[History of surgical treatment of goiter]. / Geschichte der chirurgischen Behandlung des Kropfes.

Struma has called for treatment very early in medical history due to its appearance. At the beginning of our calendar, the physicians dealt with this problem already. This paper gives a historical review about the surgical treatment of struma.

[Psychological and social behavior of females following radical operation of breast cancer]. / Das psychische und soziale Verhalten von Frauen nach der Radikaloperation eines Mammakarzinoms.

55 women having had radical mastectomy were interviewed. In 40 of them a continuing anxiety could be shown to exist. Grief, consternation about the loss of attractivity and disfigurement of the body could be found in 50 of them. The loss of self confidence may be followed by disturbances of sexuality, marital and interpersonal relationships. Reintegration into social live is often difficult, relations with the social environment being interrupted. In the course of the patient's preoperative information these emotional disturbances must be discussed by the surgeon. 17 of these patients were interviewed again after successful breast reconstruction. In all of them psychological reactions could be found to be lowered and there was a rise of self confidence, too. Therefore rehabilitation of women after mastectomy must be considered to be an important part of treatment. "Today and in future surgery will include more than mere operations."

[Cholelithiasis--cholecystectomy and colonic cancer]. / Cholelithiasis--Cholezystektomie und Kolonkarzinom.

(1) In 24,089 autopsy records from 1956 to 1979 we found in 16,653 corpses without gallstones 495 = 2.97%, and in 7,436 corpses with gallstones 266 = 3.57% colorectal cancers.--(2) In 503 corpses with previous cholecystectomy performed more than one year before death we found 17 = 3.38% colorectal cancers.--(3) There is no higher incidence of colorectal cancer after cholecystectomy.--(4) In the corpses with gallstones, cholecystectomy or cirrhosis of the gallbladder there were significantly more cancers in the right hemicolon than in corpses without gallstones.--(5) A synetiology by genetic, epidemiologic or (and) metabolic factors may be possible.--(6) A Co-influence of primary bile acids on the genesis of colorectal cancer is discussed.--(7) In patients over 50 years with gallstones it is mandatory for the surgeon to exclude a co-existing colorectal cancer before performing cholecystectomy.

[Concentration of calcium and phosphorus in patients after thyroidectomy without ligation of the inferior thyroid arteries (author's transl)]. / Das Verhalten der Serumkalzium- und Serumphosphatwerte nach Eingriffen an der Schilddrüse ohne Ligatur der Aa. thyreoideae inferiores.

In 150 patients who underwent surgery of the thyroid gland without ligation of the inferior thyroid arteries the concentrations of calcium and phosphorus were examined and the patients checked for clinical signs of hypoparathyroidism. In 149 patients without symptoms of tetania over the first 3 postoperative days a decrease of calcium could be observed as it happens likewise after cholecystectomies. Only one patient presented an acute state of hypoparathyroidism postoperatively. In this case the decrease of calcium turned out to be very rapid. Omitting the ligation of the inferior thyroid arteries lowers the incidence of postoperative hypoparathyroidism thus meeting the demand for a functional resection.

[The judgment on gas gangrene in the framework of liability cases and applications for the extension of compensation]. / Die Begutachtung von Gasbranderkrankungen im Rahmen von Haftpflichtverfahren (= mVGE) und von Anträgen auf die erweiterte materielle Unterstützung (= EMU).

On the basis of law of the German Demoncratic Republic the problems for the judgement of clostridial infections in medical reports are discussed. If in exogenous infections severe mistakes against fundamental rules of surgery are evident, malpractice must be affirmed. Endogenous infections after operations on the gastrointestinal tract are in mostly all cases induced by bacteria for the viscera. Prophylaxis is not always possible, infections are not avoidable. So in these cases for malpractice there is practically no basis. The conditions for "materian aid" are also not existant.

[Comments on the preceding article by M. Földi and L. Clodius]. / Stellungnahme zu vorstehender Arbeit von M. Földi und L. Clodius.

In clinical symptoms inexplicable by scientific rules of pathology we should think of malingering. The case history by the authors is typical of the "Syndrome of Münchhausen". In such cases the consultation of a psychiatrist is mandatory before any operation is taken into consideration.