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review on: Slavery, Law & Power in the British Empire and Early America, https://slaverylawpower.org/ (last visited 30 April 2022)

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Copyright of Trauma und Berufskrankheit is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The impact of hospital and surgeon volume on the treatment outcome based on data obtained from cohort and register studies has been controversially discussed in the international literature. The results of large-scale prospective observational studies within the framework of clinical healthcare research may lead to relevant recommendations in this ongoing discussion., Material and Methods: Within the framework of the prospective multicenter German Gastric Cancer Study 2 (QCGC 2), from 1 January 2007 to 31 December 2009 a total of 2897 patients with the histological diagnosis of gastric cancer from 140 surgical departments were registered and analyzed. The departments were subdivided according to the number of cases into 4 volume groups: I) <5, II) 5-10, III) 11-20 and IV) >20 patients with surgical interventions per year., Results: Overall 1163 patients (65.6 %) underwent surgical interventions in the departments of groups III and IV. Of the patients 521 (18 %) were scheduled for neoadjuvant treatment but with no significant differences among the various volume groups. In the departments of volume groups I and II subtotal gastric resection was performed significantly more often. Transthoracic extended surgical interventions in cases of a proximal tumor site were significantly more frequent in departments from volume group IV (p <0.001). The proportion of intraoperative fresh frozen sections correlated with the case volume: group I 23.2 % vs. group IV 61.2 %. Overall hospital mortality was 6.1 % and slightly higher in volume group I with 7.8 %. The median survival time and the 5‑year survival rate showed no significant differences between the various volume groups independent of tumor stages. There was a tendency towards a longer median survival time in volume group IV only for proximal tumor sites, i.e. adenocarcinoma of the esophagogastric junction (AEG). Using Cox regression analysis hospital volume did not have an independent impact on long-term survival., Conclusion: Hospital volume effects could only be detected for the treatment of AEG. To improve oncological long-term outcome, centralization of treatment of proximal gastric cancer appears to be recommendable.

Introduction: Ten years after the publication of "To Err is Human" in November1999, the development of patient safety efforts has been summa-rised in the statement "Ten years later, a million lives lost, billions of dollars wasted." This leads to the question why, despite evidence-based mea-sures for greater patient safety, they are not implemented or only implemented on a small scale. One approach to promote patient safety is the implementation of a safety culture. Such a safety culture is based on knowledge of employees about safe behaviour and their willingness to implement it. In this context it is interesting to explore the knowledge and the needs of medical students concerning patient safety., Material and Methods: At the University of -Magdeburg 354 medical students in their clinical semesters were asked about their knowledge of specific recommendations on patient safety and about their attitude to patient safety and risk man-agement as well as their subjective need for knowledge on this subject., Results: Only 16.7 % of the PJ (practical year) students and 11.7 % of students in all other clinical semester indicated to know the recommenda-tions for patient safety. This correlated with the answers to questions about single recommenda-tions. The importance of risk management during medical education was considered to be important by 53.3 % of the students of all clinical semesters and in particular 80.6 % of the surveyed PJ students. The answers to most questions showed a high demand for general information on patient safety. This is seen throughout all questions, especially with increasing clinical experience, and the need for information on single recommendations, such as critical incident reporting systems (CIRS), or Team Time Out., Discussion: The establishment of a safety culture is described as a useful way to fewer patient injuries. This includes knowledge on recommendations for patient safety, which may contribute to the implementation of a safety culture to reduce medical errors. Our survey shows the necessity need for information on patient safety and the students desire to acquire this knowledge. Specific courses on patient safety in first-year student education and then continuing in the post-university training seems to be the right way for an improved safety culture and fewer patient injuries, which should be further evaluated., (Georg Thieme Verlag KG Stuttgart · New York.)

The scaphocapitate fracture syndrome as a greater arc injury is a special form of the perilunate fracture dislocation. It is a combination of fractures of the scaphoid and capitate bones. This severe injury of the carpus is rare and therefore difficult to diagnose. We report the case of a 22-year-old handball player, who fell on the outstretched hand with the wrist in extension. Open reduction was performed via a dorsal approach and both fractures were treated operatively with Herbert screws. After three months the patient was able to play handball again with a good functional result.

