The use of extracorporeal shock waves in the treatment of submandibular stones is a minimally invasive approach for the treatment of this disease. Its clinical significance has been determined in a long-term retrospective study, performed as follow-up to the short-term results. From 1989 to 1994, 197 patients (88 female, 109 male; age range, 8 to 83 years) with symptomatic, sonographically detectable concretions of the submandibular gland were treated with extracorporeal shock wave lithotripsy. The review analysis was completed retrospectively in 2002 and included 191 patients with complete data. The period under review ranged from 8 to 13 years, with an average of 10.5 years. Altogether, 67 of the 191 patients (35%) either were free of stones or had no more symptoms from the residual sialoliths. Another 15% had a significant improvement in their symptoms and required no further therapy. The remaining 95 patients (50%) had residual stones; they had no symptoms in the short review period, but have had symptoms since. The therapeutic success was not influenced by the stone size, but rather by the stone location within the gland. After therapy, no severe side effects were identified. Extracorporeal shock wave lithotripsy is a possible treatment for stones in the submandibular gland. In combination with other gland-preserving methods, it now forms part of a multitherapeutic approach that renders submandibulectomy unnecessary in the majority of cases.

Although contrast medium analysis provided statistical criteria, these, however, do not possess the ability to improve the diagnostic prediction of tumor histology. Neither the morphologic classification nor contrast medium analysis was able to identify a malignant lesion sufficiently.

In the case of left supraclavicular masses, the rare differential diagnosis of a thoracic duct cyst must be considered as a possibility. Sonography as the imaging method of choice is sufficient for primary diagnosis. In addition, a thorax x-ray should be performed in order to exclude an intrathoracic involvement. Surgical extirpation marks the therapy of choice in treating such cysts.

The loss of biodiversity in agricultural landscapes has been dramatic over the past few decades with negative trends persisting. Organic farming has received widespread recognition in the scientific and politic fields for its environmental benefits, although the proportion of land cultivated organically is still small and the extent to which organic farming contributes to the promotion of biodiversity is viewed controversially. We present a critical, quantitative review of 98 mainly peer-reviewed papers selected from 801 studies in temperate climate zones published over the period 1990-2017. We quantified differences in the species richness and abundance of selected flora and fauna groups. In total, 474 pairwise comparisons that compared organic and conventional farming systems were considered. Overall, organic farming showed higher species richness or abundance in 58% of the pairs. No differences were found for 38%, 4% indicated negative effects from organic farming. The average (median) species numbers of flora on arable land were 95% higher under organic management as well as 61% higher for seedbank and 21% higher for field margin vegetation. For field birds, the species richness was 35%, and the abundance was 24% higher in organic farming; for insects, the corresponding values are 22% and 36% and for spiders 15% and 55%. Our study underlines that organic farming can play an effective role in acting against the loss of biodiversity. Future research should focus on the combined effects of landscape structures and organic farming, the effect of largescale organic farming, as well as on the correlation of species diversity and production parameters. To meet the systems' representativeness, even more strict selection criteria need to be applied in further analysis.

No abstract