Zum 150. Geburtstag von César Roux (1857–1918)

César Roux was one of the few universal surgeons at the end of the 19th century who dominated all fields of surgery and influenced current surgery with his innovative spirit. Pioneering spirit and the story of the success of modern surgery are linked with his name. On the occasion of his 150th birthday, we recall the memory of this great surgeon. The personality and the history of Professor César Roux form a part of our medical and surgical heritage.     

Die Oberkieferosteotomie in der Le-Fort-I-Ebene — ein weites Indikations-spektrum zur Korrektur verschiedener skelettaler Dysgnathien

Zusammenfassung Die Osteotomie des Oberkiefers in der Le-Fort-I-Ebene, die heute routinemäßig in der Down-fracture-Technik durchgeführt wird, hat die chirurgische Behandlung skelettaler Dysgnathien grundlegend verändert. Sie ermöglicht eine dreidimensionale Korrektur des Oberkiefers und damit des gesamten Gesichtsschädels. Darüber hinaus kann der Oberkieferzahnbogen, zusätzlich zu einer Verlagerung des gesamten Oberkiefers, durch eine zusätzliche sagittale und transversale Osteotomie erweitert, verschmälert und verkürzt werden. Die Planung einer Oberkieferosteotomie erfolgt anhand des klinischen Bildes, der Kiefermodelle und des Fernröntgenbildes. Dabei muß der Unterkiefer frühzeitig mit in die Planung einbezogen werden, da er durch die Autorotation im Gelenk den Verlagerungen des Oberkiefers folgt. Erst durch eine gleichzeitige Osteotomie auch des Unterkiefers ergibt sich ein weites Indikationsspektrum für die Oberkieferosteotomie. Bei einer kombinierten Ober- und Unterkieferosteotomie ist praktisch jedes gewünschte Profil im unteren Gesichtsdrittel erzielbar.

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Summary The osteotomy of the maxilla using the Le Fort I technique, today routinely performed in the down-fracture-technique, has changed surgical corrections of dentofacial deformities fundamentally. It offers a three-dimensional correction of the maxilla and also of the whole facial skull. Furthermore the upper dental arch can be expanded, intruded and shortened using a sagittal or transversal osteotomy in addition to a complete transposition of the maxilla. Planning of a maxillary osteotomy is performed under consideration of the clinical situation, the casts and the lateral cephalogram. The mandible must be considered at an early state of the preoperative planning, since the mandible will follow all transpositions of the maxilla by rotating with the TMJ. Only by performing a simultaneous osteotomy of the mandible, a broad spectrum of indications for maxillary osteotomy will result and practically every desired profile of the lower third of the face can be achieved using combined maxillary and mandibular osteotomies.

     

Die Haftung des Ehegatten für Krankenhausbehandlungskosten nach § 1357 BGB

Ohne Zusammenfassung     

Frühes Ovarialkarzinom

Patients with early ovarian carcinoma have a much better survival outcome than patients with more advanced disease. Comprehensive surgical staging is crucial for the determination of prognosis and treatment planning. During 2003, the first randomized trials were published demonstrating that adjuvant platinum based chemotherapy improves recurrence free and overall survival. Current treatment recommendations are largely based on the results of these studies. Accordingly, systemic adjuvant therapy should be offered to patients with disease stage Ib or higher and to patients with moderately differentiated or undifferentiated tumors. Due to incomplete surgical staging, the stage of disease in the patients included in these studies is probably underestimated, and only a fraction of the actual advanced stage patients is included.     

Magenkarzinom – eine Infektionskrankheit

Gastric cancer still represents the second most common cause of gastrointestinal cancers in Germany. A disturbing issue is that at the time of diagnosis there are less than 15% of patients for whom a cure can be achieved. Nowadays, biological, histomorphological, molecular genetic and epidemiological data suggest that Helicobacter pylori eradication may lead to the prevention of gastric pre-neoplastic lesions and even gastric cancer. At present, eradication can be offered to selected patients and populations at increased risk, but more research is required before embarking on general and global H. pylori eradication for gastric cancer prevention. The main challenge is to determine how long mucosal abnormalities remain reversible and gastric cancer development can be halted.     

Rede zur Er?ffnungsfeier der 110.Tagung der Deutschen Gesellschaft für Innere Medizin am 18.April 2004 in Wiesbaden

Ohne Zusammenfassung     

Halswirbelsäule und Halsgefäße

The cumulative frequency of diminished stability of the major cervical arteries may be estimated between 10 and 25% in the general population. About 6% may be attributable directly to variations of the carotid arteries, and about 10% indirectly to alterations of the cervical spine, especially the atlas. Other developmental disturbances may also play a role.