has been difficult except at energies high enough to eject electrons from the surface. We observed reaction-induced electron excitations during gas interactions with polycrystalline silver for a variety of species with adsorption energies between 0.2 and 3.5 electron volts. The probability of exciting a detectable electron increases with increasing adsorption energy, and the measured time dependence of the electron current can be understood in terms of the strength and mechanism of adsorption.

Progressive hydrocephalus in two members of a family with autosomal dominant Noonan phenotype.

We present a family with an autosomal dominant phenotype characterized by pulmonary valve stenosis, craniofacial dysplasia with marked hypertelorism and, as a variable feature, progressive hydrocephalus. This phenotype is manifested in four patients from three subsequent generations of a family, with expression ranging from mild pulmonary stenosis combined with slight but characteristic facial dysmorphism to severe cyanotic pulmonary valve stenosis with multiple malformations lethal in early childhood. We consider this to be an unusual variant of Noonan syndrome.

Pericentric inversion of chromosome 6 in a patient with cleidocranial dysplasia.

We describe a male patient with a pericentric inversion of chromosome 6 and classic cleidocranial dysplasia (CCD), mild to moderate mental retardation, hearing deficiency, and unusual facial appearance. We conclude that there is a causal relationship between the chromosomal disorder and the CCD.

Infant with del(3) (p25-pter): karyotype-phenotype correlation and review of previously reported cases.

We describe a boy with monosomy for the distal part of the short arm of chromosome 3. He had a congenital heart defect, tetramelic hexadactyly, and typical craniofacial anomalies. Comparison with previously reported cases confirms that the phenotype consists of an identifiable pattern of malformation.

[Therapy and prognosis of small breast cancers. Comparison of subcutaneous mastectomy procedures with ablatio mammae]. / Therapie und Prognose des kleinen Mammakarzinomas. Vergleich von subkutanen Mastektomieverfahren und Ablatio mammae.

A retrospective clinical study included 1283 patients with breast cancer. 307 of 762 tumours with known diameter (mm) were classified as stage pT1 (TNM, 70). Four groups were formed to compare the prognosis in subgroups of pT1 cancers: 0-5 mm (n = 22), 6-9 mm (n = 22), 10 mm (n = 53) and 11-20 mm (n = 210). A comparison of three types of surgery was made: Radical subcutaneous mastectomy (12), bilateral modified subcutaneous mastectomy (10, 11), and modified radical mastectomy (Auchincloss, 3). Both forms of subcutaneous mastectomy were combined with adjuvant postoperative radiotherapy to the side of the tumour. In this trial, patients were younger at diagnosis than usually stated in the literature. Small breast cancers had the same localisation and histology as large ones. Axillary lymph node metastases were identified from a tumour diameter of 6 mm upwards. Bilateral tumours were seen in 2 of 22 patients with tumours less than or equal to 5 mm. Multifocal growth was observed also in the same size range. Histologically different simultaneous invasive unilateral cancers were seen starting at a diameter of 8 mm of the larger tumour. Systemic metastases were observed in tumours of 10 mm in diameter. Local recurrences occurred in breast cancers with a diameter of 2 mm and more. There were no recurrences in the area of the nipple or areola in pT1 cancers. Small breast cancers did not appear to be biologically different from larger lesions. No prognostic subgroups of pT1 were evident beyond the established TNM staging. Disease-free survival was not significantly different between the three surgical approaches. Local recurrence was significantly less frequent after breast-conserving surgery. A negative influence of local recurrence on the prognosis was observed to a similar extent irrespective of the type of surgery. The concept of "minimal breast cancer" suggesting ablative surgery for a heterogeneous group of preinvasive and small invasive lesions is outdated. The different forms of subcutaneous mastectomy are a therapeutic alternative in the context of breast-conserving surgery of small infiltrating breast cancers. Especially the modified subcutaneous mastectomy (Beller) combines a good cosmetic result without prognostic impairment and with a potential reduction of the risc of contralateral breast cancer. Further potential applications include prophylactic treatment of high-risk patients with preinvasive lesions.

[Myeloreticulosis of the uterus following acute myeloid leukemia]. / Myeloretikulose des Uterus nach akuter myeloischer Leukämie.

Tumorous manifestations of myelosis with or without leukemia are rarely seen today as they appear at a very late stage of the disease. They are of importance to the gynecologist in the differential diagnoses concerning the breast, the endometrium and uterus, the placenta and the fetus. The case report of a myeloreticulosis of the uterus, three years after an acute myeloid leukemia was treated, is described.

A sex cord stromal tumour in a woman with XO/XX/XXX-mosaicism.

