[Pancreatogastric or jejunal anastomosis following cephalic duodenopancreatectomy--an assessment following animal experiment and clinical studies].

After partial duodenopancreatectomy the authors performed a pancreatogastrostomy with splinting the anastomosis. This method has some advantages vice versa the pancreatojejunostomy. Experiments with animals show that the beneficial effects of pancreatogastral-and pancreatojejunal anastomoses are of limited duration.

Basic concept for implantation technique of total artificial heart in humans: a review from cadaver implantations.

To develop the application technique of the total artificial heart in humans, it is important to establish a concept about the implantation procedures. Based on cadaver experiments with various types of prosthetic ventricles, some aspects in solving the surgical difficulties were described. Special interest was directed to the geometric topography, the optimal design of the prosthetic ventricles, and the possible surgical solution.

Surgical principle in total artificial heart--an experimental review.

Based on implantation experiments in calves resulted some experiences for the implantation technic of artificial hearts. After resection of the natural ventricles and of the valvular parts of the aorta and pulmonary artery the connectors should be adapted and implanted. The first connected left ventricle get a caudal-lateral traction especially under supervision of the pulmonary veins and optimal development of the aorta.

[Hormonally active pancreatic tumors (apudomas). A review].

Hormonally active pancreas tumours have ceased to be rare cases, and by means of up-to-date methods they are now more frequently diagnosed than they used to be in the past. An account, based on the authors' own experience, is given in this paper of diagnostic and surgical problems relating to the various hormone-producing tumours of the pancreas. Particular reference is made to the treatment of malignant apudomata and to new concepts which have resulted from the introduction of H2 receptor blockers.

Primary cardiac liposarcoma simulating a left atrial myxoma.

This paper reports the case of cardiac tumor which had been diagnosed as a left atrial myxoma but which later on was identified as being a primary cardiac liposarcoma. The clinical characteristics of cardiac liposarcomas, the problems of differential diagnosis, the prognosis and therapy are reviewed.

[New aspects of peritonitis treatment].

Diffuse peritonitis is a dangerous disease still nowadays. Above all endotoxinemia is responsible for the high lethality. The aim of treatment is to eliminate the source of infection by surgical measures, to drainage and eventually to lavage the peritoneal cavity.

[The Rostock artificial heart--current status and perspectives].

The authors report on their experiences gained by animal experiments (calf) and their attempts (human corpses) concerning adaptation of the apparatus to the human thorax. At the present time they do not see a chance for its routine clinical use. The main reason why is the impossibility to install the extrathoracic driving system into the thoracic cage and last not least the wear of the material used for the heart chambers.

[Current surgical management of reflux disease].

This disease has not been fully clarified yet. In our opinion, surgery should only be performed in cases of stage IV because of ulcers, irreversible scar formation, metaplasia of the epithelium, endobrachyoesophagus, stenoses or malignant degeneration. 11 patients suffering from severe reflux oesophagitis (stage IV) underwent a combination of supraselective vagotomy (to lower gastric acidity) fundoplication according to Nissen and intraoperative dilatation of the stenosis or stricture.

[Experiences with the Rostock artificial heart].

A totally artificial heart--the Rostock totally artificial heart (Rostock TAH) was implanted in calves. We can give the following deductions after 27 examinations: -- The Rostock TAH was tested successfully in endurance test about 7 months; it show no sign of wear. -- The surgical technique of the implantation was standardised and a successful experimentation is possible.

[Analysis of the surgical therapy of cardia cancer. Surgical approach, upper resection or gastrectomy, early and late results].

The author has performed radical surgery in 45 patients with carcinoma of the oesophageal gastric junction. The abdominal, abdomino-thoracic and thoracic approach are compared. With regard to later survival, the least favorable results were obtained with the abdominal incision, an approach used in 15 patients, none of them survived 5 years.

[Immune level in diffuse peritonitis (author's transl)].

In patients suffering from diffuse peritonitis serum levels of Ig A, Ig M and Ig G were examined. In general, there was no decrease of serum concentration. On the contrary an increase of Ig M and Ig A with a concomitant decrease of the serum albumin level could be observed in the postoperative phase.

[Therapeutic procedure in acute ulcer hemorrhage after cadaver donor kidney transplants].

In 62 cadaver-donor-allograft recipients we observed 11 times gastrointestinal complications 7 times (11%) an ulcer or an erosion of the mucous membrane could be secured gastroscopically. The therapeutic remedy of choice seems to be the well-timed 2/3-resection after Billroth II, since a too long hesitation increases the number of complications, has a negative influence on the choice of the intervention and increases the lethality.

EMS or HSA: which program model influences health delivery more?

The EMS and the HSA programs differ radically in concept of area of operation, agency structures, roles of consumers and health care professionals, method of funding, and control by the federal government. Both the government and providers should study the differing impact of the programs in order to determine which approach can more effectively change health care delivery.