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DerChirurg.80690846.eng.abstr
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DerChirurg.80690846.eng.abstr
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"Between September 1992 and May 1997 in the Department of Surgery at the Medical University of Luebeck 240 colorectal procedures were performed by laparoscopic techniques . Fifty-seven patients underwent laparoscopic colectomy for diverticulitis . In 52 cases sigmoid resections were performed laparoscopically , including 4 cases with simultaneous laparoscopic rectopexy . Anterior resections were necessary in 3 patients , whereas 2 patients with extended localization of diverticula required left hemicolectomies . Using atraumatic instruments and an ultrasound dissector , laparoscopic resection involved tubular dissection and preperitoneal anastomosis . The mean operative time was 234 min . In 8 cases ( 14 % ) conversion to an open procedure was necessary . Complications occurred in 6 patients ( 10.5 % ) . One patient died because of an anastomotic leakage . In conclusion , with increasing experience laparoscopic resection for diverticulitis can be performed without additional morbidity in comparison to open colectomy . In particular , the benefits of the minimally invasive method are quicker reconvalescence with reduced postoperative pain and improved cosmesis ."
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DerChirurg.80690854.eng.abstr
|
DerChirurg.80690854.eng.abstr
|
[
{
"id": "DerChirurg.80690854.eng.abstr-passage-0",
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"In the present study , for the first time the aspects of risk , benefit and the costs of laparoscopic hernioplasty in the transabdominal technique with preperitoneal placement of a polypropylene mesh are examined prospectively in a very large group of patients with 3,400 hernia repairs . The median operation time was 45 min for unilateral primary hernias , 50 min for unilateral recurrent hernias and 76 min for bilateral hernias . The frequency of complications showed a significant dependence on the individual steps in the development of the method and the individual learning curve . The same is true for the rate of recurrency . Whereas initially the rate of serious complications was 2.75 % , the rate of minor complications 11 % and the rate of recurrences 4.5 % the corresponding figures are at present 0.4 % , 4.4 % and 0.5 % . Laparoscopic hernioplasty proved to be equally as effective in the treatment of primary hernias , recurrent hernias and bilateral hernias . The large number of 11 surgeons participating proves that laparoscopic hernioplasty can be learned and that even in a teaching hospital it can be performed safely , efficiently and cost-effectively ."
],
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0,
1178
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}
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] |
[] |
[] |
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DerChirurg.80690866.eng.abstr
|
DerChirurg.80690866.eng.abstr
|
[
{
"id": "DerChirurg.80690866.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Between 1990 and 1995 , 27 patients with posttraumatic disorders of the subtalar joint were treated by correcting fusion . Preoperatively 24 patients ( 88.89 % ) suffered from pain ; 15 ( 55.56 % ) had a walking range below 100 m . Seven patients were unable to work in their original profession . After an average period of 13.85 months postoperatively the patients were examined again . At this time 18 ( 66.67 % ) had no or minimal pain ; 19 ( 70.37 % ) had no claudication . According to the score of Angus and Skuginna , in 81.48 % of patients the result of the correcting arthrodesis was successful ; according to Kitaoka's clinical rating system for ankle-hindfoot , midfoot , hallux and lesser toes , the average postoperative score was 75.8 points ."
],
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[
0,
758
]
]
}
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{
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},
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}
]
},
{
"id": "DerChirurg.80690866.eng.abstr-s6-t3",
"type": "umlsterm",
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657,
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{
"id": "DerChirurg.80690866.eng.abstr-s6-t4",
"type": "umlsterm",
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657,
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},
{
"id": "DerChirurg.80690866.eng.abstr-s6-t5",
"type": "umlsterm",
"text": [
"hallux"
],
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684,
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},
{
"id": "DerChirurg.80690866.eng.abstr-s6-t6",
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},
{
"id": "DerChirurg.80690866.eng.abstr-s6-t7",
"type": "umlsterm",
"text": [
"postoperative"
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{
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"db_id": "C0032790"
}
]
}
] |
[] |
[] |
[
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},
{
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},
{
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"type": "issue_in",
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},
{
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},
{
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},
{
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},
{
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},
{
"id": "DerChirurg.80690866.eng.abstr-s6-r6-t2.2-t1.1",
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},
{
"id": "DerChirurg.80690866.eng.abstr-s6-r7-t5.1-t3.1",
"type": "adjacent_to",
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},
{
"id": "DerChirurg.80690866.eng.abstr-s6-r8-t5.1-t2.2",
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},
{
"id": "DerChirurg.80690866.eng.abstr-s6-r9-t4.1-t2.1",
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},
{
"id": "DerChirurg.80690866.eng.abstr-s6-r10-t3.1-t5.1",
"type": "adjacent_to",
"arg1_id": "DerChirurg.80690866.eng.abstr-s6-t3",
"arg2_id": "DerChirurg.80690866.eng.abstr-s6-t5",
"normalized": []
},
{
"id": "DerChirurg.80690866.eng.abstr-s6-r12-t6.1-t2.2",
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},
{
"id": "DerChirurg.80690866.eng.abstr-s6-r13-t1.1-t2.1",
"type": "performs",
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"normalized": []
},
{
"id": "DerChirurg.80690866.eng.abstr-s6-r14-t5.1-t2.1",
"type": "location_of",
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"arg2_id": "DerChirurg.80690866.eng.abstr-s6-t2",
"normalized": []
},
{
"id": "DerChirurg.80690866.eng.abstr-s6-r15-t4.1-t5.1",
"type": "adjacent_to",
"arg1_id": "DerChirurg.80690866.eng.abstr-s6-t4",
"arg2_id": "DerChirurg.80690866.eng.abstr-s6-t5",
"normalized": []
},
{
"id": "DerChirurg.80690866.eng.abstr-s6-r16-t5.1-t6.1",
"type": "adjacent_to",
"arg1_id": "DerChirurg.80690866.eng.abstr-s6-t5",
"arg2_id": "DerChirurg.80690866.eng.abstr-s6-t6",
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},
{
"id": "DerChirurg.80690866.eng.abstr-s6-r17-t6.1-t2.1",
"type": "location_of",
"arg1_id": "DerChirurg.80690866.eng.abstr-s6-t6",
"arg2_id": "DerChirurg.80690866.eng.abstr-s6-t2",
"normalized": []
},
{
"id": "DerChirurg.80690866.eng.abstr-s6-r18-t2.1-t1.1",
"type": "affects",
"arg1_id": "DerChirurg.80690866.eng.abstr-s6-t2",
"arg2_id": "DerChirurg.80690866.eng.abstr-s6-t1",
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},
{
"id": "DerChirurg.80690866.eng.abstr-s6-r19-t3.1-t2.2",
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"arg2_id": "DerChirurg.80690866.eng.abstr-s6-t2",
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}
] |
DerChirurg.80690872.eng.abstr
|
DerChirurg.80690872.eng.abstr
|
[
{
"id": "DerChirurg.80690872.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Vascular infections after percutaneous endovascular procedures are rare . We report a case of bacterial arteritis following PTA and stent implantation into an iliac artery . It was complicated by septic embolization , ipsilateral empyema of the knee joint and formation of an infected false aneurysm . Contamination of the stent with Staphylococcus aureus is likely to be the cause . The treatment included resection of the infected arterial segment , removal of the stent , and autologous reconstruction ."
],
"offsets": [
[
0,
506
]
]
}
] |
[
{
"id": "DerChirurg.80690872.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"infections"
],
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9,
19
]
],
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] |
DerChirurg.80690877.eng.abstr
|
DerChirurg.80690877.eng.abstr
|
[
{
"id": "DerChirurg.80690877.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Haemosuccus pancreaticus is an unfrequent but known cause of an upper gastrointestinal bleeding . Pathogenesis of spontaneous severe hemorrhage of the pancreatic duct includes chronic pancreatitis generated pseudocysts or aneurysms of the visceral arteries . We present two cases of severe spontaneous gastrointestinal bleeding as a first manifestation of chronic pancreatitis , in which the diagnosis chronic pancreatitis was not known and the patients denied any gastrointestinal symptoms in their medical history at the time of hemorrhage ."
],
"offsets": [
[
0,
543
]
]
}
] |
[
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],
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12,
24
]
],
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{
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{
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{
"id": "DerChirurg.80690877.eng.abstr-s2-t1",
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"Pathogenesis"
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{
"id": "DerChirurg.80690877.eng.abstr-s2-t2",
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"pancreatic"
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{
"id": "DerChirurg.80690877.eng.abstr-s2-t4",
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184,
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{
"id": "DerChirurg.80690877.eng.abstr-s2-t5",
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"id": "DerChirurg.80690877.eng.abstr-s2-t6",
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{
"id": "DerChirurg.80690877.eng.abstr-s2-t7",
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"pancreatic duct"
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[
151,
166
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],
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{
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"db_id": "C0030288"
}
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},
{
"id": "DerChirurg.80690877.eng.abstr-s3-t1",
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"id": "DerChirurg.80690877.eng.abstr-s3-t2",
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},
{
"id": "DerChirurg.80690877.eng.abstr-s3-t3",
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"id": "DerChirurg.80690877.eng.abstr-s3-t6",
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"id": "DerChirurg.80690877.eng.abstr-s3-t8",
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{
"id": "DerChirurg.80690877.eng.abstr-s3-t9",
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{
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]
}
] |
[] |
[] |
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] |
DerChirurg.80690880.eng.abstr
|
DerChirurg.80690880.eng.abstr
|
[
{
"id": "DerChirurg.80690880.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Emergency treatment of bleeding ulcer of the duodenum is endoscopy and endoscopic bloodstaunching . In high-risk patients with Forrest I a lesions or ulcers with visible vessel ( Forrest II a ) endoscopic follow-up or early elective operation is required . Fibrin sealing can improve the results of endoscopic injection therapy for bleeding ulcer . Nevertheless , severe complications such as secondary perforation of the fibrin clot or recurrent bleeding can occur . Identification of high-risk patients and complications requires close monitoring and attention . A case of a secondary perforation of a bleeding ulcer of the duodenum after fibrin sealing is reported ."
],
"offsets": [
[
0,
669
]
]
}
] |
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[] |
[] |
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}
] |
DerChirurg.80690883.eng.abstr
|
DerChirurg.80690883.eng.abstr
|
[
{
"id": "DerChirurg.80690883.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Non-traumatic duodenocaval fistulae are rare , but may be the source of massive gastrointestional bleeding with associated fever and sepsis . These fistulae result from penetrating duodenal peptic ulcers or right nephrectomy and subsequent radiation to the upper abdomen . The outcome depends on early diagnosis and surgery before a potentially fatal hemorrhage occurs . The therapy of choice includes closure of the fistula and repair of the duodenum and inferior vena cava . We describe the seventh case with radiogenic duodenal ulcer . Gastrointestinal bleeding occurred 10 years after radical nephrectomy and radiation ( 60 Gy ) . The patient survived following partial pancreatoduodenectomy ( Whipple ) ."
],
"offsets": [
[
0,
709
]
]
}
] |
[
{
"id": "DerChirurg.80690883.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"fistulae"
],
"offsets": [
[
27,
35
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0016169"
}
]
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DerChirurg.80690908.eng.abstr
|
DerChirurg.80690908.eng.abstr
|
[
{
"id": "DerChirurg.80690908.eng.abstr-passage-0",
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"Drug treatment does not play a significant role either in the maintenance of remission induced by drugs or surgery in Crohn's disease . Considering the data available , it is reasonable that after resection of involved bowel segments an attempt is made to avoid relapses using a suitable 5-ASA preparation . This remains an individual decision following explanation of the pros and cons of the treatment to the patient . The application of immunosuppressants such as azathioprine or 6-mercaptopurine is probably more effective but hampered by a higher rate of side effects . This approach is therefore not to be generally recommended at this time . New approaches such as antibodies against tumor necrosis factor are of interest but can also currently not be recommended for practical treatment . In conclusion , at this time no drug can be recommended for remission maintenance which is safe and effective . The use of the different possibilities described remains at the discretion of the treating physician depending on the individual situation ( localization of disease , extent of operative intervention and history regarding relapses ) . Only a better understanding of etiology and pathogenesis and possible subtyping of patients with Crohn's disease can lead to better and more effective measures of remission maintenance ."
],
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0,
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]
}
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] |
[] |
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DerChirurg.80690915.eng.abstr
|
DerChirurg.80690915.eng.abstr
|
[
{
"id": "DerChirurg.80690915.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Patients with Crohn's disease are operated on with a morbidity of 15 % and a mortality of 0 % if the indication for surgery is decided in good time . After ileocecal resection the probability of having a second resection in 15-20 years is about 50 % . When elective surgery is done at an early disease stage , ileocecal resections and reoperations for anastomotic stenosis can be performed by assisted laparoscopy assisted . Laparoscopic colonic resections are done more rarely . Acute and life-threatening conditions such as obstruction , perforation and sepsis are excluded from the laparoscopic approach . In a combined series of 222 laparoscopic resections for Crohn's disease , the following types of surgery were included : ileocecal resections ( 75 ) , anastomotic resections ( 26 ) , small intestinal resections ( 4 ) , loop ileostomies ( 17 ) , gastrojejunostomies ( 3 ) , partial colonic resections ( 15 ) , colectomies ( 16 ) , loop colostomies ( 2 ) and one adhesiolysis . Two patients who sustained intraoperative bleeding underwent conversion of laparotomy . The conversion rate ranged from 0 to 22 % . Reasons for 32 conversions were : large inflammatory mass ( 14 ) , severe inflammation ( 5 ) , fistula ( 3 ) , abscess ( 1 ) , perforation ( 1 ) , small intestine dilation ( 1 ) and mesenteric thickening ( 1 ) . Mean operative time for ileocecal resections ranged from 105 to 200 min . The postoperative hospital stay was 5 to 8 days . As more experience is gained and technical improvement is achieved , additional procedures such as resolution of severe adhesions , fistula closure and resections of colonic segments will be offered to the majority of patients who require elective surgery for localized Crohn's disease ."
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] |
[] |
[] |
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DerChirurg.80690924.eng.abstr
|
DerChirurg.80690924.eng.abstr
|
[
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"id": "DerChirurg.80690924.eng.abstr-passage-0",
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"text": [
"Aseptic operations as well as operations on infected sites can be done in the same operating room . Two or more theatres can share common facilities such as X-ray equipment , scrub-up or anaesthesia areas . Sophisticated air locks with double doors , which separate the protective zone from the operating room are not necessary to maintain a good hygienic standard . Nevertheless the new requirements for theatre design by the German \" Gesetzliche Unfallversicherungen \" are much higher . In this commentary we try to summarize scientific evidence regarding design of a theatre and infection control ."
],
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0,
601
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]
}
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] |
[] |
[] |
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DerChirurg.80690930.eng.abstr
|
DerChirurg.80690930.eng.abstr
|
[
{
"id": "DerChirurg.80690930.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Laser-induced thermotherapy is an in situ ablation method for the local treatment of liver tumors . The basic prerequisite for induction of adequate treatment volumes for clinical use was the development of a thermostable application system . In an ex vivo test series , the specially developed application system ( diffuser tip ) with 5760 J had a higher thermic loading capacity than the Ringmode applicator with 4200 J , thus enabling the induction of significantly larger lesions with a volume of 7.6 cm3. The results of a further in vivo test series demonstrated that the lesions were subject to a four-phase connective-tissue organization within a 6-month period . Furthermore , the same laser energy ( 4200 J ) was associated with a significantly lower lesion volume of 2.5 cm3 in the in vivo than in the ex vivo test series . The influence of liver perfusion on the inducible lesion volume was examined in a further animal experimental study . By temporarily interrupting hepatic blood perfusion ( Pringle's maneuver ) during laser application , the effective volume could be increased to 50.3 cm3 ( P 0.01 ) using an optical beam splitter . These results show that the technical prerequisites for reliable clinical application of laser-induced thermotherapy have been fulfilled ."