Early gastric cancer (EGC) is defined as an invasive mucosal or submucosal neoplasia of the intestinal type tumor. Endoscopic mucosal tumor resection (EMR) is a new minimal invasive procedure for local tumor resection with excellent outcome in a well selected subset of patients.

Treatment of peptic ulcer disease has undergone a radical change due to the discovery of its main cause, the Helicobacter pylori infection. The management of the chronic infection is now the primary aim. Treatment of peptic ulcer essentially consists of eradicating H. pylori. A current problem is the resistance developed by H. pylori to the antibiotics used in eradication regimen. Ulcers that are induced by nonsteroidal antirheumatic (NSAR) agents and acetylsalicylic acid are gaining in importance. Optimized inhibition of acid secretion with proton pump inhibitors has made it possible to both prevent and cure ulcers in the stomach and duodenum caused by NSAR agents.

High local recurrence rates within the previous tumor bed or at the peritoneum remain an unsolved problem after surgical resection of malignant gastrointestinal tumors such as gastric, colorectal or pancreatic carcinoma. Currently, there are no standardized treatment protocols available for the prevention or treatment of peritoneal carcinomatosis. In a basic experimental trial, mitomycin, cisplatin, 5-FU, oxaliplatin and CPT-11 were used to prevent or treat peritoneal carcinomatosis induced in rats. Experiments were performed in three groups (n = 8 each) of animals plus two control groups. In the first group, Mitomycin, Cisplatin, 5-FU, Oxaliplatin and CPT-11 (n = 24 each) were applied directly following tumor cell implantation into the peritoneal cavity. In the second group, early postoperative intraperitoneal (i. p.) chemotherapy (day [d] 5, 10, 15 following surgical intervention for tumor cell transfer) was administered, whereas in the third group, late i. p. chemotherapy (d 15, 20, 25 following surgery) was given via a port-a-cath aiming for significant reduction of a visible, already established peritoneal carcinomatosis. Mitomycin and cisplatin were highly effective to prevent peritoneal carcinomatosis (direct application immediately after tumor cell transfer - 1 (st) treatment group). Using early postoperative i. p. chemotherapy (2 (nd) group), 5-FU and CPT-11 were shown to be significantly effective to reduce the intraperitoneal tumor spread. None of the cytostatic agents was able to decrease significantly an already generated peritoneal carcinomatosis (3 (rd) treatment group). The results suggest that novel chemotherapeutic drugs should be proven for their potential to alter peritoneal metastases of GI tumors i) in comparison with established drugs and ii) depending on the application time and mode.

The occurrence of heterotopic ossification (HO) is a well-recognized problem after total hip replacement. In a retrospective study, we investigated 32 patients who had undergone surgical excision of symptomatic HO followed by radiation with 7 Gy and nonsteroidal anti-inflammatory drug therapy between 1994 and 1999. The mean follow-up was 20 months (range: 12-60). Clinical and radiographic follow-up examinations included Harris hip score and classification according to Brooker. The preoperative Brooker class was III in 16 cases and IV in 16 patients. Comparison of the Brooker classification at follow-up revealed a statistically significant improvement (p < 0.0001; class 0:3, class I: 14, class II: 8, class III: 7 patients). In one case with symptomatic Brooker class III ossification, surgical reexcision of HO was necessary. A statistically significant increase (p < 0.05) in mean range of motion (ROM) was observed in flexion [preoperative: 57 degrees (+/- 26), follow-up: 83 degrees (+/- 21)], in abduction [preoperative: 17 degrees (+/- 12), follow-up: 24 degrees (+/- 9)], and in rotation (preoperative: 16 degrees (+/- 17), follow-up: 31 degrees (+/- 18)]. Comparison of preoperative Harris hip score (60 +/- 11) and Harris hip score at the time of follow-up examination (73 +/- 17) revealed a statistically significant increase (p < 0.0001) after treatment. At the time of follow-up examination, 18 patients (56%) assessed their pain symptoms as low but 6 patients (19%) reported strong pain symptoms. Nevertheless, the score at the time of examination (35 +/- 10) was statistically improved (p < 0.02) when compared to the preoperative score (30 +/- 8). Surgical excision of Brooker class III or IV heterotopic ossification with limited ROM followed by irradiation and anti-inflammatory prophylaxis results in significant improvement in flexion, abduction, and rotation arc and significant reduction of HO in radiographic examination at follow-up, but pain relief was only satisfactory.

