[Concepts of the German Society of Tropical Surgery].

The DTC promotes access to surgical care facilities of acceptable medical quality for all people in third world countries. To achieve this goal following concepts and activities are persued: Establishment of a 2-year training programme district surgery Postgraduate surgical training in Germany Workshops and annual scientific meetings Development of adapted surgical technologies Cooperation with national and international organisations Promotion of north-south partnerships between colleagues and hospitals.

Ischemia after carotid endarterectomy: comparison between transcranial Doppler sonography and diffusion-weighted MR imaging.

Background And Purpose: Hyperintense signals on diffusion-weighted MR images (DWIs) are believed to correspond accurately with cerebral ischemic events. Intraoperative transcranial Doppler sonography (TCD) can reveal hemodynamic and embolic events during carotid endarterectomy (CEA). Our purpose was to determine whether the occurrence of hyperintense signals on postoperative DWIs corresponds to intraoperative embolic or hemodynamic events.

High rates of appendicectomy in a developing country: an attempt to contribute to a more rational use of surgical resources.

Objective: In view of the high appendicectomy rate in a university teaching hospital in a developing country, we investigated the regional epidemiology of appendicitis.

Design: Prospective clinical and pathological study.

Setting: Teaching hospital, Madagascar.

[Current proctology--modern functional diagnosis].

The large majority of pathological conditions in proctology can be recognized and distinguished from each other by clinical and endoscopic means of diagnosis. Manometric and neurophysiological investigations are especially useful for understanding pathophysiology; these methods are of great clinical value whenever their results contribute to a specific concept of therapy. Functional tests are able to distinguish among the various causes of sphincteric dysfunction.

[Complexity-oriented surgical strategies in vesicovaginal fistulas].

Since 1975 a total of 55 patients with vesicovaginal fistulas have undergone surgery at the Clinic of Urology, University of Saarland, Homburg/Saar. A majority (55%) of the cases were complicated. In 9 cases supravesical urinary diversion was necessary.

[Endosonography of the rectum].

Endorectal ultrasound is proving to be a very accurate method for the preoperative staging of cancer. The tumor penetration depth is assessed with an accuracy of more than 90% for all T stages. The preoperative endosonographic evaluation of lymph nodes is superior to other imaging modalities, being more than 80% accurate in comparison to CT and lymphoscintigraphy.

[Secondary arthrosis after surgical treatment of ankle fractures].

98 patients were clinically and radiographically examined 2 to 9 years following the osteosynthesis of ankle fractures. The rate of secondary osteoarthritis was 70% including 40% of minor, 17% of medium and 13% of serious changes. Depending on the injured structures and frequency of posttraumatic osteoarthritis varies.