[Urologic errors in surgical procedures].

Background: In the examinations of the appraisal commission of Northern Rhine the third most frequent urologic errors are ascertained after surgical procedures. In order to prevent them, it is adequate to evaluate their causes.

Material And Methods: Urologic claims were examined that came before the appraisal commission for treatment errors of the Northern Rhine Physicians' Authority between 1975 and 2005.

[Limits of physician duties from the standpoint of a physician].

The occupational regulations in medicine list four professional duties. Their recognisable limits are not rigid, and in certain situations can (or even must) be crossed in both directions. The main demand concerns the carefulness (accuracy) of the doctor in practising his profession.

Perioperative treatment with filgrastim stimulates granulocyte function and reduces infectious complications after esophagectomy.

We investigated the effects of recombinant G-CSF (Filgrastim) on the function of neutrophils and the rate of infectious complications in an open-label, nonrandomized study of patients with esophageal cancer undergoing esophagectomy. In this single-center phase-II trial 20 sequential patients (19 evaluable) received Filgrastim at standard doses (300 microg or 480 microg) subcutaneously for 2 days prior to and up to 7 days after surgery. The phagocytotic activity of neutrophils and the oxidative burst in the study group and in an experimental control group (n=27) were measured on days -2, 2, and 10.

Histopathological subtypes and prognosis of gastric cancer are correlated with the expression of mucin-associated sialylated antigens: Sialosyl-Lewis(a), Sialosyl-Lewis(x) and sialosyl-Tn.

The expression of three sialylated mucin-associated antigens - sialosyl-Lewisa (SLEA), sialosyl-Lewisx (SLEX) and sialosyl-Tn (STN) - and their correlation with the TNM stage, histopathological growth pattern and prognosis was investigated in a series of 127 gastric carcinomas. Various classification systems (pTNM, WHO and Laurén) did not display any correlation with an expression of the sialomucin antigens under study. SLEA reactivity was strongly associated with an unfavorable outcome of the total population, whereas SLEX and STN did not exert such an impact.

Monoclonal antibody therapy for resected Dukes' C colorectal cancer: seven-year outcome of a multicenter randomized trial.

Purpose: As previously shown, antibody treatment increased survival of patients with resected colorectal cancer of stage Dukes' C. Since the 5-year analysis was criticized because of the wide range (2.7 to 7.

Correlation of the immunohistochemical reactivity of mucin peptide cores MUC1 and MUC2 with the histopathological subtype and prognosis of gastric carcinomas.

The expression of MUC1 and MUC2 mucin peptide core antigens in gastric carcinomas was studied by immunohistochemistry to determine correlations with TNM stage and histo-pathological classifications as well as a possible prognostic impact. Paraffin-embedded specimens from 128 gastric carcinomas with a minimal follow-up of 5 years were immunostained. In addition to a polyclonal antiserum generated against polymorphic epithelial mucin (MUC1) from human milk, 2 monoclonal antibodies (MAbs), HMFG2 (anti-MUC1) and 4FI (anti-MUC2), were applied.

p53 expression in gastric cancer: clinicopathological correlation and prognostic significance.

For evaluation of the prognostic relevance of p53 expression in gastric cancer, the immunohistochemical tissue status of 133 primary gastric cancer patients was investigated for p53 expression and the association between p53 tissue status and clinicopathological parameters was analyzed. P53 immunoreactivity was detected in the nuclei of cancer cells in 35 cases (26.3%).

Risk factors, complications, and outcome in surgery: a multivariate analysis.

Objective: To correlate variables recorded perioperatively with morbidity and mortality in an attempt to assess the predictive value of these variables for the outcome of individual patients.

Design: Prospective study.

Setting: Teaching hospital, Germany.

Hans von Haberer: a forgotten pioneer in vascular surgery.

After carrying out the first free vein graft transplantation on an aneurysm of the axillary vein by Lexer in 1907, many attempts were made to reconstruct arterial injuries with direct vascular suture technique or vein graft transplants during the Balkan War (1912) and the First World War (1914-1918). Hans von Haberer gained wide experience in the reconstructive surgery of traumatic aneurysms at the Department of Surgery at the University of Innsbruck. During this period, he operated on a total of 201 vascular aneurysms, mainly using a direct circular vascular suture technique.

[Hans von Haberer--the beginnings of reconstructive carotid surgery].

Hans von Haberer (1875-1958) gained wide experience in the reconstructive surgery of vascular aneurysms at the universities of Innsbruck, Graz, Düsseldorf and Cologne. In this period he operated on 421 vascular aneurysms--including 30 carotid aneurysms--mainly by means of direct circular vascular suture. In 1914 von Haberer described the first repair of a carotid aneurysm.

Surgical therapy of esophageal carcinoma: the influence of surgical approach and esophageal resection on cardiopulmonary function.

Objective: The effects of the different surgical approaches (transhiatal esophagectomy and right-sided transthoracic esophagectomy) on perioperative cardiopulmonary function in the surgical treatment of esophageal carcinoma are discussed controversially and have not yet been evaluated.

