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Background and Objective: Current meta-analyses have left in doubt whether general breast screening increases survival rate. This study investigated whether efforts at early diagnosis of cancer in the 1980s have had an effect on average tumor size at first diagnosis and on survival rate., Patients and Methods: From 1981 to 1990, 1656 consecutive patients (average age 56.6 years) at the I. Women's Clinic at the Ludwig-Maximilian University of Munich and the Women's Clinic Berlin-Charlottenburg were operated on for primary breast cancer. In a retrospective analysis, average tumor size at the primary operation and survival rate were determined for two periods: 1981-1985 (n=849) and 1986-1990. Mean follow-up time was 63 months., Results: There was no difference between the two cohorts regarding age (p = 0.77) and axillary node status (p = 0.14). During the follow-up period there was a gradual decrease in the tumor size at first diagnosis. (Pearson's correlation coefficient: -0.79, p < 0.001). Average tumor size in those operated on was 25 mm up to 1985, and 21 mm after 1986 (p < 0.001). Until 1985, the initial reason for mammography was the planned subsequent operation in 19% of patients (n = 164), and in 27% (n = 215; p < 0.001) since 1986. But there was no statistically significant rise in disease-specific survival rate (log rank, p=0.48). Multivariate analysis confirmed the conventional prognostic parameters, such as tumor size (relative risk 2.21) and axillary lymph node metastases (relative risk 3.57), but not the period of follow-up (p=0.90)., Conclusion: During the stated periods of follow-up there was a significant decrease in average tumor size at initial diagnosis. But this did not result in any demonstrably better disease-specific survival rate.

Background and Objective: With intensifying international travel numbers of travel associated infections and diseases will increase. Systematic studies on infections and diseases with regard to the travel destination in tropical and subtropical areas are scarce in Germany., Patients and Methods: Data regarding travel destination, reason, type and duration of travel, symptoms, clinical findings, laboratory results as well as diagnoses of 2024 patients (male 1010, mean age 35 years; female 1014, mean age 33 years) presenting at the outpatient clinic of the Institute of Tropical Medicine Berlin after returning from travel to tropical or subtropical areas were assessed., Results: The most frequent reasons for consultation were diarrhea (33 %), fever (17 %) and skin affections (14 %). A definitive diagnosis was established in 31 % (635). Significant differences were found for prevalences of infectious diseases with regard to travel destinations. 1.5 % of the travellers had contracted malaria. Only 34% of the returnees from malaria-endemic areas had taken chemoprophylaxis; in case of travel to Africa and Asia, chemoprophyplaxis corresponded to international standards in only 48 % and 23%, respectively. Giardia lamblia was the most frequently detected intestinal pathogen. Blastocystis hominis was found to be significantly associated with diarrhea., Conclusions: Most of the travel-associated infections are self-limited. In case of fever, malaria and potentially hemorrhagic fever should be excluded and be followed by a stepwise investigation on the cause of fever. In case of diarrhea, parasitologic investigations should be performed by an experienced laboratory and fresh stool samples should be used. Intensive co-operation will be necessary between physician, pharmacists and others active in the field of travel medicine in order to address the shortcomings in chemoprophylaxis for malaria. An increasing need for expertise in tropical and travel medicine, especially among private physicians is expected.

A 12-year-old girl from Zaire with AIDS (CDC: P2 D1) presented with a generalized molluscum contagiosum infection. She had suffered from systemic cryptococcosis and from cryptosporidiosis several months before admission. While molluscum contagiousum infection is usually a self-limiting disease in immunocompetent persons, a fulminant appearance and persistence of giant mollusca occurs with advanced immunodeficiency. Histological and immunohistological examinations showed a severe diminution of Langerhans and T cell populations that might enhance the dissemination of the infection. Molluscum-like lesions of cryptococci have been described, and cutaneous cryptococcosis is the main condition to be considered in the differential diagnosis. Further differential diagnoses should include American and African histoplasmosis, and the cutaneous manifestations of mycobacterial infections, of toxoplasmosis and of Pneumocystis carinii infection.

Spatial resolution of gratings of different orientation has been evaluated in 39 patients, by means of projected slides and by laser interference fringes. Both methods reveal a significantly higher resolution (about 12%) for vertical or horizontal bars compared to oblique ones. The similarity of findings for both methods is indicative of the neuronal origin of this orientation-dependent effect and exclude an optical origin.

As a physical disinfection method without chemicals required the ultraviolet irradiation was tested for disinfection of drinking water. The survival was measured as a function of exposure to radiation for S. enteritidis, E. cloacae, C. freundii, S. marcescens, E. coli, K. pneumoniae und S. faecium. The bacteria were grown in trypton soya broth until they were well into the exponential phase. Two different UV-disinfection units were tested. Both consist of cylindrical shaped chambers with one low-pressure mercury-discharge lamp with their longitudinal axis parallel to the chambers. With 10(6) cfu/ml the experiments were done with three different rates of flow of 7,2 m3/h, 4,0 m3/h and 2,0 m3/h. The minimum exposures to radiation necessary to cause a 99.999% reduction were 10-86 mWs/cm2 depending on the test bacterium and on the UV-disinfection unit. The minimum doses ranged for S. enteritidis up to 13 mWs/cm2, for E. coli up to 21 mWs/cm2, for K. pneumoniae up to 39 mWs/cm2, for S. faecium up to 42 mWs/cm2, for E. cloacae up to 43 mWs/cm2, for C. freundii up to 72 mWs/cm2, and for S. marcescens up to 86 mWs/cm2.