Laparoscopic ileo-cecal resection: case report and review of current issues in laparoscopic colorectal surgery

A successful case of laparoscopic ileocecal resection is presented. The laparoscopic surgical techniques are described. Advantages, disadvantages and controversial issues surrounding laparoscopic or laparoscopically assisted colorectal surgery are discussed. Reviewing the current literature and the authors' collective clinical experience, the conclusion is that laparoscopic or laparoscopically assisted procedures are clear indications for benign colorectal diseases. The authors believe that these approaches can be employed as palliative measures in malignant diseases or as curative procedures in prospective randomised trials.     

Conception without the development of a human being

Conception sometimes results in products that are not capable of developing into an embryo and fetus. This group, designated with the term gestational trophoblastic neoplasia, comprises the benign hydatidiform mole, the invasive mole (chorioadenoma destruens) and the frankly malignant variety, choriocarcinoma. Another type of atypical oocyte activation occurs in parthenogenesis. In the human, two types of tumors, dermoid cysts and teratomas, are believed to result from this process. We elucidate the generation of these abnormal growths and provide explanations as to why they cannot be regarded as human individuals or human beings. We argue that it is not the number of chromosomes that is required for a given form of human life to become a human being but rather the biparental origin of the chromosome set.     

Experiences in the perinatal management of congenital diaphragmatic hernia during the last 15 years in a tertiary referral institute

OBJECTIVE: Review of cases of perinatally diagnosed congenital diaphragmatic hernias with special regard to time of diagnosis, organs herniated into the thorax, associated malformations, and outcomes. METHODS: We analyzed the data of 106 cases between July 1, 1990, and June 30, 2005. The observation period was analyzed in two parts. RESULTS: Prenatal ultrasound was performed in 89.6% (95/106) of the cases. 51.7% (46/89) of the pre- and postnatally verified congenital diaphragmatic hernia cases were diagnosed before the 24th week of gestation. 11% (11/100) of the hernias were identified postnatally. 71% (71/100) of the cases were associated with other malformations. The hernia was on the left side in 86% (86/100) and bilateral in 5% (5/100) of the cases. Between 1990 and 1997, the proportion of right-sided hernias was 4.3% (2/46), while during the second period it was 13% (7/54). 27.5% (14/51) of the newborns survived the perinatal period. The survival rate of the newborns delivered by caesarean section was three times higher than that of infants delivered vaginally. In the latter group, the rate of premature deliveries was considerably higher. The pregnancy was terminated in 45% (40/89) of the cases. 15% (6/40) of the terminated cases were isolated. Intrauterine or intrapartum deaths occurred in 5.6% (5/89) of the prenatally diagnosed cases. Simultaneous thoracic herniation of liver, spleen, or stomach decreased the survival rate. In these cases, the discharge rate was between 6 and 22%. CONCLUSIONS: According to the analysis of 15-year data, the herniated organs, multiple malformations, as well as the mode of delivery influence the survival in a large number of cases. Early diagnosis predicts a large hernia, a higher malformation rate, and a less favourable prognosis.     

Studien über die Bienenlaus (Braula coeca Nitzsch,Diptera)

Ohne Zusammenfassung     

Diagnostic and psychodynamic aspects of sexual addiction appearing as a non‐paraphiliac form of compulsive sexual behaviour

Background: In recent decades, the diagnosis of sexual or love addiction has increasingly become part of the spectrum of addiction medicine. Although it does not figure under this name in either the BNO‐10 or DSM‐IV, the present scientific position is that it can be regarded as a compulsive sexual behaviour disorder that does not show the criteria of paraphilia.

Method: A case report.

Results: In the case of the 61‐year‐old patient we observed, the problems of an extramarital relationship play a central part in the syndrome with a serious conflict situation and prolonged personal and family crisis. This sexual addiction can be interpreted as identification with the father and also as the means of masculine identity. The sexual behaviour meets the criteria of addiction. Follow‐up will decide the stability of the diagnosis. In connection with this case, the authors attempt a psychodynamic analysis of triangular relationships destabilizing couple relationships.     

Network remodeling of intramural coronary resistance arteries in the aged rat: A statistical analysis of geometry

AimsTo identify the geometrical alterations in the age-remodeled rat coronary artery network and to develop a useful technique to analyze network properties in the rat heart.Methods and resultsWe analyzed the networks of the left anterior descendent coronary arteries on in situ perfused hearts of young (3 months) and old (18 months) male rats. All segments and branching over >80 μm diameter were analyzed using 50 μm long cylindrical ring units of the networks. Arterial widening and paucity, increased tortuosity were typical features in the old network. In addition, axis angles deviated more from the mother branches in the old, whereas the diameters of daughter branches fit the Murray law in both groups. The detected changes in the old network resulted in a longer blood flow route for the same direct distance.ConclusionWe developed a useful method to investigate arterial network property changes in the rat heart. Ageing resulted in longer, more tortuous flow route in the LAD network that might be hemodynamically disadvantageous.     

Cellular composition characterizing postnatal development and maturation of the mouse brain and spinal cord

The process of development, maturation, and regression in the central nervous system (CNS) are genetically programmed and influenced by environment. Hitherto, most research efforts have focused on either the early development of the CNS or the late changes associated with aging, whereas an important period corresponding to adolescence has been overlooked. In this study, we searched for age-dependent changes in the number of cells that compose the CNS (divided into isocortex, hippocampus, olfactory bulb, cerebellum, ‘rest of the brain’, and spinal cord) and the pituitary gland in 4–40-week-old C57BL6 mice, using the isotropic fractionator method in combination with neuronal nuclear protein as a marker for neuronal cells. We found that all CNS structures, except for the isocortex, increased in mass in the period of 4–15 weeks. Over the same period, the absolute number of neurons significantly increased in the olfactory bulb and cerebellum while non-neuronal cell numbers increased in the ‘rest of the brain’ and isocortex. Along with the gain in body length and weight, the pituitary gland also increased in mass and cell number, the latter correlating well with changes of the brain and spinal cord mass. The majority of the age-dependent alterations (e.g., somatic parameters, relative brain mass, number of pituitary cells, and cellular composition of the cerebellum, isocortex, rest of the brain, and spinal cord) occur rapidly between the 4th and 11th postnatal weeks. This period includes murine adolescence, underscoring the significance of this stage in the postnatal development of the mouse CNS.