bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patellar tendon anterior cruciate ligament reconstruction with conical press‐fit femoral fixation: 5‐year results in athletes population
Authors: Gobbi Alberto , Diara Alberto , Mahajan Sanjeev , Zanazzo Milco , Tuy Benjamin 
Published: August 2002

AbstractBone–patellar tendon autograft is probably the most widely used graft for ACL reconstruction. Several methods for graft fixation have been described. To avoid intra‐articular hardware we adopt biological fixation with a femoral conical press‐fit fixation. A prospective study was performed on 40 consecutive active athletes who underwent ACL reconstruction with this technique by the same surgeon between November 1994 and September 1995 (mean follow‐up 46 months, range 36–62). Results were evaluated by an independent examiner using radiography, computed tomography, subjective and objective evaluation, and isokinetic and functional strength tests. Assessment using the IKDC knee scoring revealed 85% of the patients with a normal or nearly normal knee joint; Tegner's score was 7.5 preoperatively and 6.0 postoperatively, with 60% of the athletes returning to the preinjury sport and level. No patients had instability, with 90% having less than 3 mm side‐to‐side difference on computerized analysis. The isokinetic test showed mild quadriceps deficit at 3 and 6 months, with no deficit at final follow‐up; four patients complained of anterior knee pain and had a positive kneeling test. We found no graft dislocation. All cases showed radiological evidence of graft integration at 3 months time. Long‐term results support this technique as× a simple, cost‐effective, and reliable alternative for patellar tendon fixation in ACL reconstruction.
Balance board training: prevention of traumatic injuries of the lower extremities in female soccer players?
Authors: Söderman K. , Werner S. , Pietilä T. , Engström B. , Alfredson H. 
Published: August 2002

AbstractThis prospective randomized intervention investigated whether training on a balance board could reduce the amount of traumatic injuries of the lower extremities in female soccer players. A total of 221 female soccer players from 13 different teams playing in the second and third Swedish divisions volunteered to participate in the study. Seven teams (n=121) were randomized to an intervention group and six teams (n=100) to a control group and were followed during one outdoor season (April–October). Before and after the season muscle flexibility and balance/postural sway of the lower extremities were measured in the players. There were no significant differences in age, height, weight, muscle flexibility and balance/postural sway of the lower extremities between the intervention and the control group. During the season the players in the intervention group performed a special training program consisting of 10–15 min of balance board training in addition to their standard soccer practice and games. After a 37% drop‐out the intervention group consisted of 62 players and the control group of 78 players. The results showed no significant differences between the groups with respect either to the number, incidence, or type of traumatic injuries of the lower extremities. The incidence rate of “major” injuries was higher in the intervention group than in the control group. Four of five anterior cruciate ligament injuries occurred in the intervention group, which means that we could not prevent severe knee injuries in female soccer players with balance board training. However, among the players who had been injured during the 3‐month period prior to this investigation there were significantly more players from the control group than from the intervention group who sustained new injuries during the study period.
Manometric Comprobation of Esophagogastric Junction Competence after Nissen Fundoplication and Its Relation to the Length of Fundic Wrap
Authors: del Pino Porres F. Javier , Sancho Fornos Salvador , Benages Martínez Adolfo , Mora Francisco 
Published: August 2002

Abstract.We present 98 patients operated on by two techniques of 360‐degree fundoplication due to gastroesopagheal reflux disease and divided in two groups: Group I comprised those who were given a conventional valve 5 cm in length, and group II underwent a short fundoplication that did not surpass 1.5 cm. All were subjected to preoperative esophageal manometry, with determination of the pressure and length of the lower esophageal sphincter (LES) and the motor behavior of the esophageal body. The postoperative manometric results are analyzed, checking that after fundoplication there was a significant increase in tone and length of the LES (p < 0.00005); there were no differences between the two groups (p= 0.9920 and p= 0.2160, respectively). The motor function of the esophageal body did not change after surgery. We conclude that even the smallest length of the fundic wrap does not cause a reduction in the pressure and length of the manometric LES; that is, the antireflux effectiveness, measured by manometry, did not depend on the anterior length of the valvuloplasty.
Overview of Surgical Pathology of the Thyroid Gland
Authors: Nishiyama Ronald H. 
Published: August 2002