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0,
1288
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}
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] |
[] |
[] |
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] |
DerChirurg.80690947.eng.abstr
|
DerChirurg.80690947.eng.abstr
|
[
{
"id": "DerChirurg.80690947.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Purpose : During the last few years there has been an increasing interest in evaluating quality of life ( QOL ) data regarding surgical treatment . Methods : The present study comments the efficacy of laparoscopic antireflux surgery after required Nissen fundoplication of 70 patients . Therefore , the German Gastrointestinal Quality of Life Index ( GIQLI ) was used to query the patients preoperatively and three times after surgery up to 1 year . Results : Preoperatively , we found a low general GIQLI score ( mean 92.7 points ) , which increased 6 weeks postoperatively ( 116.8 points ) , 3 months ( 124.8 ) and 1 year ( mean 123.9 points ) significantly and is now comparable to the healthy population ( 122.6 points ) . Conclusion : It is our opinion that the efficacy of the treatment of gastroesophageal reflux disease with required Nissen fundoplication can also be documented and discussed by using QOL ."
],
"offsets": [
[
0,
915
]
]
}
] |
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] |
[] |
[] |
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DerChirurg.80690951.eng.abstr
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DerChirurg.80690951.eng.abstr
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"In the period of 1 January 1990 to 31 December 1996 the thyroidectomy cases we performed were immediately followed by vocal cord evaluation using a flexible bronchoscope while the patient was still on the operating table . If an obvious cord paralysis was discovered , an exploration of the recurrent laryngeal nerve , to the level of the larynx , was performed . If the nerve was found to be intact , no further measures were taken . A severed nerve underwent suture repair . If an otolaryngologist diagnosed a vocal cord paralysis 1-5 days after surgery , a reoperation was recommended except in the cases where postoperative bronchoscopy had shown an easily mobile cord or the recurrent nerve was completely dissected during the operation . Within this 7-year period , we performed 3492 thyroidectomy operations . The diagnosis of subsequent unilateral postoperative vocal cord paralysis occurred in 48 cases . In 33 of these cases the status of the nerve in the surgical field was known : 4 patients had an intact nerve proved by complete dissection during thyroidectomy , in two patients the lesions of the nerve were detected intraoperatively ( 1 transsection , 1 partial resection ) , and 27 cases were followed by reoperation . Of the 33 patients mentioned above , in 19 instances the recurrent laryngeal nerve was found to be intact ; 3 displayed signs of local trauma , and 11 were found to be severed with total discontinuity . Those patients with an intact nerve , or local nerve trauma only , went on to develop normal function within 6 months in 20 ( 91 % ) of 22 cases . Of the 11 with a severed nerve , 8 showed \" autoparalysis \" with good voice within 4-8 months , after suture repair in 10 cases . The patient with partial resection had no repair of the nerve . If immediate postoperative evaluation showed mobility of the vocal cords but a paralysis was detected later by an otolaryngologist and repeat intervention was not done , vocal cord function was spontaneously restored in 9 of 11 patients . Four patients refused reoperation . From 1990 to 1991 , the recurrent laryngeal nerve was not always dissected during our thyroidectomy operations . However , this was done routinely from 1991 to 1996. Routine intraoperative dissection of the vocal cord nerve reduced the rate of postoperative cord paralysis from 2.0 % to 1.2 % . It also reduced the frequency of intraoperative nerve injury with total discontinuity from 0.58 % to 0.23 % ."
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[] |
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DerChirurg.80690957.eng.abstr
|
DerChirurg.80690957.eng.abstr
|
[
{
"id": "DerChirurg.80690957.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The objective of this retrospective analysis was the evaluation of direct/medical costs of immunosuppressive treatment with tacrolimus ( FK 506 ) and cyclosporin A in liver transplantation . The analysis was based on data from the german centers of a pan-European clinical trial where all given drugs as well as all serious events , graft reactions and the number of transplantations were documented . The costs of the treatment with tacrolimus were DM 158,276 per patient ; those for cyclosporin A were DM 176,392 . The main reason for the difference was the amount and types of drugs administered . The direct costs per surviving patient were in the tacrolimus group DM 192,314 ( 20 of 113 patients ) and in the cyclosporin A group DM 227,669 ( 25 of 111 patients ) . The cost-effectiveness ratio for tacrolimus is about 15.5 % better than for cyclosporin A."
],
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[
0,
860
]
]
}
] |
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] |
DerChirurg.80690963.eng.abstr
|
DerChirurg.80690963.eng.abstr
|
[
{
"id": "DerChirurg.80690963.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Anomalies of the inferior vena cava result from failures of regression during embryogenesis . Although occurring relatively infrequently , they can pose serious hazards to the surgeon during aortic aneurysm repair . Based on 2 recent cases , embryologic origins , incidence and clinical presentation of these anomalies are discussed . Different suggestions are proposed that might aid the surgeon in dealing with these anomalous structures during operations on the abdominal aorta ."
],
"offsets": [
[
0,
482
]
]
}
] |
[
{
"id": "DerChirurg.80690963.eng.abstr-s1-t1",
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"text": [
"Anomalies"
],
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[
0,
9
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0000769"
}
]
},
{
"id": "DerChirurg.80690963.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"cava"
],
"offsets": [
[
31,
35
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0521083"
}
]
},
{
"id": "DerChirurg.80690963.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"regression"
],
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[
60,
70
]
],
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{
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"db_id": "C0034979"
}
]
},
{
"id": "DerChirurg.80690963.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"embryogenesis"
],
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[
78,
91
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0018272"
}
]
},
{
"id": "DerChirurg.80690963.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"embryogenesis"
],
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[
78,
91
]
],
"normalized": [
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}
]
},
{
"id": "DerChirurg.80690963.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"vena cava"
],
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[
26,
35
]
],
"normalized": [
{
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"db_id": "C0042460"
}
]
},
{
"id": "DerChirurg.80690963.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"inferior vena cava"
],
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[
17,
35
]
],
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{
"db_name": "UMLS",
"db_id": "C0042458"
}
]
},
{
"id": "DerChirurg.80690963.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"aneurysm"
],
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198,
206
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],
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]
},
{
"id": "DerChirurg.80690963.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"repair"
],
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[
207,
213
]
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{
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"db_id": "C0043240"
}
]
},
{
"id": "DerChirurg.80690963.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"aortic aneurysm"
],
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[
191,
206
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0003486"
}
]
},
{
"id": "DerChirurg.80690963.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"embryologic"
],
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[
242,
253
]
],
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{
"db_name": "UMLS",
"db_id": "C0013943"
}
]
},
{
"id": "DerChirurg.80690963.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"origins"
],
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254,
261
]
],
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{
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"db_id": "C0079946"
}
]
},
{
"id": "DerChirurg.80690963.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"incidence"
],
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264,
273
]
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{
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"db_id": "C0220856"
},
{
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}
]
},
{
"id": "DerChirurg.80690963.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"anomalies"
],
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[
309,
318
]
],
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"db_id": "C0000769"
}
]
},
{
"id": "DerChirurg.80690963.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"suggestions"
],
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345,
356
]
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"db_id": "C0038659"
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]
},
{
"id": "DerChirurg.80690963.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"operations"
],
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[
447,
457
]
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{
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]
},
{
"id": "DerChirurg.80690963.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
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],
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},
{
"id": "DerChirurg.80690963.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
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],
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]
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"normalized": [
{
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"db_id": "C0003484"
}
]
}
] |
[] |
[] |
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DerChirurg.80690973.eng.abstr
|
DerChirurg.80690973.eng.abstr
|
[
{
"id": "DerChirurg.80690973.eng.abstr-passage-0",
"type": "abstract",
"text": [
"14 human femurs were scanned by CAT and 3D reconstructed . In every specimen digital documentation of CCD and antetorsion ( AT ) angle was performed . With a special software package ( Orthodoc ) virtual preoperative planning for implantation of a cementless total hip alloplasty was undertaken . The specimens were randomised into two groups , one of which had manual and the other one robot implantation of the femoral component . After implantation all specimens were evaluated again by CAT and CCT and AT angle were documented again . The preoperative CCD angle was 126.7 ° ( SD = 4.0 ) in the manual group and 127.8 ° ( SD = 4.3 ) in the robodoc group . Postoperatively the angle averaged 131.9 ° ( SD = 0.8 ) in the manual group and 133.2 ° ( SD = 1.9 ) in the robodoc group . Significant differences were found for the AT angle in both groups . The preoperative AT angle in the manual group was 31.3 ° ( SD = 8.8 ) , decreasing to 20.5 ° ( SD = 9.5 ) after implantation . In the robodoc group this angle was 30.9 ° ( SD = 8.0 ) before and 31.3 ° ( SD = 8.7 ) after implantation . The difference between pre- and postoperative AT angle averaged 10.8 ° ( SD = 6.4 ) in the manual group and only 0.4 ° ( SD = 0.9 ) in the robodoc-group . Conclusion : With the technique used , preoperative planning in hip alloarthroplasty is much more accurate than with the conventional technique with plain X-ray . The virtual preoperative planning can be transferred to the intraoperative setting with high precision . These factors may lead to an increase in outcome quality ."
],
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0,
1568
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] |
[] |
[] |
[
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"type": "interacts_with",
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},
{
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},
{
"id": "DerChirurg.80690973.eng.abstr-s1-r3-t1.1-t3.2",
"type": "interacts_with",
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"arg2_id": "DerChirurg.80690973.eng.abstr-s1-t3",
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},
{
"id": "DerChirurg.80690973.eng.abstr-s1-r4-t1.1-t3.1",
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"arg2_id": "DerChirurg.80690973.eng.abstr-s12-t3",
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},
{
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"type": "result_of",
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"arg2_id": "DerChirurg.80690973.eng.abstr-s12-t2",
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},
{
"id": "DerChirurg.80690973.eng.abstr-s3-r2-t4.1-t2.1",
"type": "location_of",
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"arg2_id": "DerChirurg.80690973.eng.abstr-s12-t2",
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},
{
"id": "DerChirurg.80690973.eng.abstr-s5-r1-t2.1-t1.1",
"type": "measures",
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},
{
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"type": "affects",
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},
{
"id": "DerChirurg.80690973.eng.abstr-s12-r1-t4.1-t2.1",
"type": "measures",
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"arg2_id": "DerChirurg.80690973.eng.abstr-s12-t2",
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},
{
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{
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},
{
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},
{
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}
] |
DerChirurg.80690977.eng.abstr
|
DerChirurg.80690977.eng.abstr
|
[
{
"id": "DerChirurg.80690977.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The iliac artery-ureteral fistula is a rare complication which becomes symptomatic with life-endangering bleeding . A typical feature is its intermittent occlusion , which makes diagnosis very difficult . Without knowledge of the correct diagnosis the rate of morbidity , through functional loss of the kidneys , and of mortality can be extremely high . In the following a case is described in which , after radiotherapy and chemotherapy following sigmoid resection due to carcinoma , urinary congestion of the remaining functional kidney occurred during the course of treatment . Following the placing of an endoureteral stent an iliac-ureteral fistula with massive bleeding developed . It was demonstrated by means of angiography . For the first time , therapy with endoluminal stent grafts was successfully applied ."
],
"offsets": [
[
0,
819
]
]
}
] |
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"id": "DerChirurg.80690977.eng.abstr-s1-t2",
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[] |
[] |
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] |
DerChirurg.80690981.eng.abstr
|
DerChirurg.80690981.eng.abstr
|
[
{
"id": "DerChirurg.80690981.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A granular cell tumor is one of the rare tumors of the esophagus . We present the case of a 65-year-old male patient , who was admitted to our hospital for an elective cholecystectomy . In the routine diagnostic gastroscopy an intramural tumor in the distal esophagus was incidentally found . Repeated endoscopic biopsies did not reveal the histologic diagnosis , although endoscopic ultrasound invasion to the tunica muscularis could not be excluded . After indicating the operative therapy , the tumor was removed through a thoracoscopic approach . The histologic specimen showed a granular cell tumor of the esophagus ( tumor of Abrikossoff ) . Since the tumor grade was unknown , our therapy seemed to be justified because of the low risk involved in minimally invasive operative procedures . There has been much discussion and controversy in the literature on this subject , including the potential for malignancy and the correct therapy regime , with a general shift to conservative or minimally invasive treatment . The case is discussed with a review of the literature ."
],
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]
}
] |
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] |
DerChirurg.80690985.eng.abstr
|
DerChirurg.80690985.eng.abstr
|
[
{
"id": "DerChirurg.80690985.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Post-traumatic pyogenic liver abscess is a rare disease . We present the case of a 38-year-old man with multilocular liver abscess and pleural empyema following blunt abdominal trauma . The patient had a prodrome lasting 3 months before presenting in our department . The therapy included partial hepatectomy and pleural drainage . Clinical signs , diagnosis and possible therapy are discussed in this case report ."
],
"offsets": [
[
0,
415
]
]
}
] |
[
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29
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}
]
},
{
"id": "DerChirurg.80690985.eng.abstr-s1-t2",
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"abscess"
],
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30,
37
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"id": "DerChirurg.80690985.eng.abstr-s2-r106-t1.2-t2.1",
"type": "location_of",
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"arg2_id": "DerChirurg.80690985.eng.abstr-s5-t2",
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},
{
"id": "DerChirurg.80690985.eng.abstr-s2-r107-t4.1-t1.2",
"type": "associated_with",
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},
{
"id": "DerChirurg.80690985.eng.abstr-s2-r108-t3.1-t2.1",
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},
{
"id": "DerChirurg.80690985.eng.abstr-s4-r1-t3.1-t4.1",
"type": "associated_with",
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},
{
"id": "DerChirurg.80690985.eng.abstr-s4-r2-t3.1-t1.1",
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},
{
"id": "DerChirurg.80690985.eng.abstr-s5-r1-t3.1-t1.1",
"type": "treats",
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},
{
"id": "DerChirurg.80690985.eng.abstr-s5-r2-t1.1-t3.1",
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},
{
"id": "DerChirurg.80690985.eng.abstr-s5-r3-t4.1-t1.1",
"type": "conceptual_part_of",
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"arg2_id": "DerChirurg.80690985.eng.abstr-s5-t1",
"normalized": []
}
] |
DerChirurg.80691013.eng.abstr
|
DerChirurg.80691013.eng.abstr
|
[
{
"id": "DerChirurg.80691013.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Stool frequency after ileal pouch-anal anastomosis ( IPAA ) is about 5/day after adaptation during the first year . It depends on stool volume and pouch capacity , not on the design of the pouch . In most cases evacuation is spontaneous and as complete as in healthy rectum . 67 % of patients are perfectly continent , while 19 % have to wear pads due to intermittent leakage . Complete incontinence is reported in 0-4 % of the patients . Preservation of the anal transitional zone by the double-stapling technique does not improve functional results when compared to endoanal mucosectomy or intersphincteric resection . Impairment of continence is caused by damage of the internal sphincter with consecutive decrease of the pouch-anal pressure gradient . Despite altered reflex activity , stool discrimination is preserved in most patients . The loss of colonic water and electrolyte absorption is compensated by decreased renal excretion . Alterations in bile acid metabolism are lower after IPAA than after ileostomy . Bacterial overgrowth may lead to deterioration of the functional results ."