We describe a postmenopausal woman with 45,XO/46,XX/47,XXX mosaicism who presented with a Sertoli-Leydig cell tumour and a past history of habitual abortion. The cytogenetic finding is discussed in relation to the etiology of the tumour and of the recurrent abortions.

Biochemical identification of the mucus of pseudomyxoma peritonei as the basis for mucolytic treatment.

Two cases of pseudomyxoma peritonei are presented. The gelatinous mucus was biochemically analyzed. The mucus contained approximately 98% protein and 2% to 5% carbohydrate per unit of dry weight. The predominant carbohydrate components were galactose and mannosamine. The mucus also had thromboplastic activity. Because of these findings, dextran sulfate, at concentrations between 2% and 10%, was instilled into the abdominal cavity and caused lysis of the mucus.

Bilateral breast cancer: the frequency of undiagnosed cancers.

The risk of developing cancer in the contralateral breast is five to seven times the risk of cancer occurrence for the normal female population. In patients in 365 consecutive operations, 15 frankly invasive cancers and four metastatic lesions were found in the contralateral breast as well as an additional 28 lesions in situ, totaling 13%. An additional 30% of the patients had severe dysplasia with an unknown potential for becoming cancerous. Only less than one third of the cancers in the contralateral breast were symptomatic (by palpation or mammography or both) but not recognized at the time of primary treatment. The majority of lesions in the contralateral breast are due to a second primary growth, and only a minority is metastatic. The results of 203 bilateral operations consisting of a modified subcutaneous mastectomy with axillary lymph node dissection and radiation are presented; this cosmetically acceptable procedure reduces the number of cancers in the contralateral breast to an incidence of 1% to 2%.

Carcinoma lobulare in situ B in monozygotic twins.

Some form of predisposition to breast cancer can be inherited, but it is not known whether the same applies to precancerous lesions of the breast. We are reporting on an identical incidence of carcinoma lobulare in situ type B in monozygotic twins. The case report illustrates that in identical twins the environment is usually more similar than in the general population so it is difficult to determine the hereditary component in the manifestation of a specific histologic trait. The observation may support the hypothesis that there is not only a high incidence of multicentric disease in both breasts of one person, but in the breasts of identical twin sisters too.

[Placenta percreta and rupture of the uterus (author's transl)]. / Placenta percreta und Ruptur des Uterus. Fallbericht.

A placenta percreta must be expected in 7% of all cases of abnormal implantation of the placenta. Placenta percreta is therefore a rare but serious complication of pregnancy. In 15% of the cases spontaneous rupture of the uterus occurs. Depending on the type of delivery, the maternal mortality ranges from 6-30%. Early hysterectomy is the method of choice to prevent serious complications of hermorrhage. Since the degree of infiltration of the myometrium with placenta can not be determined with accuracy, excision of the site of perforation to preserve the uterus does not appear to be indicated. The case of a 41 year old primigravida, with a previous history of infertility and myomectomy is described. Following primary Cesarean section for breech presentation an asymptomatic rupture of the uterus from the placenta percreta was detected. The rupture of the uterus was likely asymptomatic because a loop of sigmoid colon was adherent to the site of perforation.

Endodermal germ cell carcinoma (endodermal sinus tumor) of the vagina in infant girls.

An endodermal sinus tumor (endodermal germ cell carcinoma) was diagnosed in a 1-year-old girl in the vagina after hemorrhage; the tumor was completely removed by radical abdominal surgery. Postoperative polychemotherapy was performed for two years with Actinomycin D, Adriamycin, Vincristin, and Cyclophosphamide. The infant is now tumor-free for 26 months, showing almost normal somatic and psychic development. The characteristic histological patterns and clinical course of this strongly malignant tumor are demonstrated, based on 25 published case reports of endodermal sinus tumors in the vagina of little girls (aged 5-26 months). This neoplasm in early infancy has to be separated from the clear-cell adenocarcinoma of the vagina which occurs after puberty in adolescent girls and young women, and is induced by stilbestrol therapy to the mother during early pregnancy.

[Intrauterine infections in pregnancy. The significance of premature rupture of the membranes and early lung complications]. / Intrauterine Infektionen in der Schwangerschaft. Bedeutung des vorzeitigen Blasensprungs und früher Lungenkomplikationen.

The course of intrauterine infections are illustrated and 5 maternal deaths reported. Early lung complications were predominant, described as shock lung or septic pneumonia. Renal complications or disseminated intravascular coagulation were absent or developed late. In contrast to gram negative sepsis there was a frequent association with premature rupture of the membranes, which indicates the danger of this event. On microbiology gram positive rods were found more frequently than a mixed flora. The morphology of intrauterine infection is similar to those of puerperal sepsis although the clinical course is quite different. This indicates a change in infectious pattern during the last centuries.