AbstractThe purpose of this overview is to provide timely information on selected topics on the surgical pathology of the thyroid gland. Selected publications of the author and his colleagues at the University of Michigan and the Maine Medical Center form the basis of this review. Information provided in our reports is updated by perusal of recent, pertinent publications. The following questions summarize the contents of the overview. What is a “lateral aberrant thyroid”? Does it always represent metastatic carcinoma? What are dyshormogenetic goiters? Can “focal thyroiditis” in thyroid glands removed for the treatment of Graves' disease and toxic nodular goiters be predictive of the development of postoperative hypothyroidism? What is the pathology of autonomously functioning (hot) nodules? Do tall‐cell, columnar‐cell, and diffuse sclerosing types of papillary carcinomas forbode bad prognoses? What is the controversy over Hurthle cell tumors? Does the presence of a better differentiated component in an anaplastic thyroid carcinoma modify its biologic behavior? Are poorly differentiated carcinomas unique histologic variants? Does their histology affect prognosis? What is the most common small‐cell tumor of the thyroid gland? Has the Chernobyl nuclear disaster affected the incidence of childhood thyroid carcinoma? Are these radiation‐induced tumors more aggressive? The answers, some of which are controversial, are found in this overview. The aims here were to provide information to surgeons and pathologists and to improve the care of patients with thyroid disease.
Hashimoto's Disease and Thyroid Lymphoma: Role of the Surgeon
Authors: Pasieka Janice L. 
Published: August 2002

AbstractWith the turn of the century, the role of the surgeon in the treatment of diseases such as Hashimoto's and thyroid lymphoma has diminished. That is not to say that the surgeon must not have a thorough understanding of these diseases and the role he or she plays in their diagnosis and treatment. Hashimoto's disease is a common disease. Not infrequently the endocrine surgeon is faced with a thyroid nodule in a background of Hashimoto's disease. Interpretation of fine‐needle aspiration (FNA) of a nodule in a patient with the background of Hashimoto's disease may be misleading if the surgeon fails to understand the limitations of FNA. The role of the surgeon in the treatment and diagnosis of thyroid lymphomas has evolved from surgical debulking to open biopsy. With the use of irradiation and chemotherapy, the need for surgical debulking has nearly disappeared. The recent development of ancillary techniques such as light chain restriction, flow cytometry, gene rearrangement, and immunohistochemical staining have enabled cytopathologists to diagnose thyroid lymphoma by FNA, further diminishing the surgeon's role in the diagnosis and treatment of this disease.
Antibiotic Prophylaxis for Appendectomy in Children: Critical Appraisal
Authors: Tönz Martin , Schmid Philipp , Kaiser Georges 
Published: August 2002

AbstractProphylactic antibiotics are widely used during surgery, above all for clean‐contaminated or contaminated procedures. Because factors other than the degree of contamination play a critical role in regard to postoperative infectious complications, it is not evident that recommendations for antibiotic prophylaxis for an adult population can be transferred to children. The aim of the study was to analyze the incidence of postoperative infections in children undergoing appendectomy for suspected appendicitis to evaluate critically the effectiveness of prophylaxis. The charts of all children undergoing appendectomy between 1988 and 1998 were analyzed. In general, appendectomies were performed without antimicrobial prophylaxis. If a perforated appendicitis was found at operation, antibiotics were given intraoperatively. Postoperative infectious complications were defined as wound infections, intraabdominal infections, or prolonged postoperative pyrexia. During the study period of 10 years, 954 patients underwent appendectomy. In 24% of cases the appendix was perforated. Patients received prophylactic antibiotics at the surgeon's discretion. These patients were excluded from further analysis. Among those with non‐perforated appendicitis (n= 633), Infectious complications occurred in 19 (3%). Analyzing subgroups according to histologic diagnosis, the incidence was 4.2% (16/382) for gangrenous appendicitis and 1.2% (3/251) for simple appendicitis or normal appendix. These figures are clearly lower than those reported from an adult population, indicating that results from adults cannot a priori be transferred to children, and that general recommendations concerning antimicrobial prophylaxis must be considered carefully for this age group.
Growth Regulation of Thyroid and Thyroid Tumors in Humans
Authors: Goretzki Peter E. , Simon Dietmar , Dotzenrath Cornelia , Schulte Klaus‐Martin , Röher Hans‐Dietrich 
Published: August 2002