],
"offsets": [
[
0,
1096
]
]
}
] |
[
{
"id": "DerChirurg.80691013.eng.abstr-s1-t1",
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"Stool"
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0,
5
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}
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},
{
"id": "DerChirurg.80691013.eng.abstr-s1-t2",
"type": "umlsterm",
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"frequency"
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6,
15
]
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}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s1-t3",
"type": "umlsterm",
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"adaptation"
],
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81,
91
]
],
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"db_id": "C0000934"
}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"stool"
],
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[
130,
135
]
],
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}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"rectum"
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267,
273
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}
]
},
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"id": "DerChirurg.80691013.eng.abstr-s4-t1",
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"patients"
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284,
292
]
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"db_id": "C0030705"
}
]
},
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"id": "DerChirurg.80691013.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"patients"
],
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[
428,
436
]
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}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s6-t1",
"type": "umlsterm",
"text": [
"technique"
],
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[
505,
514
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"db_name": "UMLS",
"db_id": "C0025664"
}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s7-t1",
"type": "umlsterm",
"text": [
"pressure"
],
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[
736,
744
]
],
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"db_name": "UMLS",
"db_id": "C0033095"
}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s8-t1",
"type": "umlsterm",
"text": [
"reflex"
],
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[
772,
778
]
],
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"db_name": "UMLS",
"db_id": "C0034929"
}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s8-t2",
"type": "umlsterm",
"text": [
"stool"
],
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[
790,
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"db_id": "C0015733"
}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s8-t3",
"type": "umlsterm",
"text": [
"discrimination"
],
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796,
810
]
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"db_id": "C0012632"
}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s8-t4",
"type": "umlsterm",
"text": [
"patients"
],
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832,
840
]
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}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s9-t1",
"type": "umlsterm",
"text": [
"water"
],
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[
863,
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]
],
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{
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"db_id": "C0020311"
},
{
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"db_id": "C0043047"
}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s9-t2",
"type": "umlsterm",
"text": [
"electrolyte"
],
"offsets": [
[
873,
884
]
],
"normalized": [
{
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"db_id": "C0013832"
}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s9-t3",
"type": "umlsterm",
"text": [
"absorption"
],
"offsets": [
[
885,
895
]
],
"normalized": [
{
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"db_id": "C0000854"
},
{
"db_name": "UMLS",
"db_id": "C0220777"
}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s10-t1",
"type": "umlsterm",
"text": [
"bile"
],
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[
957,
961
]
],
"normalized": [
{
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"db_id": "C0005388"
}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s10-t2",
"type": "umlsterm",
"text": [
"acid"
],
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[
962,
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]
],
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"db_id": "C0001128"
}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s10-t3",
"type": "umlsterm",
"text": [
"metabolism"
],
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[
967,
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{
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"db_id": "C0025519"
},
{
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"db_id": "C0025520"
}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s10-t4",
"type": "umlsterm",
"text": [
"ileostomy"
],
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[
1010,
1019
]
],
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{
"db_name": "UMLS",
"db_id": "C0020883"
}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s10-t5",
"type": "umlsterm",
"text": [
"bile acid"
],
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[
957,
966
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0005390"
}
]
},
{
"id": "DerChirurg.80691013.eng.abstr-s11-t1",
"type": "umlsterm",
"text": [
"Bacterial"
],
"offsets": [
[
1022,
1031
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0521009"
}
]
}
] |
[] |
[] |
[
{
"id": "DerChirurg.80691013.eng.abstr-s1-r1-t2.1-t1.1",
"type": "produces",
"arg1_id": "DerChirurg.80691013.eng.abstr-s10-t2",
"arg2_id": "DerChirurg.80691013.eng.abstr-s11-t1",
"normalized": []
},
{
"id": "DerChirurg.80691013.eng.abstr-s8-r1-t1.1-t3.1",
"type": "result_of",
"arg1_id": "DerChirurg.80691013.eng.abstr-s11-t1",
"arg2_id": "DerChirurg.80691013.eng.abstr-s10-t3",
"normalized": []
},
{
"id": "DerChirurg.80691013.eng.abstr-s8-r2-t3.1-t2.1",
"type": "produces",
"arg1_id": "DerChirurg.80691013.eng.abstr-s10-t3",
"arg2_id": "DerChirurg.80691013.eng.abstr-s10-t2",
"normalized": []
},
{
"id": "DerChirurg.80691013.eng.abstr-s8-r3-t1.1-t2.1",
"type": "produces",
"arg1_id": "DerChirurg.80691013.eng.abstr-s11-t1",
"arg2_id": "DerChirurg.80691013.eng.abstr-s10-t2",
"normalized": []
},
{
"id": "DerChirurg.80691013.eng.abstr-s8-r4-t3.1-t1.1",
"type": "result_of",
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"arg2_id": "DerChirurg.80691013.eng.abstr-s11-t1",
"normalized": []
},
{
"id": "DerChirurg.80691013.eng.abstr-s9-r1-t1.2-t3.1",
"type": "affects",
"arg1_id": "DerChirurg.80691013.eng.abstr-s9-t1",
"arg2_id": "DerChirurg.80691013.eng.abstr-s10-t3",
"normalized": []
},
{
"id": "DerChirurg.80691013.eng.abstr-s9-r2-t2.1-t3.1",
"type": "affects",
"arg1_id": "DerChirurg.80691013.eng.abstr-s10-t2",
"arg2_id": "DerChirurg.80691013.eng.abstr-s10-t3",
"normalized": []
},
{
"id": "DerChirurg.80691013.eng.abstr-s10-r1-t1.1-t5.1",
"type": "consists_of",
"arg1_id": "DerChirurg.80691013.eng.abstr-s11-t1",
"arg2_id": "DerChirurg.80691013.eng.abstr-s10-t5",
"normalized": []
},
{
"id": "DerChirurg.80691013.eng.abstr-s10-r2-t3.1-t5.1",
"type": "produces",
"arg1_id": "DerChirurg.80691013.eng.abstr-s10-t3",
"arg2_id": "DerChirurg.80691013.eng.abstr-s10-t5",
"normalized": []
},
{
"id": "DerChirurg.80691013.eng.abstr-s10-r3-t2.1-t3.1",
"type": "affects",
"arg1_id": "DerChirurg.80691013.eng.abstr-s10-t2",
"arg2_id": "DerChirurg.80691013.eng.abstr-s10-t3",
"normalized": []
},
{
"id": "DerChirurg.80691013.eng.abstr-s10-r4-t5.1-t2.1",
"type": "interacts_with",
"arg1_id": "DerChirurg.80691013.eng.abstr-s10-t5",
"arg2_id": "DerChirurg.80691013.eng.abstr-s10-t2",
"normalized": []
},
{
"id": "DerChirurg.80691013.eng.abstr-s10-r5-t2.1-t5.1",
"type": "interacts_with",
"arg1_id": "DerChirurg.80691013.eng.abstr-s10-t2",
"arg2_id": "DerChirurg.80691013.eng.abstr-s10-t5",
"normalized": []
},
{
"id": "DerChirurg.80691013.eng.abstr-s10-r6-t5.1-t3.1",
"type": "affects",
"arg1_id": "DerChirurg.80691013.eng.abstr-s10-t5",
"arg2_id": "DerChirurg.80691013.eng.abstr-s10-t3",
"normalized": []
},
{
"id": "DerChirurg.80691013.eng.abstr-s10-r8-t3.1-t1.1",
"type": "produces",
"arg1_id": "DerChirurg.80691013.eng.abstr-s10-t3",
"arg2_id": "DerChirurg.80691013.eng.abstr-s11-t1",
"normalized": []
}
] |
DerChirurg.80691028.eng.abstr
|
DerChirurg.80691028.eng.abstr
|
[
{
"id": "DerChirurg.80691028.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Primary sclerosing cholangitis ( PSC ) is generally associated with ulcerative colitis ( UC ) . The disease typically progresses slowly , but ultimately , and leads to cirrhosis , liver failure or bile duct cancer . PSC patients with simultanous ulcerative colitis are also at higher risk for colorectal cancer . At the present time , there is no effective treatment for PSC , although preliminary data show encouraging results after treatment with ursodeoxycholic acid . However , there are no data concerning the delay or prevention of progress of the disease with this drug , because follow-up time is not yet long enough . Isolated bile duct strictures should be treated endoscopically . The possible effect of proctocolectomy on the course of PSC is controversial . Liver transplantation is the therapy of choice for PSC in its final stage . The 5-year survival rate ( 89 % ) is significantly better than after transplantation for other indications . Patients with ulcerative colitis have to be followed up by lifelong colonoscopy . Although the course of UC after transplantation is mostly asymptomatic , these patients are at higher risk for colorectal cancer ."
],
"offsets": [
[
0,
1168
]
]
}
] |
[
{
"id": "DerChirurg.80691028.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"cholangitis"
],
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[
19,
30
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0008311"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"colitis"
],
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[
79,
86
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0009319"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"sclerosing cholangitis"
],
"offsets": [
[
8,
30
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0008313"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"ulcerative colitis"
],
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[
68,
86
]
],
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{
"db_name": "UMLS",
"db_id": "C0009324"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"Primary sclerosing cholangitis"
],
"offsets": [
[
0,
30
]
],
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{
"db_name": "UMLS",
"db_id": "C0008313"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"disease"
],
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[
100,
107
]
],
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"db_name": "UMLS",
"db_id": "C0012634"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"cirrhosis"
],
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[
168,
177
]
],
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{
"db_name": "UMLS",
"db_id": "C0008825"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"liver"
],
"offsets": [
[
180,
185
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0345904"
},
{
"db_name": "UMLS",
"db_id": "C0023884"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"bile"
],
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[
197,
201
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0005388"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"cancer"
],
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[
207,
213
]
],
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{
"db_name": "UMLS",
"db_id": "C0006826"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s2-t6",
"type": "umlsterm",
"text": [
"liver failure"
],
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[
180,
193
]
],
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{
"db_name": "UMLS",
"db_id": "C0085605"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s2-t7",
"type": "umlsterm",
"text": [
"bile duct"
],
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[
197,
206
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0005400"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s2-t8",
"type": "umlsterm",
"text": [
"bile duct cancer"
],
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[
197,
213
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0740277"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"patients"
],
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[
220,
228
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"colitis"
],
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[
257,
264
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0009319"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"risk"
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[
284,
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]
],
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{
"db_name": "UMLS",
"db_id": "C0035647"
}
]
},
{
"id": "DerChirurg.80691028.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"cancer"
],
"offsets": [
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DerChirurg.80691035.eng.abstr
|
DerChirurg.80691035.eng.abstr
|
[
{
"id": "DerChirurg.80691035.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The overall rate of complications after ileal pouch-anal anastomosis is 60 % . This rate , however , includes complications such as bowel-obstruction and hernias . Pouch-related complications occur after ileal pouch-anal anastomosis with a frequency of 15-25 % . In an analysis of the recent literature the main risk factors are : tension of the ileal pouch-anal anastomosis , anastomotic leakage , lack of protective ileostomy , preoperatively undiagnosed Crohn's disease and the experience of the surgeon . We classified pouch related-complications into ( 1 ) surgical complications ( leakage , bleeding , pelvic sepsis , fistulas ) ; ( 2 ) technical problems ( long S-pouch spout , rectal cuff stenosis , etc. ) ; ( 3 ) functional problems ( anal sphincter insufficiency , night incontinence , hypermotility , evacuation disorders ) ; ( 4 ) pouchitis ; ( 5 ) pouch neoplasias . Pathogenesis , diagnostic features , and medical and surgical therapy are discussed in detail . In our own series of 11 pouch-redo operations we had 6 pouch fistulas ( 3 related to Crohn's disease , 3 postoperative fistulas ) , 3 wrongly constructed pouches , 1 chronic pouchitis and 1 long S-pouch spout . In 3 cases the pouch had to be excised completely . Two patients remained with a permanent ileostomy . In 6 patients the pouch could be preserved on long term . Due to the technical complexity , the need to understand pathophysiology and the need for a differentiated diagnostic procedure , this operation should be performed only in specialised centers ."
],
"offsets": [
[
0,
1543
]
]
}
] |
[
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[] |
[] |
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DerChirurg.80691045.eng.abstr
|
DerChirurg.80691045.eng.abstr
|
[
{
"id": "DerChirurg.80691045.eng.abstr-passage-0",
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"text": [
"Nowadays , restorative proctocolectomy is considered the \" gold standard \" in the surgical therapy of ulcerative colitis . Alternative procedures such as Brooke ileostomy or Kock pouch are limited to special indications . Preservation of function is the decisive advantage of the ileoanal pouch , but preservation of function is not equal to quality of life . Quality of life is a multidimensional concept that is difficult to define and measure . Quality of life can only be assessed by standardized and validated quality-of-life questionnaires . Preoperatively , patients with ulcerative colitis have a restricted quality of life , depending on the intensity of their disease . Proctocolectomy is the curative therapy and improves quality of life . When evaluating quality of life it is not essential if patients are treated by Brooke ileostomy or restorative proctocolectomy . The advantage of restorative proctocolectomy is the improvement in some aspects such as sexuality and physical acticity . The \" Total Quality-of-Life Index \" is not impoved . Preoperatively , patients should be informed that preservation of function by restorative proctocolectomy is accompanied by an increased postoperative morbidity in comparison to other procedures . Decreased quality-of-life results when complications occur postoperatively that cannot be controlled over a long period of time . In some cases excision of the ileoanal pouch may be the most sensible way of solving the problems . On the other hand , patients without complications and good function after ileoanal pouch procedure may achieve a quality of life comparable to that of healthy controls . Preoperatively , patients should be aware of this risk-benefit relationship and should share the responsibility of the decision for or against restorative proctocolectomy ."
],
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0,
1825
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}
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] |
DerChirurg.80691059.eng.abstr
|
DerChirurg.80691059.eng.abstr
|
[
{
"id": "DerChirurg.80691059.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In a prospective study we investigated 168 patients with musculoskeletal tumors , including 71 sarcomas , by core needle biopsy using the high-speed device Autovac . Monitoring with colour-coded duplex sonography allowed a well-aimed puncture of smaller or deeply localized lesions and also permitted the discrimination of necrotic and viable parts of the tumor . Adequate material for histologic diagnosis including grading and determination of tumor subtype was obtained from soft tissue sarcomas , soft tissue metastases , malignant lymphomas , plasmacytomas , and osteolytic skeletal secondaries . In contrast , in benign soft tissue and bone tumors the diagnosis could be established in only 66 % of cases . Although skeletal sarcomas were identified as malignant mesenchymal lesions , a complete histologic classification of tumor subtype frequently was not possible due to an insufficient tissue specimen . With an accuracy of 97 % for the diagnosis of malignancy and of 94 % for the diagnosis of soft tissue sarcoma the results of core needle biopsies were comparable to those of incisional biopsies , the reference standard in the diagnosis of musculoskeletal tumors . Regarding the known disadvantages and the oncological risks of incisional biopsies , needle biopsy should replace the open procedure as the primary means of diagnosis in soft tissue and osteolytic bone tumors ."
],
"offsets": [
[
0,
1388
]
]
}
] |
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},
{
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"tumors"
],
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79
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],
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},
{
"id": "DerChirurg.80691059.eng.abstr-s1-t3",
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"sarcomas"
],
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[
95,
103
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],
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{
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},
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"needle"
],
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"biopsy"
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},
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"id": "DerChirurg.80691059.eng.abstr-s1-t7",
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5,
22
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{
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"needle biopsy"
],
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114,
127
]
],
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{
"id": "DerChirurg.80691059.eng.abstr-s1-t9",
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109,
127
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{
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[] |
[] |
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] |
DerChirurg.80691068.eng.abstr
|
DerChirurg.80691068.eng.abstr
|
[
{
"id": "DerChirurg.80691068.eng.abstr-passage-0",
"type": "abstract",
"text": [
"To reduce the need for excisional biopsies in the diagnosis of breast masses , the accuracy of core needle biopsy ( CNB ) was determined in a university hospital setting . 150 consecutive women with solitary palpable breast masses underwent CNB over a 2-year period . Histological diagnosis was established , and in the case of cancer the type , grade and estrogen and progesterone receptors were determined . CNB findings were compared with those independently obtained from the subsequently excised lesions . There were 103 malignant and 47 benign lesions . CNB diagnosed 136 lesions ( 90.7 % ) correctly . Fourteen biopsies were inconclusive . Histological type was correct in all cases and grading in 83.5 % . Correct hormone receptor status was obtained in 97.1 % of cases for estrogen and 91.3 % for progesterone . Diagnosis of histological type , grading , and hormone receptors obtained from CNB material is a safe way to analyze palpable breast lesions and therefore a useful tool to select patients for preoperative treatment ."
],
"offsets": [
[
0,
1037
]
]
}
] |
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}
] |
DerChirurg.80691072.eng.abstr
|
DerChirurg.80691072.eng.abstr
|
[
{
"id": "DerChirurg.80691072.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Sentinel lymph node ( SN ) biopsy in primary breast cancer seems to be an alternative to complete axillary lymph node dissection for evaluation of the axillary lymph node status in selected patients . Following evaluation of the technique of SN biopsy , we applied SN biopsy clinically to 23 selected patients . A lymphoscintigraphy was performed preoperatively to evaluate lymphatic drainage . The SN was identified in the operating room by use of a hand-held gamma camera and a blue vital dye . The SN was found in all 23 patients . In 17/23 the SN was tumor free and no axillary dissection was performed ; 6/23 showed a positive SN and complete axillary dissection was done . Intraoperative lymphatic mapping and SN biopsy may be the treatment of choice for evaluation of axillary node status in selected patients , for it combines accurate nodal staging and low morbidity ."
