Gastrostomies: Evolution, techniques, indications, and complications

Incidence of melanoma is certainly rising all over the world and this observation has been related to a more frequent and prolonged exposure to the rays of the sun. The authors critically review pertinent literature and conclude that descriptive epidemiology of melanoma does not give survival trends and does not support the claim that melanoma is ultraviolet (UV) dependent. Analytical epidemiology has not reached a consensus on this aspect. Experimental data available are also difficult to interpret because there are consistent differences of susceptibility to UV among different animals, among lamps used and methods of measuring employed in various laboratories. Information available shows that the maximal relative biological activity of UV in humans is at about 305 nm. This evaluation greatly depends on (1) thickness of the skin, (2) the quantity and quality of secretions that cover the skin, (3) cleanness of the skin, (4) the latitude, (5) the weather, (6) the hour of the day and (7) the presence of chemical carcinogens in the air and on the skin. The authors stress the importance of the criteria of clinical diagnosis recently introduced in clinical practice and higher public awareness as the causes of the increasing incidence of melanoma.

Increasing incidence of cutaneous melanoma, ultraviolet radiation and the clinician.

The reversed gastric tube provides a relatively simple method of esophageal replacement in children. A thirty year experience of this technique is described together with the long-term results in 34 patients. Complications such as anastomotic leakage and stricturing have responded well to treatment and only one patient died. The reversed gastric tube remains a useful alternative to other methods of esophageal substitution.

The reversed gastric tube for esophageal replacement in children

A technique for gastrostomy has been described which includes circumferential, staggered interrupted sutures and an omental seal. The technique minimizes gastric necrosis and intraperitoneal leaks.

A technique for gastrostomy.

Der neu abgegrenzte acral-lentiginose Melanomtyp kommt an Handtellern, Fussohlen und subungual vor, ohne das alle Melanome dieser Lokalisation acral-lentiginos sind. Entscheidend ist der histologische Befund. Die Ergebnisse der klinischen und histologischen Studien der letzten zehn Jahre werden dargestellt. Zur Zeit ist die Klassifikation des malignen Melanoms in die vier Typen erneut in Diskussion.

Acral-Ientiginöses Melanom

Section I: colostomy.

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Section I: colostomy.