AbstractIn a study of growth regulation of the human thyroid gland and thyroid tumors we investigated the impact of iodine and that of the thyroid‐specific growth‐stimulating hormone TSH. Further studies included locally active growth factors such as the epidermal growth factor, insulin‐like growth factor, and tissue transforming growth factors alpha and beta. In addition to studies of growth regulation by the various growth factors in mostly normal thyrocytes, the impact of tumor‐specific mutations in oncogenes and tumor‐suppressor genes was investigated. The results demonstrated distinct changes in tissue specificity and sensitivity to external stimuli. This rather complex view on thyrocyte growth regulation may be confusing, but it describes the biologic reality more precisely. Increased knowledge of the regulatory processes may lead to the development of new tumor‐ and patient‐specific therapeutic approaches, especially for preventing benign goiter recurrence and for treating follicular and papillary thyroid cancers.
Thyroid Nodules: Rational Management
Authors: Wong Christopher K.M. , Wheeler Malcolm H. 
Published: August 2002

AbstractThyroid nodules are the commonest disorder presenting to the endocrine surgeon. Most of the lesions are benign, but the principal problem facing the clinician is that of identifying the malignant nodule requiring surgery. Current diagnostic methods are reviewed, and the role of intraoperative frozen section in particular is examined in a series of 155 patients undergoing thyroidectomy for solitary thyroid nodule. It is concluded that when the fine‐needle aspiration cytology (FNA) result is malignant intraoperative frozen section is unnecessary and contributes little to the management. Frozen section, however, is considered to be of value when the FNA result is reported as benign, suspicious, or inadequate. It permits identification of many malignant lesions that would otherwise require a second operation to complete a total thyroidectomy. Details of the indications for surgery and the operative strategy are discussed.
Molecular Analysis of Mechanisms Regulating Drug Sensitivity and the Development of New Chemotherapy Strategies for Genitourinary Carcinomas
Authors: Naito Seiji , Koga Hirofumi , Yokomizo Akira , Sakamoto Naotaka , Kotoh Shuji , Nakashima Michitaka , Kiue Akira , Kuwano Michihiko 
Published: August 2002

AbstractThe emergence of drug‐resistant tumors during treatment remains one of the major obstacles in cancer chemotherapy. Overexpression of P‐glycoprotein encoded by the multidrug resistance 1 (MDR1) gene or multidrug resistance‐associated protein (MRP) (or both) and decreased expression of DNA topoisomerase II are responsible for expression of the multidrug resistance (MDR) phenotype. The expression of P‐glycoprotein is also often observed in untreated cancers showing spontaneous MDR, such as renal cell carcinoma. Regarding cisplatin resistance, decreased cisplatin accumulation, an increase in cisplatin detoxification by glutathione‐related enzymes or metallothionein (or both), and increased repair of DNA damage are all considered to play an important role. The combination of reversal agents targeting such drug resistance markers may be a way to improve the outcome of chemotherapy. Regarding the presently available reversal agents, however, clinically relevant chemosensitizing doses cannot be given to humans without inducing significant toxicity. The development of new agents that reverse drug resistance without causing significant toxicity and their clinical application based on the mechanisms regulating drug sensitivity may therefore be a potentially effective new treatment strategy for genitourinary carcinomas.
Bedside Percutaneous Tracheostomy: Clinical Comparison of Griggs and Fantoni Techniques
Authors: Byhahn Christian , Wilke Hans‐Joachim , Lischke Volker , Rinne Thorsten , Westphal Klaus 
Published: August 2002

