Zentralblatt für Chirurgie
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The operative treatment of pilonidal sinus is characterized by an increased rate of wound healing complications and late recurrences. The Limberg transposition flap is an easy method for covering the defect after excision of the pilonidal sinus. ⋯ Between 6/96 and 7/99 we treated 42 patients using this method without complications of wound healing or recurrences. Comparison of literature results of different operative treatments (open granulation, primary suture, Z-plasty) shows lessened complication and recurrence rates for the Limberg transposition flap, which is the method of choice for chronic pilonidal sinus nowadays.
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Truth and truthfulness are traditional subjects of philosophy. The paper discusses different concepts of truth (epistemological, ontological, normative) and different theories about the acquisition of truth (truth as correspondence, coherence or consensus, pragmatic theories of truth, and truth as immediate subjective evidence). The last part deals with the moral question of truthfulness or sincerity and its conflict with benevolence in cases of patient information about a fatal illness.
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The indication of vena cava filter implantation is controversially discussed. A pure prophylactic indication is increasingly favoured, especially for temporary filter systems without any anamnestic pulmonary embolisms. On the basis of the available literature and our own results a critical analysis of this issue is given. ⋯ Local infections of the catheter and introducer sets were observed in two patients. Moreover, in one case the strut of a temporary filter broke and subsequently dislocated 17 days after insertion. We conclude on the basis of these complication rates that until the results of randomised studies are available the usage of all filter systems should be limited to highly selected cases.
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Biography Historical Article
[Rahel Hirsch (1870-1953). The first Prussian woman medical professor].
Dr. Rahel Hirsch was only the second woman to attain a professional medical position at the Charité Hospital in Berlin. For more than 16 years, she worked in Clinic II Internal Medicine. ⋯ Not permitted to practice in London, she underwent a serious crisis. When she died, she was impoverished. More than a decade later, she was posthumously admitted into the "Galerie of famous Jewish scientists." Her discovery, which had been so greatly criticized, was named after her.
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Historical Article
[Surgery school. Tradition-transition-change in paradigm?].
First Schools in Surgery already at the antiquity. During the medieval some slow developments in this regard throughout Europe, especially in France and Italy. ⋯ Tremendous changes in our time with a break of the generations, new structures at the universities, far reaching separation into subdisciplines of surgery and explosive technical developments question the meaning of surgical schools in the old sense. But there will apparently be a continuation, even in a changed matter and this on the background of a shift of the paradigm.