Ascending thrombophlebitis of the superficial leg veins is known to propagate into the deep leg veins and to embolize. In a prospective study we followed up 44 patients with sonographically diagnosed ascending thrombophlebitis into the deep veins (V. saphena magna n = 40, V. saphena parva n = 4). In 15 of 44 cases (34%) thrombosis of the crossing veins was found intraoperatively and 6 of 44 crossings were filled with floating thrombi into the deep vein lumina (14%). Among complications of treatment (11.4%) recurrence of thrombi in the ligated superficial residual vein stump was seen in 2 of 44 cases. One of these patients suffered a symptomatic, non-fulminant pulmonary embolism. The other patient developed a femoral vein thrombosis. 1 patient had an abscess and 1 a seroma of the groin. In 11% of all cases ascending thrombophlebitis diagnosed duplex sonographically was not effective in preventing propagation of thrombi into the deep veins thromboembolism remains a complication of ascending thrombophlebitis.

Thirty new malignant tumours were found in 1080 patients (634 men, 446 women; mean age 37.6 +/- 13.6 years) after a median follow-up period of 5 years following 1245 cadaveric kidney transplantations performed between 1972 and 1990. The mean dialysis period before transplantation had been 4.0 +/- 3.1 years. Regarding the type of tumour, carcinomas were by far the most frequent, while there was only one lymphoma. The annual malignancy incidence for renal transplant patients was 0.5%. This is 3.5 times higher for men and 4.2 times for women than in the normal population. Immunosuppression with azathioprine and/or antithymocytic globulin (n = 395) produced the same malignancy incidence (0.54%) as with cyclosporin (n = 685; 0.60%). On the other hand, malignant tumours occurred much earlier under cyclosporin than under azathioprine/antithymocytic globulin (27 and 68 months, respectively).

Vom 01. 01.1980 bis 31.12. 1988 wurden 149 Patienten mit einem Morbus Basedow weitgehend subtotal reseziert. Die Schilddrüsenreste hatten eine Größe von 2–3 g je Seite.

UNLABELLED:From 01. 01. 1980-31. 12. 1988 149 patients with Graves' disease were subtotally thyreoidectomized with little rests of 2-3 g on each side. The nervi recurrente and the parathyreoids were exposed.RESULTS:There was only one permanent pulsy of the recurrence nerve and no permanent hypoparathyreoidsm. 146 patients could be observed: two had a recidiv and must be treated with radiojodine. 70% of our patients were hypothyreotic, 20% euthyreotic. We think that the operation is the therapy of choice in young patients with Graves' disease.

Der PFI wird aus dem Quotienten der mittleren und maximalen Frequenzverschiebung eines gepulsten Dopplersignals berechnet. Er korreliert mit dem peripheren Strömungswiderstand. Der Normalbereich wurde an Nierenarterien 60 gesunder Probanden ermittelt. 163 konsekutive Duplex-Untersuchungen wurden in Transplantatarterien von 58 Patienten durchgeführt. Der PFI wurde mit klinischen Parametern, Isotopennephrografie und ggf. einer Transplantatbiopsie verglichen. Eine Abstoßung wurde in 85% richtig zutreffend (Sensitivität) und in 81% richtig nicht zutreffend (Spezifität) erkannt. Der PFI erlaubt damit, nicht invasiv zwischen Nierenversagen und Abstoßung zu unterscheiden.

Von den analen Veränderungen bei Morbus Crohn besitzen nur Abscesse und Fisteln Krankheitswert, selten einmal Fissuren. Während die chirurgische Entlastung von Abscessen immer indiziert ist, ist das therapeutische Vorgehen bei Analfsteln abhängig von der Art der Fisteln und von den im Vordergrund stehenden Symptomen der Grunderkrankung. Bei einfachen Fisteln ist die lokalchirurgische Therapie meist erfolgreich, im eigenen Krankengut zu 80 %. Bei komplizierten Fisteln sollte wegen der hohen Rezidivrate konservativ oder nur begrenzt lokalchirurgisch behandelt werden.

A method of enlarging localized duodenal stenosis is described in a case of chronic pancreatitis. After incision of the duodenum in the stenosis area, the defect is closed by an open, vascularized jejunum transplant. This method has several advantages over by-pass procedures. The physiological passage of the ingesta is preserved. Other methods such as a pedicle graft from the stomach or the colon may be functionally equally good, but more dangerous.

The different ways of metastases of carcinoma of the anus can hardly be removed by radical surgery and require other procedures than the lower carcinoma of the rectum. In comparing Miles operation in T3/T4 carcinomas of the anus with the combined therapy of local excision and radiotherapy results showed no great difference in T1/T2 tumors the Miles operation is not necessary. In T3/T4 carcinomas irradiation derives its worth from the few possible procedures ro radical surgery. In T1/T2 tumors irradiation can be an alternative (T1) or an additional treatment (T2) to the local excision.

Carcinoma of the anal region is rare compared with rectal cancer. It constitutes 2%-6% of all malignant tumours of the anorectal region. (Beersiek et al. to be published, Gam-stetter et al. 1977). The rareness of the disease causes therapeutic uncertainty and often gives rise to individualized therapy without proven guidelines. This was true for the therapeutic measured applied in the small number of patients presented here.