Fees for outpatient operations in Germany: development, evaluation and European comparison.

In Germany, discussions on the fees for statutory sickness insurance for ambulatory surgery has, in the last few years, become almost a symbol of dispute for the German health services. Outpatient surgeons complain about the fact that the fees do not cover their services. They see innovation severely threatened by bureaucracy, profitability by planned economy, rights by reasons of State, aggravated by the 'reform' attempts of the Greens and Socialist coalition Federal Government.

[Ambulatory surgery: an unavoidable perspective of a partially complete concept].

Whatever social security system is in place, the increasing burden of health costs on public finance and individuals own resources is difficult to bear. Available resources and equipment should be used for essential treatment and complaints about lack of resources are only justifiable when responsible use is being made of those which are currently available. Thanks to current medical techniques, new drugs and a set-up adapted to the problem, day surgery is playing a significant role in solving this problem, to the complete satisfaction of patients, surgeons and nursing teams.

[Development of ambulatory surgery. An irreversible perspective].

Whatever the social security system, the burden of health care costs is rising at an intolerable rate. It is however unacceptable to complain about a lack of resoures as long as the resources which are available are not used responsibly. Thanks to new technologies and drugs, ambulatory surgery, with its own adapted structures, can help to ensure responsible use of resources and satisfy patients, surgeons and allied health workers.

Sarcoma arising in irradiated jawbones. Possible relationship with previous non-malignant bone lesions. Report of 6 cases and review of the literature.

Thirty-seven cases of radiation-induced sarcoma of the jaw are reviewed from the literature and six new cases are reported. It appears that irradiation seems to play a significant role in the development of jaw sarcoma: 10% of jaw sarcomas arise in irradiated bone. The initial lesion, however, that required irradiation appears to be equally important: 46% of the cases were found to have fibrous dysplasia as the initial lesion, whereas 18% of the remaining cases included diverse bone lesions.

A rare and complex case of multifocal mucocutaneous lupus tuberculosis with isolated lesion of the tongue.

We have described a case of plurifocal tuberculous lupus with a localization limited to the tongue. This finding is remarkable because of its rarity. The weakly positive tuberculin reaction and the discovery of a concomitant myeloproliferative syndrome add interest and complexity to the case.