],
"offsets": [
[
0,
877
]
]
}
] |
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DerChirurg.80691077.eng.abstr
|
DerChirurg.80691077.eng.abstr
|
[
{
"id": "DerChirurg.80691077.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A special instrument was developed in order to quantify intraoperatively the traction forces which are employed during Shouldice repair of a primary inguinal hernia while adapting the lateral edge of the rectus sheath and the iliopubic tract . Further investigations were performed under the Valsalva manoeuvre and simultaneous measurement of the intra-abdominal pressure . In 25 patients an average increase in traction forces of 3.62 +/- 0.60 N was registered when the hernial gap was decreased to 0.3 cm . By applying the Valsalva manoeuvre with an average increase of 32 mm Hg in intra-abdominal pressure , traction was increased by a further 1.67 +/- 0.20 N on average . Hernia repair , tensing of the abdominal muscles and increasing the intra-abdominal pressure , however , have a small effect on the traction forces affecting the edges of the hernial gap . It may therefore be concluded that these factors , frequently believed causal for early hernia recurrence , are actually less influential as the force vector stressing the repair zone points in a different direction ."
],
"offsets": [
[
0,
1082
]
]
}
] |
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] |
[] |
[] |
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DerChirurg.80691082.eng.abstr
|
DerChirurg.80691082.eng.abstr
|
[
{
"id": "DerChirurg.80691082.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Laparoscopic gastric banding has become a common procedure in bariatric surgery . Early as well as late complications are , in comparison to conventional techniques , rare . Complications arising from the operative technique are : perforation , early pouch dilatation , gastric slippage , infections of the port and the band , erosion and defects of the band tube . Insufficient weight loss and late pouch dilatation arise from unsatisfactory compliance on the part of the patient . In 7.5 % of 146 cases , reoperations were necessary . Obstruction of the pouch stoma and a slippage resulted in total food intolerance . After radiologic diagnosis the band system should be deflated first and a naso-gastric tube applied . If this does not result in the pouch collapsing , a revision operation is needed ."
],
"offsets": [
[
0,
804
]
]
}
] |
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[] |
[] |
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DerChirurg.80691089.eng.abstr
|
DerChirurg.80691089.eng.abstr
|
[
{
"id": "DerChirurg.80691089.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Prognostically relevant factors based on the histological assessment of the resected pancreas are known . However , additional parameters , such as biological staging of the intrinsic malignant potentiality of the tumor , would be useful . There has been no uniform finding of a relationship between CD44 variant expression and tumor progression . Method : We assessed the expression pattern and prognostic impact of CD44 standard and CD44 isoforms v4, v5, v6, v7 and v10 in 40 ductal pancreatic carcinomas by immunochemistry on paraffin-embedded tumor material in patients after tumor resection . At the time of the investigation neither histomorphological parameters nor the survival time were known . Results : There was no correlation between the histomorphological parameter and the expression of CD44 splice variants . CD44 splice variants v4-v10 were almost only expressed in tumor tissue . In ductal pancreatic carcinoma , patients with an overexpression of CD44 splice variants had a worse prognosis . However , because of the small number of cases this was statistically not significant . Conclusion : CD44 splice variants may have an influence on prognosis in ductal pancreatic carcinoma . However , further investigation on a larger number of patients is necessary to confirm these results ."
],
"offsets": [
[
0,
1303
]
]
}
] |
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DerChirurg.80691101.eng.abstr
|
DerChirurg.80691101.eng.abstr
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"id": "DerChirurg.80691101.eng.abstr-passage-0",
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"The article deals with the case of an inflammatory pseudotumour of the lung in conjunction with histoplasmosis of the hilar lymph glands in a 35-year-old immunocompetent woman in a non-endemic area . She had been suffering from headaches and painful swelling of the lower legs , reddening and hyperthermia for 1.5 years . In addition to the above-mentioned symptoms she also complained of a typical flush syndrome which had begun a year later . The main paraclinical finding was a round mass in the right lung in chest radiography . After considering various differential diagnostic possibilities , thoracotomy and resection of the upper lobe of the right lung were performed . The histological diagnosis of the material removed was that of an inflammatory pseudotumour of the lung , combined with histoplasmosis of the hilar lymph glands . Following a postoperative period without complications , antimycotic treatment was performed . The discussion includes whether the simultaneous occurrence of these two diseases is coincidental or whether there is a causal relation between the two . The authors also discuss various treatments with reference to the relevant literature ."
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[] |
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DerChirurg.80691105.eng.abstr
|
DerChirurg.80691105.eng.abstr
|
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[] |
[] |
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DerChirurg.80691129.eng.abstr
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DerChirurg.80691129.eng.abstr
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[] |
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DerChirurg.80691134.eng.abstr
|
DerChirurg.80691134.eng.abstr
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[
{
"id": "DerChirurg.80691134.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Interchange of information has become possible independent of the user's place or time by modern telemedical services and opens up new dimensions for diagnostic and therapeutic procedures . For teleconferences and teleconsultations in surgery , the intraoperative high-quality transmission of live images is essential without disturbing the sterility and operation routine . The clinical specifications require special systems for broadband , stereoscopic online image transmission both intra- and inter-institutionally . Moreover , a telemedical concept integrates the communication equipment suitable for the different diagnostic and functional facilities of a clinic , a digital multimedia patient record and modules for cooperative working . These implementations are a prerequisite for extensive telesurgical interventions using navigational tools , guided instruments or autonomous roboter systems . The realization of such a comprehensive telesurgical concept ( OP 2000 ) is presented ."
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0,
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] |
[] |
[] |
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{
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{
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{
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{
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},
{
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},
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},
{
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},
{
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},
{
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},
{
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},
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},
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},
{
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},
{
"id": "DerChirurg.80691134.eng.abstr-s4-r1-t5.1-t2.2",
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},
{
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},
{
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},
{
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{
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{
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{
"id": "DerChirurg.80691134.eng.abstr-s4-r10-t5.1-t6.1",
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{
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}
] |
DerChirurg.80691141.eng.abstr
|
DerChirurg.80691141.eng.abstr
|
[
{
"id": "DerChirurg.80691141.eng.abstr-passage-0",
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"The diagnosis of malalignments of the lower extremities includes analysis of the geometry of the whole leg . The first step in the diagnostic process is a standardized physical examination . It provides valuable background information for an effective radiological diagnosis . Even with a thorough standardized physical examination it is not possible to define exactly the deformity or decide on an operative procedure . The diagnosis of axis deviations in the frontal plane can be measured on a conventional plain X-ray of the whole leg . In this view it is very important that the knee joints are in a true a. p . view independent on torsional deformities of the lower legs . Today the gold standard to measure the torsion and length of the lower extremities is the CT scan . However , the multitude of analytical methods for CT measurements described in the literature do not lend themselves readily to comparison ; thus , it is difficult to identify a clear method of choice . Not every CT measurement is better than a physical examination . Evidence of reproducibility and accuracy is a prerequisite for useful interpretation of the results . Up to this point in the literature there are only reference values for the Ulm CT Method . One alternative is the MR scan , which avoids radiological risks , but the reproducibility and accuracy of the MRI method are not as good as for the CT method . Another alternative is ultrasound , where recent advances in the measurement of torsion and length of the lower extremities have proven competitive with or superior to the accuracy of MRI . The three-dimensional determination of the torsion and length of the lower extremities by ultrasound has now assumed a leading role in the non-radiological diagnosis of malalignments of the lower extremities in children and adolescents . This method furthermore is increasingly being used in preoperative planning of leg deformities in adults ."
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] |
DerChirurg.80691153.eng.abstr
|
DerChirurg.80691153.eng.abstr
|
[
{
"id": "DerChirurg.80691153.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Basically , four post-traumatic conditions of the proximal femur can be improved by corrective osteotomies : recurring luxations and subluxations of the hip joint ; necrosis of the femoral head ; non-unions ; deformities . Dependent on the individual situation , the following procedure can be recommended , including diagnosis of deformities and indication and therapy of corrective osteotomies : analysis of the problem from the viewpoint of history , clinical findings and imaging techniques ; indication for corrective osteotomy ; graphic planning ; operation technique . Particularities of post-traumatic conditions with regard to diagnosis , indication and surgical technique are indicated . Only with perfectly tailored concepts can we respond to the individual situation of an individual patient and reflect the variety and complexity of post-traumatic conditions of the proximal femur ."
],
"offsets": [
[
0,
895
]
]
}
] |
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]
],
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}
]
},
{
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],
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106
]
],
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},
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],
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]
],
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}
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},
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},
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181,
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},
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"id": "DerChirurg.80691153.eng.abstr-s2-t3",
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"id": "DerChirurg.80691153.eng.abstr-s2-t5",
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DerChirurg.80691161.eng.abstr
|
DerChirurg.80691161.eng.abstr
|
[
{
"id": "DerChirurg.80691161.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Post-traumatic malalignment can occur on one or several planes following fractures in close proximity to the knee joint . In a clinical and radiological analysis of deformities , the frontal , sagittal and longitudinal alignment , as well as differences in femoral or tibial length and torsion , must be taken into account . The location of the correctional osteotomy is usually defined by the center of the angular and torsional deformity . Of decisive importance when choosing the site of the osteotomy are the local quality of bone and the soft tissue envelope , the condition of the articular cartilage in the different compartments of the knee , the stability of ligamentocapsular structures and preexistent deformities of the distal femur and proximal tibia . Therefore , the location of correctional osteotomies must be modified , depending on the individual situation . The appropriate approach and technique must be chosen from the different available operative techniques . Inaccurate planning and inappropriate operative techniques pose severe risks . Specific postoperative complications are compartment syndromes , nerve irritation and infection ."
],
"offsets": [
[
0,
1160
]
]
}
] |
[
{
"id": "DerChirurg.80691161.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"fractures"
],
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DerChirurg.80691167.eng.abstr
|
DerChirurg.80691167.eng.abstr
|
[
{
"id": "DerChirurg.80691167.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Post-traumatic deformities do occur as a result of disturbed fracture healing with loss of bone stock , necrosis of fragments or the development of pseudarthrosis resulting in malunion or progressive malalignment . In the majority of the cases these disturbances can be related to technical problems of primary fracture treatment like insufficient reduction or implant failure . On the other hand , complex deformities with involvement of the adjacent joints may also be a result of injuries of the growth plate in childhood . In some cases primary correction is impossible because of critical conditions of the bone and the soft tissue envelope in the center of deformation . If a secondary correction is indicated , knowledge of all reconstructive techniques is essential to choose the appropriate method and carry out successful and exact correction of malalignment of the affected limb after detailed planning ."
],
"offsets": [
[
0,
915
]
]
}
] |
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[] |
[] |
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DerChirurg.80691178.eng.abstr
|
DerChirurg.80691178.eng.abstr
|
[
{
"id": "DerChirurg.80691178.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The general aspects for the analysis of malalignment of the low tibial region in the three-dimensional space are discussed . Recommendations for clinical and radiological diagnostics prior to low tibial osteotomies are given . Closing wedge , opening wedge , dome-shaped , distraction , rotational and step-shaped osteotomies as well as combined procedures are described . The possibilities of these techniques are pointed out for malalignment after lower leg , pilon and ankle fractures , as well as after trauma of the distal epiphysis of the tibia . Arthroscopy of the ankle is an additional tool for detailed planning of the adequate surgical procedure . The importance of determining an early correction cannot be underestimated ."
],
"offsets": [
[
0,
735
]
]
}
] |
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28,
36
]
],
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],
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125,
140
]
],
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}
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},
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],
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203,
214
]
],
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DerChirurg.80691197.eng.abstr
|
DerChirurg.80691197.eng.abstr
|
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"id": "DerChirurg.80691197.eng.abstr-passage-0",
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"text": [
"Clinical trials on exogenous application of polypeptide growth factors in chronic wounds have not fulfilled the high expectations derived from results of experimental studies . There is no convincing evidence that growth factors may substitute for good wound care and efficient surgical approaches to wound closure . The ultimate goal of treatment of chronic ulcerations remains reconstitution of a durable skin envelope without unstable scarring . Therefore , optimization of current methods of wound therapy , including reconstructive vascular and plastic surgery and adequate metabolic and wound control , should be employed before any adjuvant growth factor therapy is attempted . As long as efficient and inexpensive therapy of chronic wounds by growth factors has not been demonstrated , empincal growth factor treatment should be rejected on scientific and economic grounds . Current use appears to be reasonable only under a regime of controlled clinical studies comparing growth factor treatment with conventional wound therapy and operative measures according to the rules of \" good clinical practice \" ."
],
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0,
1114
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]
}
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DerChirurg.80691214.eng.abstr
|
DerChirurg.80691214.eng.abstr
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"From August 1992 to March 1997 , 66 patients with 71 displaced intraarticular calcaneal fractures were prospectively examined after an operative treatment using an extended lateral approach and the ASIF calcaneal plate followed by early functional postoperative treatment ( mean follow-up 25 months , retrieval rate 96 % ) . To classify the type of fracture and to verify the results of reduction and of retention CT scans in the coronal and transverse plane were performed pre- and postoperatively and on the day of assessment . The Zwipp Score was used for clinical evaluation . After fractures with 5 to 8 points according to the calcaneal fracture scale , 97 % of the patients had an anatomical or near anatomical reduction of the posterior facet and the clinical outcome in 82 % of the patients was graded as good or excellent . In 70 % of patients with a fracture rated 9 to 10 points a good reduction was demonstrated and clinically there were 67 % good or excellent results . But in the fractures with 11 to 12 points , despite 40 % good reductions , the clinical outcome was graded as good in 10 % of the patients only . However , if the postoperative displacement of the posterior facet was more than 2 mm no patient had a good result independent of the type of fracture . Due to restoration of the geometry of the most comminuted fracture types and the immediate partial weight bearing secondary soft tissue problems could be minimized without any loss of articular reduction . Anatomical reduction and stable internal fixation together with adequate physical therapy are apparently preconditions but not a guarantee for a good clinical result after displaced calcaneal fractures ."
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{
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] |
DerChirurg.80691224.eng.abstr
|
DerChirurg.80691224.eng.abstr
|
[
{
"id": "DerChirurg.80691224.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Baker's cysts were treated operatively in 19 patients in the Department of Traumatology of the University of Cologne from 1988 to 1997. The subjective and objective results were evaluated with a questionnaire and a clinical examination and sonography ( follow-up : 95 % ) . All patients were examinated before surgery , sonography and X-ray of the knee were performed . We differentiated between the congenital primary cyst ( 39 % ) , and the secondary form , which was always associated with an intraarticular lesion ( 61 % ) . Arthroscopy was performed in all secondary forms of Baker's cyst . Postoperative complications were two reinterventions due to one hematoma and one effusion . Patient's evaluation of operation result was \" excellent \" in 61 % and \" good \" in 39 % of cases . All knee joints had a full range of motion . There was only one case of a recurrent cyst . The primary form of Baker's cyst has always to be extirpated , according to our clinical experience . The extirpation of the secondary Baker's cyst and the relevance of arthroscopy and treatment of the basic disease have to be discussed ."