Abstract.Elective tracheostomy is widely considered the preferred airway management of patients on long‐term ventilation. In addition to open tracheostomy, a number of percutaneous procedures have been introduced during the last two decades, among them techniques according to Griggs (guidewire dilating forceps, or GWDF) and to Fantoni (translaryngeal tracheostomy, or TLT). The aim of the study was to evaluate these two techniques in terms of perioperative complications, risks, and benefits in critically ill patients. A series of 100 critically ill adult patients on long‐term ventilation underwent elective percutaneous tracheostomy, either according to the Griggs (n= 50) or Fantoni (n= 50) technique. Tracheostomy was performed under general anesthesia at the patient's bedside. The mean (±SD) operating times were short, 9.2 ± 3.9 minutes (TLT) and 4.8 ± 3.7 minutes (GWDF) on average. Perioperative complications were noted in 4% of patients during either TLT or GWDF and included massive bleeding, mediastinal emphysema, posterior tracheal wall injury, and pretracheal placement of the tracheostomy tube. With regard to oxygenation, pre‐ and postoperative arterial oxygen tension divided by the fraction of inspired oxygen (PaO2/FiO2) ratios did not vary significantly, and no perioperative hypoxia was noted regardless of the technique used. We conclude that both TLT and GWDF represent attractive, safe alternatives to conventional tracheostomy or other percutaneous procedures if carefully performed by experienced physicians and under bronchoscopic control.
Teaching Hospital Perspective of the Quality of Trauma Care in Lagos, Nigeria
Authors: Onwudike Madu , Olaloye Olufemi A. , Oni Olusola O.A. 
Published: August 2002

Abstract.Information including respiratory rate, blood pressure, Glasgow Coma Scale, and anatomic injuries were obtained for all injured patients consecutively admitted to the Lagos University Teaching Hospital (LUTH) during the 9‐month period from September 1995 to May 1996. The data were analyzed using the UK Major Trauma Outcome Study (MTOS) methodology. The Revised Trauma Score (RTS), the Injury Severity Score (ISS), and the Probability of Survival (Ps) were calculated for each patient. In addition, the “M,”“z,” and “w” scores were calculated for blunt injuries. Of the 253 patients (median age 28 years; male/female ratio 4:1) studied, 85% suffered blunt trauma, 75% of which were due to RTA. About 60% of RTA victims were pedestrians. Only 8% of nonpedestrian victims wore protective devices. The mean ISS was 10, the mean RTS 6.98, and the mean Ps 0.96. The “m” statistic for blunt trauma was 0.91, and there were 122 survivors compared to the 163 predicted. The “z” and “w” scores were −18.49 and −24.55, respectively. Altogether, 42.7% of patients with ISS > 15 and 40.7% with RTS < 7.5 died. According to these results, the severity of injuries encountered in Lagos is comparable to those reported from the United Kingdom and the United States, but the death rate is higher.
Pathology and Nomenclature of Human Gastrointestinal Neuroendocrine (Carcinoid) Tumors and Related Lesions
Authors: Klöppel Günter , Heitz Philipp U. , Capella Carlo , Solcia Enrico 
Published: August 2002

AbstractThe pathology and nomenclature of the neuroendocrine cell proliferations in the gut are reviewed. The neoplastic lesions are discussed within the light of a new classification system that attempts to consider the morphologic, functional, and biologic features of the tumors.
Disadvantages of Muscle‐Sparing Thoracotomy in Patients with Lung Cancer
Authors: Sugi Kazuro , Nawata Sumihiko , Kaneda Yoshikazu , Nawata Kouiti , Ueda Kazuhiro , Esato Kensuke 
Published: August 2002

