BackgroundCancer research has made great progress in the recent years. With the increasing number of options in diagnosis and therapy the implementation of tumorboards (TUBs) has become standard procedure in the treatment of cancer patients. Adherence tests on tumor board decisions are intended to enable quality assurance and enhancement for work in tumor boards in order to continuously optimize treatment options for cancer patients.MethodsSubject of this study was the adherence of the recommendations made in three of 14 tumorboards, which take place weekly in the Center for Integrated Oncology (CIO) at the University Hospital Bonn. In total, therapy recommendations of 3815 patient cases were checked on their implementation. A classification into four groups has been made according to the degree of implementation. A second classification followed regarding the reasons for differences between the recommendation and the therapy which the patient actually received.ResultsThe study showed that 80.1% of all recommendations in the three TUBs were implemented. 8.3% of all recommendations showed a deviance. Most important reasons for the deviances were patient wish (36.5%), patient death (26%) and doctoral decision, due to the patient’s comorbidities or side effects of the treatment (24.1%).Interestingly, deviance in all three tumor boards in total significantly decreased over time.ConclusionsAim of the study was to clarify the use of tumor boards and find approaches to make them more efficient. Based on the results efficiency might be optimized by increased consideration of patients` preferences, improved presentation of patient-related data, more detailed documentation and further structuring of the tumor board meetings.

No abstract

The results of the first screening round suggest that MRI is suitable for lung cancer screening with an excellent sensitivity and specificity for nodules ≥ 6 mm.

No abstract

Es wird gezeigt, daß von den drei bekannten Modifikationen des Bleichromats auf dem Wege der Fällung nur die rhombische und die monokline erhalten werden. Die monokline ist die weitaus beständigere. Eine Vorschrift zur Herstellung rein monokliner Bleisulfat‐chromatmischkristalle wird gegeben. Die Eigenschaften der einzelnen Modifikationen werden beschrieben. Die tetragonale Form kann erhalten werden, wenn man Bleimolybdat einbaut. Die so erhaltenen Mischkristalle sind orangerot. Ihr Kristallgitter wird beschrieben. Das Endprodukt alkalischer Einwirkung auf Bleichromate ist ein wohldefiniertes, monoklines, rotes basisches Chromat, dessen Gitter mitgeteilt wird. Mischkristallisation der Bleichromate mit Chromaten und Sulfaten von Metallen ähnlicher Gitterabstände ergibt eine gewisse Stabilisation des Bleichromats, besonders wenn die Mischkristalle monokline Struktur haben. Einige Blei‐Erdalkalimischkristalle werden beschrieben. Blei ‐ Zinkchromatmischkristalle konnten nicht hergestellt werden, dagegen Zink‐Strontiumchromatmischkristalle, deren analytische Definition jedoch noch aussteht.

There are various approaches for total knee arthroplasty (TKA). On the basis of an analysis of the clinical results, it has been demonstrated that the midvastus approach (MV) is advantageous in the early postoperative period compared to the medial parapatellar surgical approach (MPP). The aim of this investigation was therefore to investigate whether the clinical advantage of MV is reflected in the functional outcome. This single blinded, prospective, randomised study was based on a power analysis. Selected randomised patients (MPP = 10, MV = 11) were examined using an instrumental gait analysis system (VICON) preoperatively, and 5 weeks (5 W) and 6 months (6 M) after implantation. The results were compared to a healthy control group (CG = 53). Besides clinical parameters, the primary objective of this study was to measure objective gait parameters; the secondary objective was to record self-assessment (Knee Society score, WOMAC). In both treatment groups, the measurements improved during the investigation period, although most parameters did not reach the CG levels. MV gave better values for the kinetic parameters sagittal knee moment (5 W) and knee power (5 W, 6 M), as well as self-assessment (WOMAC, 6 M). Other clinical parameters were similar in the two groups. In summary, in the early postoperative period, MV led to advantages in function and in subjective behaviour in daily life. From the biomechanical point of view, the MV approach is preferable.

No abstract

Management of patients suffering from metastatic malignant melanoma and brain metastasis remains challenging in routine clinical practice. The inhibitory anti-CTLA-4 antibody ipilimumab has recently been approved as second-line therapeutic option for melanoma patients. Increasing evidence suggests distinct therapeutic activity on central nervous system metastases, although this continues to be actively debated. Here, we present the case of a patient suffering from metastatic melanoma, including symptomatic brain metastasis, who showed a partial response to ipilimumab in extracranial tumor manifestations, while the disease was progressing intracranially. Subsequently, intracranial disease progression could be managed by local irradiation. An overview of currently available literature on the efficacy of ipilimumab in melanoma patients with central nervous system metastases is provided.