],
"offsets": [
[
0,
1116
]
]
}
] |
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{
"id": "DerChirurg.80691224.eng.abstr-s1-t5",
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"id": "DerChirurg.80691224.eng.abstr-s1-t7",
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"id": "DerChirurg.80691224.eng.abstr-s1-t8",
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"id": "DerChirurg.80691224.eng.abstr-s2-t1",
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"text": [
"All"
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"id": "DerChirurg.80691224.eng.abstr-s2-t2",
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"id": "DerChirurg.80691224.eng.abstr-s2-t3",
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"id": "DerChirurg.80691224.eng.abstr-s2-t4",
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"id": "DerChirurg.80691224.eng.abstr-s3-t1",
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"id": "DerChirurg.80691224.eng.abstr-s3-t2",
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"id": "DerChirurg.80691224.eng.abstr-s3-t3",
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"id": "DerChirurg.80691224.eng.abstr-s4-t1",
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"id": "DerChirurg.80691224.eng.abstr-s4-t4",
"type": "umlsterm",
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"id": "DerChirurg.80691224.eng.abstr-s5-t1",
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"id": "DerChirurg.80691224.eng.abstr-s5-t2",
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] |
[] |
[] |
[
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{
"id": "DerChirurg.80691224.eng.abstr-s1-r8-t4.1-t1.1",
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{
"id": "DerChirurg.80691224.eng.abstr-s1-r9-t8.1-t2.1",
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] |
DerChirurg.80691230.eng.abstr
|
DerChirurg.80691230.eng.abstr
|
[
{
"id": "DerChirurg.80691230.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Between January 1989 and March 1997 , 175 patients with traumatic shoulder dislocations were treated by conservative means ( median age 41 years , 39 F , 136 M ) . In 78 patients ( 17 F , 61 M ) a clinical and radiological follow up ( median 50 months , range 6-106 ) could be obtained . Additionally , a diagnostic ultrasound was carried out in all patients . The recurrence rate in the group younger than 30 years ( G 30 ; n = 35 ) was 86 % ; in the group older than 30 years ( G > 30 ; n = 43 ) it was 21 % ( P 0.05 ) . Persisting neurological deficits were found in 6 patients ( 8 % ) . According to the Rowe score , 16 patients ( 46 % ) of the G 30 achieved excellent or good results , in the G > 30 , 29 patients ( 67 % ) . In 17 % of cases , a glenohumeral arthrosis was diagnosed be radiological means . 18 % had radiological signs of a previous fracture of the greater tuberosity . Hill-Sachs lesions were identified in 19 % of cases . Rotator cuff tears were diagnosed in 9 % by ultrasound . No relationship between the duration of immobilization and the recurrence rate was found ( P = 0.95 ) . The recurrence rate following primary shoulder dislocation depends primarily on the patients ' age ."
],
"offsets": [
[
0,
1206
]
]
}
] |
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] |
[] |
[] |
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DerChirurg.80691238.eng.abstr
|
DerChirurg.80691238.eng.abstr
|
[
{
"id": "DerChirurg.80691238.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Total knee arthroplasty has become a routine procedure in surgery . Deep infections have an incidence of 2-5 % . Major risk factors are large prostheses , rheumatoid arthritis , diabetes mellitus and postoperative wound-healing complications . In large soft-tissue defects with skin necrosis , local wound care shows poor results , especially if loosening of the prosthesis and necrosis of the patellar ligament are evident . In these cases , no standard surgical therapy has been developed yet . Thus , we consider meticulous débridement with synovialectomy to be mandatory . Exchange of the prosthesis may be necessary . Soft-tissue coverage ought to be performed with a gastrocnemius muscle flap covered with a split-thickness skin graft . In the last three years , 11 patients with large soft-tissue defects and necrosis of the ligament were treated according to this concept . In all cases the muscle flap healed primarily and soft tissue coverage was excellent . Two patients who underwent single-stage removal and reimplantation of the prosthesis showed reinfections of the prosthesis . Reconstruction of the ligament was performed with the flap tendon . The patients with two-stage removal and reimplantation of the prosthesis and those who retained their implants had a good functional outcome . The gastrocnemius muscle flap provides easy and reliable soft-tissue reconstruction in large defects . In our patients a two-stage operation for reimplantation of the prosthesis was superior to a single-stage procedure . The reconstructed ligament should be reinforced with autologous material to prevent a secondary rupture . Early reconstruction with sufficient soft-tissue coverage and reconstruction of the ligament offers the patient the best chances of obtaining a good functional result and prevents arthrodesis or amputation . In addition , reconstructive surgery reduces the length of hospital stay and costs ."
],
"offsets": [
[
0,
1924
]
]
}
] |
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[] |
[] |
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DerChirurg.80691244.eng.abstr
|
DerChirurg.80691244.eng.abstr
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"id": "DerChirurg.80691244.eng.abstr-passage-0",
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"Osteomyelitis can be subdivided into a bacterial exogenic ( post-traumatic/postoperative ) , bacterial endogenic ( hematogenous ) and an abacterial type , including the rare group containing primary chronic sclerosing osteomyelitis , which is typically localized in the clavicle . In a review of the literature , the criteria for the various types of chronic sclerosing osteomyelitis are analyzed . Out of a group of 17 patients with osteomyelitis of the clavicle treated between 1978 and 1996 , three cases of primary chronic sclerosing osteomyelitis are demonstrated . In the differential diagnosis , primary chronic sclerosing osteomyelitis of the clavicle has to be taken into consideration despite its rareness . After establishing a diagnosis by biopsy , in contrast to the other forms , drug therapy will be the treatment of choice and not an operation ."
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[] |
[] |
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DerChirurg.80691252.eng.abstr
|
DerChirurg.80691252.eng.abstr
|
[
{
"id": "DerChirurg.80691252.eng.abstr-passage-0",
"type": "abstract",
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"The arterial blood supply of the arm is unique , as the collateral circulation is especially good . Because of this anatomic peculiarity it is possible to deal with lack of peripheral pulse without critical ischemia occurring in fractures in the elbow region . We present two children with supracondylar fractures of the humerus with damage to the brachial artery and the different management results . It is necessary to carry out the immediate diagnostic and therapeutic procedures in order to prevent late complications . We conclude that Volkmann's ischemic contracture can always be prevented ."
],
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}
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[] |
[] |
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] |
DerChirurg.80691257.eng.abstr
|
DerChirurg.80691257.eng.abstr
|
[
{
"id": "DerChirurg.80691257.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Noma is an ulcerative-necrotizing gingivo-stomatitis eventually leading to severe destruction of the midface , including lips and cheek , maxilla/mandible , nose and rarely the orbit . The defects are usually unilateral . Children from economically underdeveloped countries are predominantly affected . Medically untreated the disease has a high mortality rate , which can be dramatically lowered by adequate antibiotic therapy started in time . Predisposing factors include malnourishment , immunosuppression , and poor oral hygiene . Forty-eight noma patients were surgically treated in Sokoto , Nigeria during October 1997 by an Interplast Germany team sponsored by AWD Stiftung Kinderhilfe . Interdisciplinary surgical strategies and results , e . g . ankylosis release , local flap coverage and 12 pedicled musculocutaneous latissimus dorsi island flaps , as well as a noma classification ( NOMAC ) , are presented ."
],
"offsets": [
[
0,
921
]
]
}
] |
[
{
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"text": [
"Noma"
],
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0,
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DerChirurg.80691263.eng.abstr
|
DerChirurg.80691263.eng.abstr
|
[
{
"id": "DerChirurg.80691263.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Postoperative infection in the locomotor system may lead to malpractice suits . The aim of the study was to determine the success rate of these claims and the type of expert-confirmed medical negligence so that strategies for avoiding such negligence can be offered . A total of 261 decrees concerning suspected malpractice after postoperative infection in the locomotor system were retrospectively evaluated . Of these , 43.7 % claims were successful . The most frequent type of negligence was late diagnosis ( 34.2 % ) , followed by inconsistant treatment ( 27.2 % ) and insufficient surgical revision ( 5.3 % ) . In 33.3 % , combined types of negligence were found . Most frequently , negligence was suspected after infection following hand surgery and internal fixation of long bones . The highest success rate of claims was seen after puncture of joints ( 69.2 % ) . Insufficient documentation was confirmed in 15.3 % . The majority of negligence resulted from diagnostic and therapeutic doubts , which could be avoided , e . g . , by a clear definition of infection , consultation of a second opinion , a 2nd-look operation , undelayed and radical surgical revision , painstaking follow-up and disciplined documentation ."
],
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0,
1227
]
]
}
] |
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}
] |
[] |
[] |
[
{
"id": "DerChirurg.80691263.eng.abstr-s5-r1-t1.1-t2.2",
"type": "evaluation_of",
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},
{
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},
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}
] |
DerChirurg.80691280.eng.abstr
|
DerChirurg.80691280.eng.abstr
|
[
{
"id": "DerChirurg.80691280.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Barber's disease is produced by short hairs that penetrate the interdigital spaces of the hands . The following chronic inflammatory reaction causes fistulas or sinuses and cysts . We present the case of a patient with interdigital pilonidal sinuses of all web spaces in both hands . Such an extensive case of this occupational disease has so far not been reported ."
],
"offsets": [
[
0,
366
]
]
}
] |
[
{
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0,
8
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{
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}
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},
{
"id": "DerChirurg.80691280.eng.abstr-s1-t3",
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"hairs"
],
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38,
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]
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},
{
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90,
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]
},
{
"id": "DerChirurg.80691280.eng.abstr-s2-t1",
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"causes"
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142,
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}
]
},
{
"id": "DerChirurg.80691280.eng.abstr-s2-t2",
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"fistulas"
],
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149,
157
]
],
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{
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}
]
},
{
"id": "DerChirurg.80691280.eng.abstr-s2-t3",
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"sinuses"
],
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[
161,
168
]
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}
]
},
{
"id": "DerChirurg.80691280.eng.abstr-s2-t4",
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173,
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},
{
"id": "DerChirurg.80691280.eng.abstr-s2-t5",
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206,
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}
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},
{
"id": "DerChirurg.80691280.eng.abstr-s3-t2",
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242,
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},
{
"id": "DerChirurg.80691280.eng.abstr-s3-t3",
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},
{
"id": "DerChirurg.80691280.eng.abstr-s4-t2",
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{
"db_name": "UMLS",
"db_id": "C0028797"
}
]
}
] |
[] |
[] |
[
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},
{
"id": "DerChirurg.80691280.eng.abstr-s1-r2-t3.1-t1.1",
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},
{
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},
{
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{
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},
{
"id": "DerChirurg.80691280.eng.abstr-s1-r6-t3.1-t4.1",
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},
{
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},
{
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},
{
"id": "DerChirurg.80691280.eng.abstr-s2-r2-t1.1-t4.1",
"type": "degree_of",
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},
{
"id": "DerChirurg.80691280.eng.abstr-s2-r3-t5.1-t4.1",
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{
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{
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{
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{
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},
{
"id": "DerChirurg.80691280.eng.abstr-s2-r8-t3.1-t1.1",
"type": "location_of",
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"arg2_id": "DerChirurg.80691280.eng.abstr-s4-t1",
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},
{
"id": "DerChirurg.80691280.eng.abstr-s2-r9-t1.1-t5.1",
"type": "result_of",
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"arg2_id": "DerChirurg.80691280.eng.abstr-s2-t5",
"normalized": []
},
{
"id": "DerChirurg.80691280.eng.abstr-s2-r10-t3.1-t5.1",
"type": "location_of",
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"arg2_id": "DerChirurg.80691280.eng.abstr-s2-t5",
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},
{
"id": "DerChirurg.80691280.eng.abstr-s2-r11-t1.1-t5.1",
"type": "associated_with",
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"arg2_id": "DerChirurg.80691280.eng.abstr-s2-t5",
"normalized": []
},
{
"id": "DerChirurg.80691280.eng.abstr-s2-r12-t5.1-t4.1",
"type": "degree_of",
"arg1_id": "DerChirurg.80691280.eng.abstr-s2-t5",
"arg2_id": "DerChirurg.80691280.eng.abstr-s2-t4",
"normalized": []
},
{
"id": "DerChirurg.80691280.eng.abstr-s2-r13-t4.1-t5.1",
"type": "associated_with",
"arg1_id": "DerChirurg.80691280.eng.abstr-s2-t4",
"arg2_id": "DerChirurg.80691280.eng.abstr-s2-t5",
"normalized": []
},
{
"id": "DerChirurg.80691280.eng.abstr-s2-r14-t3.1-t4.1",
"type": "location_of",
"arg1_id": "DerChirurg.80691280.eng.abstr-s3-t3",
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},
{
"id": "DerChirurg.80691280.eng.abstr-s2-r15-t1.1-t4.1",
"type": "result_of",
"arg1_id": "DerChirurg.80691280.eng.abstr-s4-t1",
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},
{
"id": "DerChirurg.80691280.eng.abstr-s3-r1-t3.1-t2.1",
"type": "interconnects",
"arg1_id": "DerChirurg.80691280.eng.abstr-s3-t3",
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},
{
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DerChirurg.80691292.eng.abstr
|
DerChirurg.80691292.eng.abstr
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[
{
"id": "DerChirurg.80691292.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Surgery and surgeons have a direct relationship to publicity . In the media , the entertainment aspect prevails over information ( infotainment ) , and scandal also dominates because of negative reports . The cause in many cases is a lack of information , which is always a problem when transmitting scientific information to the public . Economic pressures and diminished resources as well as a simultaneous increase in the demands made on medicine make it mandatory that surgeons communicate properly . They are being degraded more and more to \" delivering \" medicine , and the relationship between the surgeon and his patient has been reduced to a collision of greediness on both sides . We are in continuous conflict with the power of the media and are being challenged to improve our public relations . The public image of surgery today is determined by surgical performance and competence in communication ."
],
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[] |
[] |
[
{
"id": "DerChirurg.80691292.eng.abstr-s1-r2-t2.1-t1.1",
"type": "issue_in",
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"type": "isa",
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{
"id": "DerChirurg.80691292.eng.abstr-s4-r2-t1.1-t3.1",
"type": "issue_in",
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"arg2_id": "DerChirurg.80691292.eng.abstr-s7-t3",
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},
{
"id": "DerChirurg.80691292.eng.abstr-s4-r3-t4.2-t3.1",
"type": "issue_in",
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"arg2_id": "DerChirurg.80691292.eng.abstr-s7-t3",
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{
"id": "DerChirurg.80691292.eng.abstr-s5-r2-t2.1-t1.1",
"type": "issue_in",
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{
"id": "DerChirurg.80691292.eng.abstr-s7-r2-t3.1-t1.1",
"type": "issue_in",
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},
{
"id": "DerChirurg.80691292.eng.abstr-s7-r4-t3.1-t1.2",
"type": "evaluation_of",
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{
"id": "DerChirurg.80691292.eng.abstr-s7-r5-t3.1-t1.2",
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"arg2_id": "DerChirurg.80691292.eng.abstr-s7-t1",
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}
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DerChirurg.80691300.eng.abstr
|
DerChirurg.80691300.eng.abstr
|
[
{
"id": "DerChirurg.80691300.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Hospitals are competing with each other for the limited financial resources available in the health care sector . Comparison of hospitals is legally required ( BPflV § 5 ) to improve financial efficiency in the health care sector and make competition between hospitals keener , while also objectivizing it . If comparison of the hospitals is really to enhance profitability or efficiency , and not just to reduce the prices for hospital stays regardless of quality , it must extend to far more than the global figures in the compilation summarizing performance and calculation and the hospital statistics ( no . of cases , days of care , length of stay , case lump sums and special fees ) . Documentation of particular features of the patient population , the potentials of the hospital and description of the treatment processes yield valuable information on capacity and performance level . With rising costs , the danger is growing that the quality and risk dimension of the actual medical treatment will not be promoted with the same enthusiasm by those offering the service . Hospital audit does not only allow a check on the hospital's own situation with regard to performance , quality , efficiency and patient satisfaction , but can also provide a basis for structural planning . The fact is that all efforts made and steps taken by the responsible persons in the hospital to improve the quality of structures , processes and results can only be successful if they are also perceived by the patients , the doctors who refer them and the visitors . If hospital audit is restricted to the bed occupancy and the invoicing data , it is only realistic to expect cuts in performance level . This would be bad for the patient and , in view of the consequent costs , also for the overall costs in the health care sector . Against the backdrop of a future performance-related system of remuneration instead of the principle of covering one's own costs that has been in place hitherto , openness about treatment results gains in importance as a competition parameter for qualified hospitals ."
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0,
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DerChirurg.80691305.eng.abstr
|
DerChirurg.80691305.eng.abstr
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"The hospital environment of most Western countries is currently undergoing dramatic changes . Competition among hospitals is increasing , and economic issues have become decisive factors for the allocation of medical care . Hospitals therefore require management tools to respond to these changes adequately . The balanced scorecard is a method of enabling development and implementation of a business strategy that equally respects the financial requirements , the needs of the customers , process development , and organizational learning . This method was used to derive generally valid success factors for hospital management based on an analysis of an academic hospital in Switzerland . Strategic management , the focus of medical services , customer orientation , and integration of professional groups across the hospital value chain were identified as success factors for hospital management ."