AbstractAt our institute patients with lung cancer had traditionally undergone lobectomy with mediastinal lymph node dissection using a standard posterolateral approach. The considerable morbidity associated with the standard posterolateral thoracotomy led us to investigate an alternative muscle‐sparing approach. A prospective, randomized study of 30 patients with primary lung cancer (stage I or II) was performed to compare the following: operative field size, number of dissected lymph nodes, surgery time, postoperative pain, shoulder range of motion, and pulmonary function test results between patients who underwent either standard thoracotomy (SP group, n = 15) or the muscle‐sparing thoracotomy (MS group, n = 15). The procedure should provide enough operative field size to access the mediastinum. Compared with the standard posterior thoracotomy, the muscle‐sparing thoracotomy supplied a smaller operative field (218 ± 31 versus 165 ± 41 cm2) and required more surgery time (87 ± 13 minutes) than the standard posterior thoracotomy (66 ± 12 minutes). There were no significant differences in the number of dissected mediastinal lymph nodes. During the early postoperative days, pain and restriction of shoulder flexion were significantly less in the MS group than in the SP group. There were no significant differences in pulmonary function between the two groups. In terms of the operative field there is a marked disadvantage with the muscle‐sparing incision compared with standard thoracotomy. The operative field is significantly smaller than with a standard thoracotomy, requiring more time to dissect the mediastinum; however, the pain is less and shoulder range of motion is superior to what is seen after standard thoracotomy during the early postoperative period. We conclude that there is no overall advantage to using the muscle‐sparing incision in patients with lung cancer.
Clinical Spectrum and Outcome of Functional Extraadrenal Paraganglioma
Authors: O’Riordain Diarmuid S. , Young William F. , Grant Clive S. , Carney J. Aidan , van Heerden Jon A. 
Published: August 2002

AbstractFunctioning extraadrenal paragangliomas represent more than 10% of all pheochromocytomas, occur at diverse anatomic locations, and are said to have a higher malignancy rate than intraadrenal pheochromocytomas. Sixty‐six patients had surgery for catecholamine‐producing paragangliomas between 1952 and 1992. Median follow‐up was 8.8 years. Median age was 40 years (11–67 years); the male/female ratio was 29:37. Familial disease occurred in 9 patients (13.6%), and 10 patients (15.2%) also developed adrenal pheochromocytoma. Solitary paragangliomas occurred in 52 patients: 46 abdominal, 4 thoracic, and 2 head and neck. Fifty‐three tumors developed in 14 patients with multiple paragangliomas: 38 abdominal and 15 thoracic. Of 28 patients with solitary tumors undergoing localization studies over the past 10 years accurate localization was achieved in 27. There was one operative death; 15 patients had persistent disease; and 50 were cured postoperatively. Of those cured, nine developed recurrence, disease‐free survival being 86%, 80%, and 80% at 5, 10, and 20 years. Metastatic disease was found in 14 patients (21%), 7 of whom have died. An additional 10 patients (15%) had locally invasive disease, of whom 4 have died. Cause‐specific survivals at 5, 10, and 20 years were 90%, 83%, and 72%. Risk factors for death from pheochromocytoma were tumor size > 5 cm (p= 0.0002), metastatic disease (p= 0.001), and tumor invasion (p= 0.0023). Cause‐specific survival for patients with tumors > 5 cm was 59% at 15 years compared to 100% among patients with tumors ≤ 5 cm (p= 0.0003). Functional paragangliomas are frequently malignant and are associated with a high incidence of persistent or recurrent disease. Tumor size > 5 cm and the occurrence of invasive or metastatic disease are strong predictors of outcome. Most tumors are abdominal, and imaging is highly successful for localization.