[Solid-pseudo-papillary tumor of the pancreas (SPPT) as sonographic incidentaloma in the context of acute appendicitis].

Objective: Review of the literature (Medline) based on a clinical case.

Case: A twenty one year old lady presented with a one day history of acute right sided lower abdominal pain associated with leucocytosis and the clinical signs of an acute abdomen. Sonography showed fluid coincident with cocardal formation in the right lower abdomen.

[6 years V.A.C. in general surgery -- clinical data from 128 patients].

Since the introduction of vacuum assisted closure therapy (V.A.C.

Early onset of a decreased intracellular magnesium and phosphate concentration in smooth muscle cell of SHR.

A decrease in total magnesium content is not a direct proof of a decreased magnesium ion concentration. It could reflect a phosphate alteration or an ATP metabolism disorder. Plasma phosphate levels are lower in spontaneously hypertensive rats (SHRs) than in Wistar-Kyoto rats (WKYs), and defects in membrane regulation or mitochondrial ATP synthase occur.

Complex pattern of colon cancer recurrence including a kidney metastasis: a case report.

We report a case of a 77-year-old female with a local recurrence of cancer after right hemicolectomy which infiltrated the pancreatic head affording pancreatoduodenectomy, who developed 3 years later recurrent tumor masses localized in the mesentery of the jejunum and in the lower pole of the left kidney. Partial nephrectomy and a segment resection of the small bowel were performed. Histological examination of both specimens revealed a necrotic metastasis of the primary carcinoma of the colon.

[Laparoscopic hernioplasty by transabdominal preperitoneal approach].

Introduction: Despite the increasing acceptance of the TAPP-procedure by patients and general practitioners this method has to be further examined. In addition to the classic surgical criteria of examination, subjective aspects of patient comfort must be taken into consideration as they are getting more and more significant for the evaluation of different methods.

Methods: According to this objective patients were clinically examined and questioned about specific topics of quality of life after TAPP-operations.

[Surgeons learn how to learn. Study of 76,499 herniorrhaphies performed between 1993 and 1997 registered by the chamber of physicians in Westfalia-Lippe].

Introduction: New techniques require "new" surgeons who are able to apply them safely. The bushfire-like employment of laparoscopic cholecystectomy confronted a community of surgeons totally inexperienced in that technique. Thus, the collective learning curve was paralleled by a temporary increase of postoperative complications.

[Clinical anatomy in the operating room. A model of integrated medical education].

Clinical relevance of theoretical knowledge is advantageous to be demonstrated early during preclinical education in medical schools. We describe a new way for anatomists and surgeons of teaching anatomy together during surgical procedures in the operating theatre, thus demonstrating successfully the need of keen insight in the field of gross anatomy. The students reported to be motivated to learn anatomy.

[Learning and optimising minimally invasive techniques by operating on embalmed human corpses].

The expansion of minimally invasive surgery worldwide provokes an intensive interest of all surgical disciplines in gaining possibilities for research, learning and teaching by operating on human corpses. Despite the fact that German anatomical institutes in general have the infrastructure to realise such clinical cooperations, at present they may offer such opportunities only to a restricted degree, since the concentration on student teaching and anatomic research limits the capacity of the staff for a commitment in this field of applied science. To provide a basis for future estimations of the efforts necessary to perform solo surgery on the human cadaver, especially with emphasis on research, quality control and teaching, this article reports on practical experiences with such a project named "ANAtoMIC", identifying minimal conditions which have to be realised.

Anatomic guidelines for the prevention of abdominal wall hematoma induced by trocar placement.

A knowledge of the parietal structures of the abdominal wall is necessary to minimize risks of operative procedures like laparoscopy. For means to prevent intraoperative bleeding and the occurrence of abdominal wall hematoma, we studied the course of the inferior epigastric arteries and the ascending branch of the deep circumflex iliac artery in 21 human cadavers. The abdominal wall structures were dissected and the distances of the arteries in relation to anatomic structures such as the umbilicus, pubic symphysis, superior ischial spine and lower edge of the rib-cage were measured.

[Transplantation of the kidney of an 80-year-old donor after complex revascularization with good transplant function].

There is no age limit in kidney donation. Kidney function has to be evaluated on an individual basis even in elderly donors. We report the transplantation of the kidney of an 80-year-old donor with good organ function postoperatively.

[C-reactive protein in the early diagnosis of postoperative infection following bone surgery].

Of a prospective 101 patient study group after different operative osteosynthetic procedures 94 patients without postoperative infection showed a uniform acute phase response which was characterized by determination of C-reactive protein levels, ESR, WBC and body temperature. 7 patients suffering from infection in the postoperative period but no patient with non-inflammatory complications showed distinct CRP value patterns. In 4 wound infections CRP increased from day 2 to 4 and thus was the earliest sign of developing infection.

[Injuries to retroperitoneal arteries in lumbar intervertebral disk surgery].

Retroperitoneal bleeding as a rarely occurring but life-threatening event after lumbar disc surgery is being presented in three cases. Discussion includes necessary steps in establishing the diagnosis for adequate therapy by referring to clinical features with their anatomical background.

[Early functional treatment of rupture of the fibular ligament with a personally developed ankle splint].

The inversion trauma of the ankle joint is one of the most important and frequent injuries. The treatment of recent rupture of the fibular ligament is now a point for discussion. Operative or conservative treatment is possible.

[Rare pancreatic tumors from the viewpoint of our own patient sample].

Four less common tumours of the pancreas are being presented with histological findings (malignant haemangiopericytoma, small cell type anaplastic carcinoma, microcystic cystadenoma, dysontogenetic cyst) from our own patient data. The discussion includes general considerations about preoperative staging and grading as well as the differential diagnosis of the kind of tumours.

[Gallstone ileus--is it possible to reduce the still high mortality rate? An analysis of personal cases and review of the literature].

Acute intestinal obstruction caused by gallstones: we report about our own experience with 13 patients and discuss this topic by referring to the current literature. Since there is indeed a tendency towards multimorbidity in our high-aged population, a gallstone ileus should always be included in the differential diagnosis of acute intestinal obstruction in the elderly. We put emphasis on a less traumatic operative procedure (enterolithotomy).