[Retrospectively experiencing the menopause in Germany and in Papua New Guinea: a comparative report]. / Retrospektives Erleben der Menopause in Deutschland und in Papua Neuguinea im Vergleich.

INTRODUCTION: The objective of this study was to examine the experience of menopause in postmenopausal women from Germany and in postmenopausal women from Papua New Guinea. METHODS: Experience of menopause were assessed by formation of symptom groups (e. g. hot flushes, cardiac or sleeping trouble, depression, touchiness, drop in performance, vaginal dryness, painful joints or muscles), following the Menopause Rating Scale (MRS). Apart from the translated English version a questionaire in Pidgin English was offered. Questions about positive and negative experience of menopause and the acceptance of hormonal replacement therapy were included. Statistical analysis was performed both descriptively and for the group analyses the Chi-squared-test and the Mann Whitney's U test. RESULTS: 40 postmenopausal German women and 41 postmenopausal women from Papua New Guinea were asked about their experience of menopause. The German women were 58.7 years old (range from 52 to 62) and had two children on average (range from 0 to 4). 87.7 % had experience of symptoms. In Papua New Guinea mean age was 55.2 years (range from 48 to 70), parity six (range from 2 to 12). 76.9 % had experience of symptoms. There were significant intercultural differences between the experience of depressive mood, general drop of performance, sexual experience and the vaginal dryness and we found no significant intercultural differences between the experiences of hot flushes, cardiac trouble, sleeping trouble, nervousness and urological symptoms. 50 % of the German women take hormonal replacement therapy and nobody of Papua New Guinea. CONCLUSION: The experience of menopause as seen in the developed countries does not exist in the developing countries. The perception about illness and well-being are formed by culturally produced patterns.

[The multisegmental electron irradiation of the chest wall following ablative therapy of breast cancer]. / Zur multisegmentalen Elektronenbestrahlung der Thoraxwand nach ablativer Therapie des Mammakarzinoms.

PURPOSE: The paper describes the clinical aspects of postoperative irradiation of breast cancer using electron arc technique at the chest wall. The value of the treatment is assessed by long-term results concerning the rate of local recurrences and side effects. The advantages of the procedure are described with regard to physical and technical aspects. PATIENTS AND METHODS: After mastectomy, 117 patients underwent and adjuvant radiotherapy of the chest wall by multisegmental electron rotation technique with energies between 4 and 14 MeV. The number and angular range of the segments as well as the energy of the electrons depended on the peculiar thickness of the chest wall. 25 times 2 Gy were applied within five weeks. The treatment planning is based on a patient model constructed from five CT-slices at least. RESULTS: In four cases (3.4%) a local relapse and in one case (0.9%) a relapse in supraclavicular lymphatics was found. The recurrences appeared after an average period of 32 months. The mean observation time was 70 months. In 37 women (32%) distant metastases were seen after 29 months on an average. The five-year survival rate is 73.5%. CONCLUSION: In comparison to usual techniques using photons the described method shows a more homogeneous dose distribution to the chest wall and a reduction of lung radiation exposure. The clinical result of this dose adaptation to the treatment volume is a lower rate of local relapses and of side effects, inclusive late reactions. It can be suggested that the efficiency of the procedure will be ameliorated in future using special electron compensators. This will result in a more favorable adaptation of dose distribution to the anatomical situation in regard to the cranio-caudal profile.