Methods: In a prospective randomized study including 32 patients, we investigated the effects of the surgical approach (blunt dissection (n = 16) versus transthoracic en-bloc resection (EB) (n = 16)) in the treatment of esophagus carcinoma on perioperative cardiopulmonary function. The following parameters were measured in all patients: cardiac index (CI), mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary artery pressure (MPAP), pulmonary capillary wedge pressure (PCWP), intrapulmonary shunt (QS/QT), arterio-alveolar (aaDO2), arterio-venous oxygen pressure difference (avDO2), and blood gas analyses.

Role of transanal endoscopic microsurgery in the palliative treatment of rectal cancer.

Background: Palliative, minimal invasive treatment of rectal cancer is advocated in patients with advanced and incurable disease or poor clinical condition and in those who refuse radical surgery. Several methods have been used during recent years. We report our experience with palliative transanal endoscopic microsurgery.

Colorectal cancer--a multivariate analysis of prognostic factors.

The data from 1050 patients who had undergone colorectal carcinoma resection at the University of Cologne between 1976 and 1990 were studied. The aim of the study was to determine the concomitant effects on survival of several patient characteristics (sex, age, tumour localization, blood transfusion) and histopathological variables (Dukes' staging). We first calculated survival rates, both including and excluding post-operative mortality.

Gasless videoendoscopic implantation of an aortobifemoral vascular prosthesis via a transperitoneal versus extraperitoneal approach: an experimental study.

Purpose: To report progress in the development of a new minimally invasive surgical technique for aortobifemoral grafting utilizing gasless videoendoscopy.

Methods: In an experimental study, aortobifemoral Dacron vascular prostheses were implanted in 20 human cadavers using videoendoscopic techniques in both transperitoneal and extraperitoneal approaches. Rather than inducing pneumoperitoneum, the abdominal wall was elevated with an electrically powered lifting system.

[The beginnings of reconstructive vascular surgery in Austria].

Hans von Haberer (1875-1958) gained wide experience in the reconstructive surgery of traumatic aneurysms during the 1st world war at the Surgical Department of the University of Innsbruck. In the period 1914-1918 he operated on altogether 201 vascular aneurysms, mainly using a direct circular vascular suture. In 1914 von Haberer described the first reconstruction of a carotid aneurysm.

[Effect of surgical trauma on NK cell activity in esophageal carcinoma after transmediastinal dissection vs. transthoracic en bloc resection].

In order to assess the impact of surgical trauma involved in the therapy of esophageal carcinoma on the cellular immune system, a perspective study was performed involving perioperative hematological parameters. The activity of natural killer cells and the serum concentrations of interleukin-2, interleukin-6 and TNF-alpha were measured in 12 cases of transmediastinal dissection and 10 cases of transthoracic en bloc esophageal resection and compared to values of a control group of thoracic and abdominal surgical patients with non-malignant maladies. Natural killer cells assume a central role in the non-specific immunological response in tumor patients.

Quality of life after surgical therapy of bronchogenic carcinoma.

Quality of life (QL) after the "curative" resection of non-small cell bronchogenic carcinoma was assessed by patients using the EORTC QL questionnaire (QLQ) and by a psychologist using the Spitzer Index. Quality of life was assessed in 52 patients on one occasion 12 months postoperatively and in 20 patients regularly starting with a preoperative assessment. Self- and external evaluation showed a significant correlation (r = 0.

Anastomotic tissue oxygen tension during esophagectomy in patients with esophageal carcinoma.

Submucosal tissue oxygen tension (PtO2) was measured in 20 patients with cervical esophagogastrostomy after resection of esophageal carcinoma, using a Clark-type oxygen electrode. The mean gastric baseline PtO2 was 54.6 +/- 10.

Value of bronchoscopic pneumonia diagnosis: prospective study.

In a prospective clinical study we examined whether bronchoscopically controlled suctioning is preferable to the blind suctioning of mucus aspirates for bacterial identification of intensive care unit patients with pneumonia. Forty patients with clinical and radiologic signs of pneumonia underwent both bronchoscopically controlled and blind endotracheal lavage. Bronchoscopically controlled suctioning did not demonstrate greater sensitivity for identifying organisms than the results obtained from blind suctioning (58 organism were bronchoscopically identified, compared to 57 organisms identified by blind suctioning; p = 0.

Isolated hyperthermic perfusion with mitoxantrone of melphalan in malignant melanoma of the limb.

Background: Melphalan administered by isolated hyperthermic perfusion of the affected limb is an accepted treatment for malignant melanoma of the extremities. In contrast, pharmacologic and phase I studies suggest that, because of its high uptake, mitoxantrone may give even better local control, but data on survival, onset of metastases, and local and systemic toxicities have not yet been reported.

Methods: A matched-pairs comparison was performed to examine differences in the tolerability and effectiveness of isolated hyperthermic extremity perfusion with mitoxantrone (n = 44) and melphalan (n = 44) in high risk and locoregionally (P < 0.

Immunostimulation by propionibacteria--effects on immune status and antineoplastic treatment.

Experimental studies were performed to investigate further the effects of immunotherapy with Propionibacterium avidum KP-40 on thymocyte proliferation, maturation and emigration in BALB/c-mice. Thymus weight and thymocyte counts, especially cells presenting the immature or cytotoxic/suppressor phenotype were significantly increased. Due to enhanced emigration, peripheral blood lymphocyte and monocyte counts as well as expression of activation markers were significantly upregulated.