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[] |
[] |
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DerChirurg.80691315.eng.abstr
|
DerChirurg.80691315.eng.abstr
|
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"Metastasis formation is a multistep process that requires tumor cells to progress through many different stages . One of the first steps is a disturbance of the epithelial integrity through a decrease in intercellular homotypic adhesion . Proteolysis of the extracellular matrix , as well as increased locomotion , leads to intravasation and dissemination of the tumor cells . In the target organs metastasizing cells adhere to the endothelium , extravasate and form metastases . Finally , neoangiogenesis is required for the initiation as well as the growth of the metastases , providing the tumor cells with both nutritive agents and growth factors . This leads to the conclusion that anti-proteolytic and anti-angiogenic substances could provide effective therapeutic approaches for the control of metastatic growth . Whether or not this goal can be accomplished by synthetic or endogenous drugs must still be demonstrated by basic and definitive clinical research ."
],
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]
}
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[] |
[] |
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DerChirurg.80691324.eng.abstr
|
DerChirurg.80691324.eng.abstr
|
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"Different conceptions to revise the licensing regulations for physicians ( Approbationsordnung fuer Aerzte ) aim to interlock preclinical and clinical subjects . Therefore a more practice-oriented anatomy has to be taught in basic and postgraduate medical education . At the Westfalian Wilhelms University of Muenster we established an interdisciplinary anatomical education , executed by clinical lecturers in cooperation with the educational staff of the Department of Anatomy . The integral element is the comprehensive constitution of clinical anatomy : clinical practitioners of different specialties together with anatomists give lessons in applied anatomy accompanying the dissection course . Clinically experienced lecturers of anatomy guide senior medical students in practical courses , refreshing their anatomical knowledge using particular prosections . These courses correlate with the topics of the distinct clinical tutorials . Conjointly clinical practitioners and anatomists plan , and perform meetings in postgraduate medical education ."
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DerChirurg.80691329.eng.abstr
|
DerChirurg.80691329.eng.abstr
|
[
{
"id": "DerChirurg.80691329.eng.abstr-passage-0",
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"text": [
"After ileal pouch-anal anastomosis in patients with ulcerative colitis ( UC ) and familial adenomatous polyposis ( FAP ) , in addition to postoperative morbidity and functional outcome quality of life is a relevant factor for assessment of the operation's success . Between 1982 and 1997 restorative proctocolectomy was performed in 602 patients ( UC : n = 424 ; FAP : n = 178 ) at the Department of Surgery , University of Heidelberg . The assessment of pre- and postoperative quality of life was done through a prospective study ( before restorative proctocolectomy , before and 1 year after closure of ileostomy ) . This study ( UC : n = 27 ; FAP : n = 7 ) revealed a poor preoperative quality of life in patients with ulcerative colitis . Proctocolectomy is the decisive factor for the improvement of quality of life in the surgical treatment in UC . Quality of life could not be further significantly improved by ileostomy closure . Before proctocolectomy , FAP patients showed a quality of life , activity and function similar to that of healthy controls . In FAP patients proctocolectomy led to a significant loss of quality of life . This loss could only partly be regained by ileostomy closure . Quality of life and activity comparable to that of healthy controls can be achieved in UC patients by restorative proctocolectomy ."
],
"offsets": [
[
0,
1336
]
]
}
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] |
DerChirurg.80691334.eng.abstr
|
DerChirurg.80691334.eng.abstr
|
[
{
"id": "DerChirurg.80691334.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Between 1987 and 1996 302 patients were treated for colorectal liver metastases . Out of this pool 252 completely documented cases were analysed . Forty-five patients ( 18 % ) of this population were 70 years or older at time of admission . In this population 17 major resections and 8 minor liver resections were performed . In 9 patients irresectable metastases were diagnosed during treatment of the primary tumor . In 3 cases laparotomy had to be finished as exploration . Eight patients were treated without surgery . Mortality after liver resection was 4 % , morbidity 28 % . The 5-year-survival-rate ( Kaplan-Meier ) of the R0 resected patients ( n = 21 ) was 44 % . Comparison between the elderly patients and the younger population shows no significant differences in type and extent of treatment or in stage of disease . Survival , morbidity and mortality after liver resection also show no significant differences . These results show that even in elderly patients liver resection for colorectal metastases can be performed efficently and with a curative intention ."
],
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[
0,
1077
]
]
}
] |
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[] |
[] |
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DerChirurg.80691340.eng.abstr
|
DerChirurg.80691340.eng.abstr
|
[
{
"id": "DerChirurg.80691340.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Between July 1995 and June 1996 , 280 patients were operated on for inguinal hernia within the scope of a prospective , randomized study . The aim of the study was to compare the Shouldice technique with tension-free hernioplasty ( Lichtenstein , TAPP ) . The operation time was comparable in all three groups . There was less need for analgesics and postoperative morbidity was less after the tension-free technique . No severe complications such as deep wound infection or infection of the implant were seen in any of the groups . After a follow-up period of 18 months , we found two recurrences after the Shouldice operation and one recurrence in each of the tension-free groups . Treatment satisfaction after tension-free hernioplasty was high . One year after the Shouldice operation , about 10 % of the patients were dissatisfied because of persistent discomfort and pain . Because of lower morbidity , less pain , and low recurrence rates after tension-free hernioplasty , we find the tension-free techniques to be superior to conventional hernioplasty ."
],
"offsets": [
[
0,
1061
]
]
}
] |
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[] |
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DerChirurg.80691357.eng.abstr
|
DerChirurg.80691357.eng.abstr
|
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{
"id": "DerChirurg.80691357.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Benign intracavitary cardiac tumors lead to \" malignant \" complications , so early diagnosis and adequate treatment are of vital importance . Our investigation summarizes a 10-year experience after surgical treatment of 29 patients suffering from benign intracavitary cardiac tumors . The postoperative histological examination revealed a myxoma in 27 cases ; in 2 cases a papillary fibroelastoma was diagnosed . The main symptom in 19 patients was dyspnea . In 8 cases an embolic event occurred . All patients underwent extirpation of the tumor . Early mortality was 10 % , while late mortality was 4 % . The treatment of choice of benign intracavitary cardiac tumors is extirpation , which , due to unpredictable embolic complications , is to be carried out immediately should the tumor have a lobulated tuberous surface . In such cases the descriptive function of echocardiography is of considerable importance ."
],
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915
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]
}
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DerChirurg.80691362.eng.abstr
|
DerChirurg.80691362.eng.abstr
|
[
{
"id": "DerChirurg.80691362.eng.abstr-passage-0",
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"text": [
"Budd-Chiari syndrome ( BCS ) with hepatic vein occlusion is a rare disorder that can effectively be treated in advanced stages with orthotopic liver transplantation . We report on 16 patients who received 18 liver grafts and were followed up for at least 2 years . In 7 patients a hematological disorder was confirmed by bone marrow biopsy . One patient died after 4 months due to cytomegalovirus pneumonia ; another patient died after 2 years due to progressive liver failure after portal vein thrombosis . The actuarial 5-year survival rate is 87.5 % compared to 85.3 % in all other 710 orthotopic liver transplantations performed from September 1988 to December 1995 at our institution . Anticoagulation consisted of intravenous heparin and overlapping continuation with dicoumarin . Three patients received hydroxyurea for thrombocytosis , one patient for 1 week only early after the transplantation . Two postoperative abdominal hemorrhages required laparotomy . Two patients had to be retransplanted , one for thrombosis of the hepatic artery and portal vein after discontinuation of dicoumarin due to GI bleeding and one for hepatic vein thrombosis after insufficient dicoumarin intake . Terminal BCS represents a good indication for orthotopic liver transplantation ; however , life-long , closely monitored anticoagulation is essential ."
],
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[] |
[] |
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DerChirurg.80691369.eng.abstr
|
DerChirurg.80691369.eng.abstr
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"id": "DerChirurg.80691369.eng.abstr-passage-0",
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"text": [
"Despite the widespread availability of antibiotics and a declining incidence , pleural empyema still represents a serious intrathoracic disease often requiring surgical treatment for successful therapy . 104 patients with complicated pleural empyema were treated at our hospital between June 1991 and June 1997. In this retrospective study the main causes for pleural empyema were pneumonia in 41.3 % and direct inoculation of the pleural space by major and minor thoracic surgery in 30.8 % . Further diseases leading to an empyma of the pleural space were oesophageal perforation ( 11.5 % ) , ARDS ( 8.7 % ) and hematogenous infection ( 7.7 % ) . Eighty-four patients ( 80.8 % ) underwent surgery , of whom 17 patients required multiple operations . Conservative therapy with chest tube drainage and systemic application of tested antibiotics was performed in 20 patients . The overall mortality of our patients was 19.2 % , but depending on the underlying disease differed considerably between 8.3 % and 44.4 % . Multiple operations caused by persisting empyema had a significantly higher mortality rate ( 58,8 % ) than single operations ( 10.5 % ) ."
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[] |
[] |
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] |
DerChirurg.80691376.eng.abstr
|
DerChirurg.80691376.eng.abstr
|
[
{
"id": "DerChirurg.80691376.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The hand-sutured coloanal anastomosis requires adequate and atraumatic exposure of the anal canal in order to avoid sphincter damage . We evaluated a new modified anal retractor to improve exposure of the anal canal and thread handling during construction of hand-sutured coloanal anastomosis . This new device was used during all coloanal and transperineal procedures performed in 1997 in our hospital . This new device is safe and extremely comfortable for the surgeon . It speeds up the procedure and keeps sutures out of the way when completing a coloanal anastomosis ."
],
"offsets": [
[
0,
573
]
]
}
] |
[
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"device"
],
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]
],
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},
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}
]
},
{
"id": "DerChirurg.80691376.eng.abstr-s3-t2",
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] |
[] |
[] |
[
{
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"type": "produces",
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DerChirurg.80691378.eng.abstr
|
DerChirurg.80691378.eng.abstr
|
[
{
"id": "DerChirurg.80691378.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Extravasation injuries can result in extensive soft-tissue defects . On the cellular level there are five different pathophysiological mechanisms . Early treatment ( surgical removal of the extravasated material within 24 h ) and late treatment ( debridement and coverage ) are different . Thirty-two patients who suffered a significant extravasation were treated surgically by the Department of Plastic Surgery between 1989 and 1997. In 8 patients , referred within the first 24 h , the extravasated material could be removed by saline flushout . None of these patients developed soft-tissue defects or skin necrosis . The other 24 patients were referred late ( mean 19 days after the injury ) . Patients with defects of the dorsum of the hand or cubital fossa area who underwent debridement , temporary wound coverage and skin grafting ( n = 11 ) presented complete healing 52 days after the referral . Defects of the same regions covered by a flap after debridement ( n = 6 ) healed within 14 days . The healing time of defects of the forearm ( n = 2 ) and dorsum of the foot ( n = 5 ) was a mean of 15 days after skin grafting . Cytotoxic and osmotically active substances should be removed by saline flushout within 24 h . In defects of the dorsum of the hand and cubital fossa , early debridement and coverage with an adequate flap should be performed ."
],
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}
] |
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{
"id": "DerChirurg.80691378.eng.abstr-s11-r9-t5.1-t1.1",
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{
"id": "DerChirurg.80691378.eng.abstr-s11-r10-t5.1-t3.1",
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] |
DerChirurg.80691383.eng.abstr
|
DerChirurg.80691383.eng.abstr
|
[
{
"id": "DerChirurg.80691383.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Gastric teratomas are rare and mostly benign . They frequently become evident as a palpable abdominal mass . A malignant , aggressive solid tumor must be excluded . We present a 6-month-old male infant with a history of bleeding of the upper gastrointestinal tract . After in toto excision the histopathology was that of a benign gastric teratoma . Our method of reading the diagnosis and the subsequent therapy are described ."
],
"offsets": [
[
0,
427
]
]
}
] |
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{
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8,
17
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}
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},
{
"id": "DerChirurg.80691383.eng.abstr-s3-t1",
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140,
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},
{
"id": "DerChirurg.80691383.eng.abstr-s4-t1",
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]
},
{
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{
"id": "DerChirurg.80691383.eng.abstr-s5-t3",
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"id": "DerChirurg.80691383.eng.abstr-s6-t1",
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]
}
] |
[] |
[] |
[
{
"id": "DerChirurg.80691383.eng.abstr-s4-r2-t1.2-t3.2",
"type": "uses",
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},
{
"id": "DerChirurg.80691383.eng.abstr-s4-r3-t1.1-t3.1",
"type": "issue_in",
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"arg2_id": "DerChirurg.80691383.eng.abstr-s6-t3",
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},
{
"id": "DerChirurg.80691383.eng.abstr-s4-r5-t1.2-t3.1",
"type": "issue_in",
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"arg2_id": "DerChirurg.80691383.eng.abstr-s6-t3",
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},
{
"id": "DerChirurg.80691383.eng.abstr-s4-r6-t1.1-t3.2",
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},
{
"id": "DerChirurg.80691383.eng.abstr-s6-r1-t1.2-t3.1",
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},
{
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"type": "precedes",
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},
{
"id": "DerChirurg.80691383.eng.abstr-s6-r3-t3.1-t1.2",
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},
{
"id": "DerChirurg.80691383.eng.abstr-s6-r4-t1.1-t3.1",
"type": "conceptual_part_of",
"arg1_id": "DerChirurg.80691383.eng.abstr-s6-t1",
"arg2_id": "DerChirurg.80691383.eng.abstr-s6-t3",
"normalized": []
},
{
"id": "DerChirurg.80691383.eng.abstr-s6-r5-t3.1-t1.1",
"type": "measures",
"arg1_id": "DerChirurg.80691383.eng.abstr-s6-t3",
"arg2_id": "DerChirurg.80691383.eng.abstr-s6-t1",
"normalized": []
}
] |
DerChirurg.80691386.eng.abstr
|
DerChirurg.80691386.eng.abstr
|
[
{
"id": "DerChirurg.80691386.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Perforated appendicitis within a hernia of any localisation is found in paediatric patients and in the elderly . Despite all modern diagnostic bias , it still may be found unexpectedly during operation . The fore most aim of surgical treatment has to be protection of the intra-abdominal cavity during appendectomy . Thus we provide it for contamination and avoid additional injury of the old and weak patient . The reported case fits in the history of unusual appendectomies ."