The realization of internal and external surgical quality assurance is natural for hospital physicians. External influences on the hospital and a changed understanding of organisation demand a development of classical quality assurance. The primary aim is a patient orientated quality assurance related to the medical benefits and the patient individual needs. The active creation and establishing of functional organisation process and interprofessional and interdisciplinary structures in hospital setting is a requirement of time.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary stroke disease linked to chromosome 19 q 12. We report on two families affected by this disease, which is characterised by recurrent subcortical ischaemic strokes, progressive pseudobulbar palsy, and presenile dementia. Neuroimaging revealed multiple deep infarcts and diffuse leukoencephalopathy. Diagnosis of CADASIL based on the typical clinical feature without vascular risk factors, the neuroradiological signs of extensive leukoencephalopathy, and the autosomal dominant pattern of inheritance. CADASIL might be an underestimated cause of familial stroke and should be considered in the differential diagnosis of hereditary stroke.

A case of locally extensive perigenital Paget's disease in an 84-year-old man is presented. Topical application of 5-fluorouracil emerged as the safest and most effective treatment because of the patient's poor general condition and the extensive involvement of the pubic and genital skin.

In this case report we describe the MRI findings of a 24-year-old male with adrenoleukomyeloneuropathy, an intermediate form of X-linked adrenoleukodystrophy and adrenomyeloneuropathy. At the onset of illness MRI revealed circumscribed lesions of tracts and fiber systems of the CNS. One year later MRI showed progressive demyelination of the parietal and occipital medullary layer corresponding to the clinical deterioration. Such a progression of MRI findings has not previously been reported in the literature.

The idiopathic hypereosinophilic syndrome (HES) is a rare disease characterised by prolonged eosinophilia of undetectable cause and by the presence of varying internal symptoms and frequent neurological signs. We report on a 43-year old man with HES who developed cerebral infarction and organic psychosyndrome. Chemotherapy resulted in lower eosinophil counts and marked improvement of central nervous system dysfunction. We comment on possible pathophysiologic mechanisms of central nervous system involvement in HES.

The urinary protein pattern was determined in 46 healthy male and female subjects, 64 patients with an uncomplicated course of pregnancy and 88 hypertensive pregnant women by use of a special urine preparation and a modified SDS-polyacrylamide gel electrophoresis (SDS-PAGE). There were no differences in the protein electrophoresis pattern between the control subjects, independent of sex and age, and the pregnant women. The number of protein bands did not change in the course of pregnancy and in the post partum period. In both groups, an intensively stained protein band with an apparent molecular weight of 105 kD was detected. In 71 of the 88 hypertensive pregnant women we found a marked reduction in intensity or complete disappearance of the 105 kD protein band. Follow-up analysis in 30 of these pregnant women showed, that in 24 cases disappearance of the 105 kD band occurred simultaneously with and in 6 women before clinical manifestation of the disease. There were no differences in the protein electrophoresis pattern between patients with preexisting renal or hypertensive disease and hypertensive women without a complicated history. In 49 of the 52 hypertensive pregnant women complete reappearance of the 105 kD band was observed 2 to 14 days after delivery. By using silver staining and Western blot, the 105 kD band was identified as Tamm-Horsfall protein. Our findings may reflect a transitory tubular dysfunction in cases of preeclampsia and support the hypothesis of an immunological pathogenesis of the disease.