a similar meeting of foreign ministers in Berlin last Monday, the four countries called off a proposed leaders’ summit because of a lack of progress in implementing the Minsk peace plan, which was agreed in September.

The war between Ukrainian forces and pro-Russian rebels broke out soon after Russia annexed Crimea last year, creating the worst crisis in East-West relations since the Cold War. Western governments accuse Russia of backing the rebels, including by sending in troops, a charge Moscow denies.

Earlier on Tuesday, the Kremlin said increased military activity by Ukrainian government forces had undermined hopes of arranging a four-way summit, Russia’s RIA news agency reported.Spigelian hernia: case report.
A spigelian hernia is an uncommon hernia of the anterior abdominal wall. We herein report a case of spigelian hernia, pre-operatively diagnosed as an incisional hernia. A 61-year-old woman had undergone an abdominal hysterectomy 14 years prior to her admission to our hospital complaining of a left lower abdominal mass with recurring pain. At the time of the operation the hernial orifice appeared not to be related to her previous surgical scar, but was located at the spigelian fascia below the level of the umbilicus. The hernial sac was dissected and the defect of the abdominal wall was closed. The diagnosis of a spigelian hernia can be difficult because of its nonspecific clinical findings and insidious nature. Diagnostic procedures and differential diagnosis are herein discussed