],
"offsets": [
[
0,
477
]
]
}
] |
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{
"id": "DerChirurg.80691386.eng.abstr-s1-t1",
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"appendicitis"
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11,
23
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"db_id": "C0003615"
}
]
},
{
"id": "DerChirurg.80691386.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"hernia"
],
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33,
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}
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},
{
"id": "DerChirurg.80691386.eng.abstr-s1-t4",
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"elderly"
],
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103,
110
]
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"db_id": "C0001792"
}
]
},
{
"id": "DerChirurg.80691386.eng.abstr-s2-t1",
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"diagnostic"
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{
"id": "DerChirurg.80691386.eng.abstr-s2-t2",
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}
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"id": "DerChirurg.80691386.eng.abstr-s2-t3",
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}
]
},
{
"id": "DerChirurg.80691386.eng.abstr-s3-t1",
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"id": "DerChirurg.80691386.eng.abstr-s3-t2",
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"id": "DerChirurg.80691386.eng.abstr-s3-t3",
"type": "umlsterm",
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234,
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],
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"db_id": "C0087111"
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}
]
},
{
"id": "DerChirurg.80691386.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"appendectomy"
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302,
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"injury"
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375,
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}
]
},
{
"id": "DerChirurg.80691386.eng.abstr-s4-t2",
"type": "umlsterm",
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"id": "DerChirurg.80691386.eng.abstr-s4-t3",
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"id": "DerChirurg.80691386.eng.abstr-s5-t1",
"type": "umlsterm",
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442,
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}
]
},
{
"id": "DerChirurg.80691386.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
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461,
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"db_name": "UMLS",
"db_id": "C0003611"
}
]
}
] |
[] |
[] |
[
{
"id": "DerChirurg.80691386.eng.abstr-s1-r1-t3.1-t4.1",
"type": "interacts_with",
"arg1_id": "DerChirurg.80691386.eng.abstr-s4-t3",
"arg2_id": "DerChirurg.80691386.eng.abstr-s3-t4",
"normalized": []
},
{
"id": "DerChirurg.80691386.eng.abstr-s1-r2-t1.1-t3.1",
"type": "occurs_in",
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"arg2_id": "DerChirurg.80691386.eng.abstr-s4-t3",
"normalized": []
},
{
"id": "DerChirurg.80691386.eng.abstr-s1-r3-t2.1-t1.1",
"type": "degree_of",
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"arg2_id": "DerChirurg.80691386.eng.abstr-s5-t1",
"normalized": []
},
{
"id": "DerChirurg.80691386.eng.abstr-s1-r4-t1.1-t2.1",
"type": "degree_of",
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"arg2_id": "DerChirurg.80691386.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "DerChirurg.80691386.eng.abstr-s1-r5-t2.1-t3.1",
"type": "occurs_in",
"arg1_id": "DerChirurg.80691386.eng.abstr-s5-t2",
"arg2_id": "DerChirurg.80691386.eng.abstr-s4-t3",
"normalized": []
},
{
"id": "DerChirurg.80691386.eng.abstr-s1-r6-t2.1-t1.1",
"type": "result_of",
"arg1_id": "DerChirurg.80691386.eng.abstr-s5-t2",
"arg2_id": "DerChirurg.80691386.eng.abstr-s5-t1",
"normalized": []
},
{
"id": "DerChirurg.80691386.eng.abstr-s1-r7-t1.1-t4.1",
"type": "occurs_in",
"arg1_id": "DerChirurg.80691386.eng.abstr-s5-t1",
"arg2_id": "DerChirurg.80691386.eng.abstr-s3-t4",
"normalized": []
},
{
"id": "DerChirurg.80691386.eng.abstr-s1-r8-t1.1-t2.1",
"type": "result_of",
"arg1_id": "DerChirurg.80691386.eng.abstr-s5-t1",
"arg2_id": "DerChirurg.80691386.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "DerChirurg.80691386.eng.abstr-s1-r9-t4.1-t3.1",
"type": "interacts_with",
"arg1_id": "DerChirurg.80691386.eng.abstr-s3-t4",
"arg2_id": "DerChirurg.80691386.eng.abstr-s4-t3",
"normalized": []
},
{
"id": "DerChirurg.80691386.eng.abstr-s1-r10-t2.1-t4.1",
"type": "occurs_in",
"arg1_id": "DerChirurg.80691386.eng.abstr-s5-t2",
"arg2_id": "DerChirurg.80691386.eng.abstr-s3-t4",
"normalized": []
},
{
"id": "DerChirurg.80691386.eng.abstr-s2-r1-t3.2-t1.1",
"type": "isa",
"arg1_id": "DerChirurg.80691386.eng.abstr-s3-t3",
"arg2_id": "DerChirurg.80691386.eng.abstr-s5-t1",
"normalized": []
},
{
"id": "DerChirurg.80691386.eng.abstr-s2-r2-t3.2-t2.1",
"type": "isa",
"arg1_id": "DerChirurg.80691386.eng.abstr-s3-t3",
"arg2_id": "DerChirurg.80691386.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "DerChirurg.80691386.eng.abstr-s2-r3-t1.1-t2.1",
"type": "isa",
"arg1_id": "DerChirurg.80691386.eng.abstr-s5-t1",
"arg2_id": "DerChirurg.80691386.eng.abstr-s5-t2",
"normalized": []
}
] |
DerChirurg.80691388.eng.abstr
|
DerChirurg.80691388.eng.abstr
|
[
{
"id": "DerChirurg.80691388.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Benign , proliferative changes of the Brunner's gland are very rare and account for about 10 % of duodenal bulb neoplasias . The authors present a case of Brunner's gland adenoma of unusual dimensions ( 12 x 5 x 2.5 cm ) . The patient presented with vague epigastric discomfort as isolated symptoms . In this case we performed surgical treatment , including a duodenotomy and polypectomy . Because they are localized in the submucosa small , superficial endoscopic biopsies may fail to confirm the diagnosis . Malignancy seems to occur only very rarely , with only 14 cases reported in the literature . As the majority of Brunner's adenomas are quite small , endoscopic polypectomy will confirm the diagnosis and cure the condition in most cases . Large symptomatic adenomas may require surgical resection ."
],
"offsets": [
[
0,
807
]
]
}
] |
[
{
"id": "DerChirurg.80691388.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"Brunner's"
],
"offsets": [
[
38,
47
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0605770"
}
]
},
{
"id": "DerChirurg.80691388.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"neoplasias"
],
"offsets": [
[
112,
122
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0027651"
}
]
},
{
"id": "DerChirurg.80691388.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"Brunner's"
],
"offsets": [
[
155,
164
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0605770"
}
]
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DerChirurg.90700006.eng.abstr
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DerChirurg.90700015.eng.abstr
|
DerChirurg.90700015.eng.abstr
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[
{
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"text": [
"Soaring health care costs are also forcing surgeons and anaesthesiologists to introduce practice patterns that allow more efficient use of expensive hospital resources . Because perioperative ward expenditures account for approximately one-third of the hospital costs incurred for surgical inpatients , with personnel costs being a major component , interventions that decrease the length of stay can result in considerable savings without affecting the quality of care . Interventious that can reduce the length of stay are outpatient preoperative evaluation and same-day admission , improvement of OR efficiency and sufficient cost-effective facilities for qualified postoperative care ."
],
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[
0,
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}
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DerChirurg.90700018.eng.abstr
|
DerChirurg.90700018.eng.abstr
|
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[] |
[] |
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DerChirurg.90700023.eng.abstr
|
DerChirurg.90700023.eng.abstr
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]
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[] |
[] |
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DerChirurg.90700031.eng.abstr
|
DerChirurg.90700031.eng.abstr
|
[
{
"id": "DerChirurg.90700031.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Solid tumors do not grow beyond a size of a few millimetres without supply of nutrients and growth factors by the vascular system . Only when tumors produce angiogenic growth factors new vessels are formed by sprouting of capillaries from the existing vascular system . The tumor can grow and tumor cells reach the circulation through these new and permeable vessels . The vascular endothelial growth factor ( VEGF ) is the most prominent angiogenic growth factor . VEGF is produced by almost all solid tumors : its receptors are expressed only on vascular endothelial cells and predominantly in vessels in the proximity of the tumor . Therefore , the VEGF/VEGF-receptor system is a target for anti-angiogenic cancer therapy . Experiments show that inhibition of the VEGF-mediated endothelial cell activation interferes with tumor growth and metastases formation . Appropriate therapeutic strategies are currently under clinical investigation ."
],
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[
0,
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]
}
] |
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] |
[] |
[] |
[
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DerChirurg.90700036.eng.abstr
|
DerChirurg.90700036.eng.abstr
|
[
{
"id": "DerChirurg.90700036.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Video-assisted thoracoscopic surgery is now recommended for the treatment of primary spontaneous pneumothorax . We studied the validity of this method at our general surgical department in a prospective group with regard to effectiveness and complication rate . The combination of thoracoscopic bulla resection with tetracycline pleurodesis resulted in a 100 % recurrence-free rate of 28 pneumothoraces at a median follow-up of 19 months . We observed no intraoperative complications . We conclude that video-assisted thoracoscopic surgery is an effective treatment for primary spontaneous pneumothorax and can safely be carried out even in a general surgical unit . The legal aspects are discussed in detail ."
],
"offsets": [
[
0,
710
]
]
}
] |
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[] |
[] |
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DerChirurg.90700043.eng.abstr
|
DerChirurg.90700043.eng.abstr
|
[
{
"id": "DerChirurg.90700043.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Intraoperative radiotherapy ( IORT ) is a new concept in the treatment of recurrent and primary advanced colorectal tumors . Between October 1994 and December 1997 27 patients ( primary tumor : 8 , first recurrent tumor : 12 , second recurrent tumor : 7 ) received IORT ( 32 applications ) . Chemotherapy and percutaneous radiotherapy had already been given to all patients with advanced and recurrent colorectal tumors . The intraoperative irradiation was performed through HDR iridium afterloading . A flexible flab - individually adapted to the \" tumor bed \" - was used as applicator . The contact dose ranged from 10 to 15 Gy . The mean operation time ( rectum resection : 5 , rectum amputation : 14 , debulking : 8 ) increased by 30 min on average . Eight patients had postoperative complications : perianal wound infections ( 3 ) , sacrovesical fistulas ( 3 ) , leakage of anastomosis ( 1 ) and neural ureter dysfunction ( 1 ) . To date - on average 17.1 months ( range : 3-33 ) after operation - 13 patients are free of tumor recurrence or show stable disease . Ten patients - all of them had macroscopic residual tumor - have local tumor progression combined with good quality of life . Only 4 patients died ( acute kidney failure , stroke , marasmus , systemic progression ) . The afterloading flab technique represents a technically simple , minimally harmful procedure in the therapy of colorectal tumor . Even when IORT with electrons is not feasible or the patients have already been irradiated , a higher radiation dose is possible . Given the demonstrated rate of local tumor recurrence , the afterloading flab technique seems to be a valuable treatment alternative to extended , high-risk resections . Long-term follow-ups will be necessary ."
],
"offsets": [
[
0,
1758
]
]
}
] |
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DerChirurg.90700049.eng.abstr
|
DerChirurg.90700049.eng.abstr
|
[
{
"id": "DerChirurg.90700049.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Background : Although the majority of surgeons regard Hartmann's operation as therapeutic standard in perforations of the colon complicated by peritonitis this procedure has been critically discussed in recent years . Advocates of one-stage techniques criticized bad postoperative results ( high morbidity and mortality ) and long-term outcome ( low rates of intestinal restoration ) . The aim of our study was to investigate whether the late results after Hartmann's operation justify this criticism . Method : From 1982 to 1997 Hartmann's operations were performed in 103 patients for colonic perforations . In 63 % of cases inflammatory diseases caused colonic complications . The average Mannheimer Peritonitis Index ( MPI ) was 19. Seventeen patients died postoperatively ( mortality : 16.5 % ) . In 69 patients ( 80 % ) intestinal restoration could be performed after an average interval of 122 days ( complication rate : 6 % , no mortality ) . On follow-up , patients were asked to give information on their general state , changes of housing , abdominal complaints , and quality of life . Results : Data on 93 % of patients could be obtained . The median follow-up time was 75 months . Eleven patients had died ; the remaining 72 were investigated . 86 % described the quality of their lives as good or very good ; only 11 % indicated severe loss of activity . Quality of life did not differ between patients in whom intestinal continuity had been restored and those in whom it had not been restored . Anastomotic strictures developed in 7 % of cases , always after stapled anastomosis . Conclusions : According to our results , long-term outcome after Hartmann's operation is good . 80 % of patients underwent intestinal restoration with low morbidity ( 6 % ) and no mortality . A great majority of patients indicated the quality of their lives as good or very good : this assessment was not dependent on restoration of intestinal continuity ."
],
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0,
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"id": "DerChirurg.90700049.eng.abstr-s17-r2-t1.1-t3.1",
"type": "performs",
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"arg2_id": "DerChirurg.90700049.eng.abstr-s17-t3",
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] |
DerChirurg.90700059.eng.abstr
|
DerChirurg.90700059.eng.abstr
|
[
{
"id": "DerChirurg.90700059.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The aim of this study was to investigate postoperative und long-term results after radical tumor surgery in complicated colorectal cancers . One hundred and twenty-six ( 11.7 % ) of 1071 patients treated for large bowel cancer between 1986 and 1997 were operated on for bowel obstruction ( 84 ; 7.8 % ) or perforation ( 42 ; 3.9 % ) . Postoperative mortality was significantly higher in complicated than in uncomplicated cancers ( 19 % after bowel obstruction , 38 % after perforation , 6 % in uncomplicated cases ) . Development of preoperative organ dysfunction determined survival in both complications . Mortality after perforations was influenced by the degree of peritonitis and tumor stage , while patients after bowel obstruction were at greater risk in the case of cardiac comorbidity . Long-term results depended on tumor stage but not on complications . Our concept of radical tumor surgery in emergency operations was supported by the fact that long-term results of patients surviving the acute stage of complicated colorectal cancers did not differ from those of patients with uncomplicated carcinomas ."
],
"offsets": [
[
0,
1116
]
]
}
] |
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{
"id": "DerChirurg.90700059.eng.abstr-s1-t2",
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"id": "DerChirurg.90700059.eng.abstr-s2-t2",
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"id": "DerChirurg.90700059.eng.abstr-s2-t3",
"type": "umlsterm",
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"id": "DerChirurg.90700059.eng.abstr-s2-t4",
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"id": "DerChirurg.90700059.eng.abstr-s2-t5",
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"large bowel"
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"id": "DerChirurg.90700059.eng.abstr-s3-t1",
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"id": "DerChirurg.90700059.eng.abstr-s3-t2",
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"id": "DerChirurg.90700059.eng.abstr-s4-t1",
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"id": "DerChirurg.90700059.eng.abstr-s4-t2",
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"id": "DerChirurg.90700059.eng.abstr-s5-t1",
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"id": "DerChirurg.90700059.eng.abstr-s5-t2",
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"id": "DerChirurg.90700059.eng.abstr-s5-t7",
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"id": "DerChirurg.90700059.eng.abstr-s5-t8",
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"id": "DerChirurg.90700059.eng.abstr-s7-t3",
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]
}
] |
[] |
[] |
[
{
"id": "DerChirurg.90700059.eng.abstr-s1-r1-t1.1-t4.1",
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{
"id": "DerChirurg.90700059.eng.abstr-s1-r4-t6.1-t1.1",
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{
"id": "DerChirurg.90700059.eng.abstr-s1-r5-t1.1-t5.1",
"type": "affects",
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{
"id": "DerChirurg.90700059.eng.abstr-s1-r6-t6.1-t4.1",
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},
{
"id": "DerChirurg.90700059.eng.abstr-s1-r7-t3.1-t1.1",
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{
"id": "DerChirurg.90700059.eng.abstr-s1-r8-t1.1-t3.1",
"type": "affects",
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},
{
"id": "DerChirurg.90700059.eng.abstr-s1-r9-t3.1-t4.1",
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},
{
"id": "DerChirurg.90700059.eng.abstr-s1-r10-t1.1-t6.1",
"type": "affects",
"arg1_id": "DerChirurg.90700059.eng.abstr-s7-t1",
"arg2_id": "DerChirurg.90700059.eng.abstr-s7-t6",
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{
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},
{
"id": "DerChirurg.90700059.eng.abstr-s1-r12-t1.1-t3.1",
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},
{
"id": "DerChirurg.90700059.eng.abstr-s1-r14-t5.1-t1.1",
"type": "produces",
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"arg2_id": "DerChirurg.90700059.eng.abstr-s7-t1",
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},
{
"id": "DerChirurg.90700059.eng.abstr-s2-r1-t6.1-t3.1",
"type": "degree_of",
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},
{
"id": "DerChirurg.90700059.eng.abstr-s2-r2-t2.1-t6.1",
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{
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},
{
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{
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{
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"type": "location_of",
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},
{
"id": "DerChirurg.90700059.eng.abstr-s2-r7-t3.1-t6.1",
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] |
DerChirurg.90700066.eng.abstr
|
DerChirurg.90700066.eng.abstr
|
[
{
"id": "DerChirurg.90700066.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Mechanical ventilation is a well-etablished strategy in intensive care medicine . ICU trauma patients require analgesia , and sedation mostly consists of benzodiazepines and opioids with increasing doses over time . The weaning period is complicated by the withdrawal syndrome , showing tachycardia , hypertonia , tachypnea and restlessness . Although treatment with clonidine can influence these symptoms , tachypnea still remains the main problem in weaning patients from mechanical ventilation . Adding sufentanil , an opioid with greater effects on analgesia than on respiratory depression compared with fentanyl , tachypnea can be reduced to normal frequency . In this way weaning management can be managed more easily for the benefit of both , the patient and physician . In comparison with a group of 50 patients treated with clonidine alone , 72 patients treated with clonidine/sufentanil showed a shorter period from the start of spontaneous ventilation until extubation ( 4.8 vs 7.6 days ) and until discharge from the ICU ( 7.7 vs 12.4 days ) . The number of reintubations caused by respiratory exhaustion decreased from 16.0 to 2.8 % ."
