[Gastrointestinal stromal tumor (GIST) of the anterior rectal wall. R0 resection with simultaneous radical retropubic prostatectomy]. / Gastrointestinaler Stromatumor (GIST) der vorderen Rektumwand. R0-reseziert bei simultaner radikaler retropubischer Prostatektomie.

This case report deals with a 79-year-old patient with a gastrointestinal stromal tumor (GIST) of the anterior rectal wall which was unusually located between the rectum and the prostate gland. In addition, this patient suffered from subvesical obstruction accompanied by an elevated PSA level. These circumstances led to our decision to operate on the tumor via simultaneous radical retropubic prostatectomy. In our opinion this resection technique was easier and less traumatic for the patient compared to procedures performed via the abdomen and perineum. This case report demonstrates that in the case of tumors located between the rectum and the prostate gland the differential diagnosis should include not only prostate carcinoma but also rare tumor entities such as GIST.

[Rheologic changes in the postprandial phase]. / Rheologische Veränderungen in der Postprandialphase.

In this study, the postprandial changes of blood rheology and lipid parameters after a lipid-enriched test meal (75% lipids) versus a normal lipid composition control meal (30% lipids) were monitored. Six healthy volunteers were given a high lipid test meal (85 g lipids, 3800 kJ) as well as a control test meal (30% lipids, 3730 kJ) after 7 days. 3-6 hours after ingestion of the test meal, triglyceride levels peaked with an increase of about 120% after the lipid-enriched test meal and of about 55% after the control meal. The mean levels of plasma viscosity increased from 1.25 mPas to 1.29 mPas 3 hours after ingestion of the lipid-enriched test meal, whereas the blood rheology parameters, such as plasma viscosity and red blood cell aggregation, were nearly unchanged after the control meal with normal lipid composition. The changes of plasma viscosity after the lipid-enriched test meal were caused by an increase of triglyceride levels and an increase of fibrinogen levels in the postprandial phase by nearly 60% (mean value). Two different rheological reaction patterns have been demonstrated. Whereas 5 individuals showed the increase of blood rheology parameters mentioned above, one person had a very pronounced increase of plasma viscosity from 1.34 to 1.42 mPas and fibrinogen levels from 155 mg/dl to 280 mg/dl after the lipid-enriched test meal. This marked postprandial increase of blood viscosity may contribute to a flow limitation of myocardial microcirculation in patients with coronary artery disease.