],
"offsets": [
[
0,
1147
]
]
}
] |
[
{
"id": "DerChirurg.90700066.eng.abstr-s1-t1",
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"text": [
"ventilation"
],
"offsets": [
[
11,
22
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042491"
},
{
"db_name": "UMLS",
"db_id": "C0035203"
}
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"normalized": []
},
{
"id": "DerChirurg.90700066.eng.abstr-s7-r11-t4.1-t5.2",
"type": "result_of",
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"arg2_id": "DerChirurg.90700066.eng.abstr-s7-t5",
"normalized": []
},
{
"id": "DerChirurg.90700066.eng.abstr-s7-r12-t4.1-t5.1",
"type": "result_of",
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"arg2_id": "DerChirurg.90700066.eng.abstr-s7-t5",
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},
{
"id": "DerChirurg.90700066.eng.abstr-s7-r13-t7.1-t1.1",
"type": "manages",
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"arg2_id": "DerChirurg.90700066.eng.abstr-s7-t1",
"normalized": []
},
{
"id": "DerChirurg.90700066.eng.abstr-s7-r14-t5.1-t4.1",
"type": "result_of",
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"arg2_id": "DerChirurg.90700066.eng.abstr-s7-t4",
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},
{
"id": "DerChirurg.90700066.eng.abstr-s7-r15-t5.2-t4.1",
"type": "result_of",
"arg1_id": "DerChirurg.90700066.eng.abstr-s7-t5",
"arg2_id": "DerChirurg.90700066.eng.abstr-s7-t4",
"normalized": []
},
{
"id": "DerChirurg.90700066.eng.abstr-s7-r16-t7.1-t6.1",
"type": "carries_out",
"arg1_id": "DerChirurg.90700066.eng.abstr-s7-t7",
"arg2_id": "DerChirurg.90700066.eng.abstr-s7-t6",
"normalized": []
}
] |
DerChirurg.90700079.eng.abstr
|
DerChirurg.90700079.eng.abstr
|
[
{
"id": "DerChirurg.90700079.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Cryophlebectomy , a more recent technique in varicose veins surgery , was evaluated in comparision with conventional techniques . Group IA : Microphlebectomy , invaginative stripping of the long saphenous vein , tourniquet , n = 90 ; group IB : only microphlebektomie and tourniquet , n = 72. Group IIA : Cryostripping of the long saphenous vein in combination with cryosurgical distal avulsion of varicosities and microphlebectomy , n = 112 ; gr . IIB : only cryosurgical distal avulsion of varicosities and microphlebectomy . Data were compared regarding duration of operation and hospitalisation and cosmetic outcome . Hospital stay ( gr . IA : 9,1 +/- 5,1 d vs. gr . IIA : 6,1 +/- 2,1 d , gr . IB : 5,5 +/- 2,3 d vs. gr . IIB : 4,8 +/- 2,5 d ) and duration of operation ( gr . IA : 113,6 +/- 35 min vs. gr . IIA : 67 +/- 21,3 min , gr . IB : 74,4 +/- 35,3 min vs. gr . IIB : 53,3 +/- 15,5 min ) were found to be significantly shorter and cosmetic result and postoperative discomforts improved in the cryophlebectomy-group . We conclude that the use of this combination of methods reduces invasivity , rises the patient's well-being and helps in cost-reduction ."
],
"offsets": [
[
0,
1165
]
]
}
] |
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{
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"technique"
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32,
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"db_id": "C0025664"
}
]
},
{
"id": "DerChirurg.90700079.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"veins"
],
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54,
59
]
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"db_name": "UMLS",
"db_id": "C0042449"
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"id": "DerChirurg.90700079.eng.abstr-s1-t3",
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{
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"comparision"
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"db_id": "C0030561"
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"type": "umlsterm",
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"comparision"
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87,
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"techniques"
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{
"id": "DerChirurg.90700079.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"varicose veins"
],
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45,
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"db_id": "C0042345"
}
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},
{
"id": "DerChirurg.90700079.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"invaginative"
],
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160,
172
]
],
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"db_name": "UMLS",
"db_id": "C0042276"
}
]
},
{
"id": "DerChirurg.90700079.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"invaginative"
],
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160,
172
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],
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"db_id": "C0079891"
}
]
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{
"id": "DerChirurg.90700079.eng.abstr-s2-t3",
"type": "umlsterm",
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"vein"
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{
"id": "DerChirurg.90700079.eng.abstr-s2-t4",
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"tourniquet"
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212,
222
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"id": "DerChirurg.90700079.eng.abstr-s2-t5",
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{
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}
]
},
{
"id": "DerChirurg.90700079.eng.abstr-s2-t7",
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"cryosurgical"
],
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366,
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]
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}
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},
{
"id": "DerChirurg.90700079.eng.abstr-s2-t8",
"type": "umlsterm",
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"varicosities"
],
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398,
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]
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{
"id": "DerChirurg.90700079.eng.abstr-s2-t9",
"type": "umlsterm",
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],
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"db_id": "C0036186"
}
]
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{
"id": "DerChirurg.90700079.eng.abstr-s2-t10",
"type": "umlsterm",
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],
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331,
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}
]
},
{
"id": "DerChirurg.90700079.eng.abstr-s3-t1",
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"cryosurgical"
],
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460,
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]
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{
"id": "DerChirurg.90700079.eng.abstr-s3-t2",
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]
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"id": "DerChirurg.90700079.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"operation"
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}
]
},
{
"id": "DerChirurg.90700079.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"hospitalisation"
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}
]
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{
"id": "DerChirurg.90700079.eng.abstr-s4-t3",
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603,
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{
"id": "DerChirurg.90700079.eng.abstr-s5-t1",
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"Hospital"
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622,
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"postoperative"
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}
]
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"id": "DerChirurg.90700079.eng.abstr-s14-t1",
"type": "umlsterm",
"text": [
"use"
],
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1049,
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},
{
"id": "DerChirurg.90700079.eng.abstr-s14-t2",
"type": "umlsterm",
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"methods"
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"db_id": "C0025663"
},
{
"db_name": "UMLS",
"db_id": "C0025664"
}
]
}
] |
[] |
[] |
[
{
"id": "DerChirurg.90700079.eng.abstr-s1-r1-t6.1-t3.2",
"type": "associated_with",
"arg1_id": "DerChirurg.90700079.eng.abstr-s2-t6",
"arg2_id": "DerChirurg.90700079.eng.abstr-s1-t3",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s1-r2-t5.1-t6.1",
"type": "causes",
"arg1_id": "DerChirurg.90700079.eng.abstr-s2-t5",
"arg2_id": "DerChirurg.90700079.eng.abstr-s2-t6",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s1-r3-t1.1-t6.1",
"type": "location_of",
"arg1_id": "DerChirurg.90700079.eng.abstr-s14-t1",
"arg2_id": "DerChirurg.90700079.eng.abstr-s2-t6",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s1-r4-t3.2-t3.1",
"type": "issue_in",
"arg1_id": "DerChirurg.90700079.eng.abstr-s1-t3",
"arg2_id": "DerChirurg.90700079.eng.abstr-s4-t3",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s1-r5-t3.2-t6.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90700079.eng.abstr-s1-t3",
"arg2_id": "DerChirurg.90700079.eng.abstr-s2-t6",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s1-r6-t1.1-t3.1",
"type": "issue_in",
"arg1_id": "DerChirurg.90700079.eng.abstr-s14-t1",
"arg2_id": "DerChirurg.90700079.eng.abstr-s4-t3",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s1-r7-t5.1-t3.1",
"type": "issue_in",
"arg1_id": "DerChirurg.90700079.eng.abstr-s2-t5",
"arg2_id": "DerChirurg.90700079.eng.abstr-s4-t3",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s1-r8-t6.1-t3.1",
"type": "issue_in",
"arg1_id": "DerChirurg.90700079.eng.abstr-s2-t6",
"arg2_id": "DerChirurg.90700079.eng.abstr-s4-t3",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s2-r1-t2.1-t7.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90700079.eng.abstr-s14-t2",
"arg2_id": "DerChirurg.90700079.eng.abstr-s2-t7",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s2-r2-t7.1-t2.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90700079.eng.abstr-s2-t7",
"arg2_id": "DerChirurg.90700079.eng.abstr-s14-t2",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s2-r3-t4.1-t7.1",
"type": "treats",
"arg1_id": "DerChirurg.90700079.eng.abstr-s2-t4",
"arg2_id": "DerChirurg.90700079.eng.abstr-s2-t7",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s2-r4-t2.1-t4.1",
"type": "uses",
"arg1_id": "DerChirurg.90700079.eng.abstr-s14-t2",
"arg2_id": "DerChirurg.90700079.eng.abstr-s2-t4",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s2-r5-t5.1-t7.1",
"type": "treats",
"arg1_id": "DerChirurg.90700079.eng.abstr-s2-t5",
"arg2_id": "DerChirurg.90700079.eng.abstr-s2-t7",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s2-r6-t2.1-t5.1",
"type": "uses",
"arg1_id": "DerChirurg.90700079.eng.abstr-s14-t2",
"arg2_id": "DerChirurg.90700079.eng.abstr-s2-t5",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s4-r1-t1.1-t3.1",
"type": "uses",
"arg1_id": "DerChirurg.90700079.eng.abstr-s14-t1",
"arg2_id": "DerChirurg.90700079.eng.abstr-s4-t3",
"normalized": []
},
{
"id": "DerChirurg.90700079.eng.abstr-s4-r2-t1.1-t1.2",
"type": "isa",
"arg1_id": "DerChirurg.90700079.eng.abstr-s14-t1",
"arg2_id": "DerChirurg.90700079.eng.abstr-s9-t1",
"normalized": []
}
] |
DerChirurg.90700085.eng.abstr
|
DerChirurg.90700085.eng.abstr
|
[
{
"id": "DerChirurg.90700085.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Intimal sarcoma of the pulmonary artery is an extremely rare type of malignant tumor of the large vessels . Despite systematic diagnostics , distinguishing between pulmonary emboli and tumors is difficult . We report a patient who was referred because of suspected embolic occlusion of the pulmonary artery . The operation was started with the intention of performing a pulmonary artery thromboendarterectomy ; however , intraoperative histology revealed a malignant mesenchymal tumor . Therefore , the left lung was resected with the use of extracorporeal circulation , and the pulmonary trunk and right pulmonary artery were reconstructed . A solitary right lung metastasis was resected 3 months later using stapling devices . Complete surgical resection is the treatment of choice for patients with sarcoma of the pulmonary arteries . Surgical therapy often includes extensive reconstructive measures . Since , thromboembolic obstruction cannot be excluded preoperatively , patients with this type of disease should be treated at centers experienced with the broad spectrum of pulmonary artery surgery ."
],
"offsets": [
[
0,
1106
]
]
}
] |
[
{
"id": "DerChirurg.90700085.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"sarcoma"
],
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[
8,
15
]
],
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{
"db_name": "UMLS",
"db_id": "C0036210"
}
]
},
{
"id": "DerChirurg.90700085.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"artery"
],
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[
33,
39
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0003842"
}
]
},
{
"id": "DerChirurg.90700085.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"malignant"
],
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[
69,
78
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0006826"
}
]
},
{
"id": "DerChirurg.90700085.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"tumor"
],
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[
79,
84
]
],
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{
"db_name": "UMLS",
"db_id": "C0027651"
}
]
},
{
"id": "DerChirurg.90700085.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"vessels"
],
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[
98,
105
]
],
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{
"db_name": "UMLS",
"db_id": "C0005847"
},
{
"db_name": "UMLS",
"db_id": "C0148346"
}
]
},
{
"id": "DerChirurg.90700085.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"pulmonary artery"
],
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[
23,
39
]
],
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{
"db_name": "UMLS",
"db_id": "C0034052"
}
]
},
{
"id": "DerChirurg.90700085.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"malignant tumor"
],
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[
69,
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]
],
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"db_name": "UMLS",
"db_id": "C0006826"
}
]
},
{
"id": "DerChirurg.90700085.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"systematic"
],
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[
116,
126
]
],
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{
"db_name": "UMLS",
"db_id": "C0220922"
}
]
},
{
"id": "DerChirurg.90700085.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"emboli"
],
"offsets": [
[
174,
180
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013932"
}
]
},
{
"id": "DerChirurg.90700085.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"tumors"
],
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[
185,
191
]
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{
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"db_id": "C0027651"
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]
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[] |
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DerChirurg.90700089.eng.abstr
|
DerChirurg.90700089.eng.abstr
|
[
{
"id": "DerChirurg.90700089.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Mesenteric cysts are a rare cause of disease . In our hospital we treated one patient who suffered from bilateral ureteral obstruction followed by hydronephrosis , caused by a large mesenteric cyst . Because of its extent complete enucleation - the surgical procedure of choice - was not possible . We opened the cyst and made an external percutaneous drainage . After this treatment the patient recovered and even after 6 months there was no recurrence ."
],
"offsets": [
[
0,
455
]
]
}
] |
[
{
"id": "DerChirurg.90700089.eng.abstr-s1-t1",
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"text": [
"cysts"
],
"offsets": [
[
11,
16
]
],
"normalized": [
{
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"db_id": "C0010709"
}
]
},
{
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DerChirurg.90700092.eng.abstr
|
DerChirurg.90700092.eng.abstr
|
[
{
"id": "DerChirurg.90700092.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Adrenocortical insufficiency ( Addison's disease ) is a functional diagnosis . At the beginning of this century , tuberculosis was recognized as the main etiological cause ( 50-70 % ) . Today , however , tuberculosis represents only 10 % of the cases . Adrenocortical insufficiency is mainly caused by autoimmune adrenalitis ( more than 50 % ) . Unilateral adrenocortical disease is usually asymptomatic or presents , as in the case described , with minor symptoms . This case report of adrenal tuberculosis illustrates the current challenges of diagnosis and therapy ."
],
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[
0,
569
]
]
}
] |
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] |
[] |
[] |
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DerChirurg.90700096.eng.abstr
|
DerChirurg.90700096.eng.abstr
|
[
{
"id": "DerChirurg.90700096.eng.abstr-passage-0",
"type": "abstract",
"text": [
"To optimise the microsurgical training in our clinic we organized a permanent possibility to practice microsurgical techniques of vascular anastomosis . This includes stepwise education by means of plastic materials , human placenta and the rat model . The most important role in this concept is played by the placenta . It supplies a realistic simulation of different in vivo situations concerning microvascular anastomosis . As to availability , handling and costs the placenta is superior to animal models and has replaced them almost completely in our educational concept ."
],
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0,
577
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]
}
] |
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] |
[] |
[] |
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DerChirurg.90700123.eng.abstr
|
DerChirurg.90700123.eng.abstr
|
[
{
"id": "DerChirurg.90700123.eng.abstr-passage-0",
"type": "abstract",
"text": [
"For patients with liver metastases , surgery currently represents the only possibility for cure , with a mean 5-year survival rate of 25-35 % . Due to refinement in operative and anesthetic techniques and improved critical care with decreased morbidity ( 25 % ) and mortality ( 5 % ) , hepatic resection is a safe and efficient procedure . Surgery has repeatedly achieved long-term disease-free survival in 20-25 % of patients . However , only 10-25 % of patients with colorectal liver metastases can undergo potentially curative liver resection . Therefore , accurate staging plays a pivotal role in selecting patients who would benefit from surgery . For metastatic colorectal cancer , resection offers the only potential for cure . For symptomatic neuroendocrine tumors , hepatic resection offers long-term palliation in many cases and cure in some . The role of hepatic resection for noncolorectal and nonneuroendocrine metastases , however , is less well defined . Recurrence of hepatic metastases after seemingly curative resection is observed in about 40-60 % of the cases . Only 20-35 % of these recurrent metastases appear to be resectable , resulting in an overall 3-year survival rate of about 30 % . The morbidity and mortality from repeat hepatectomy is similar to that of first hepatic resection . All results together demonstrate that resection and re-resection of liver metastases can provide long-term survival rates and can be beneficial in a carefully selected group of patients without extrahepatic disease ."
],
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0,
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]
}
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[] |
[] |
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] |
DerChirurg.90700141.eng.abstr
|
DerChirurg.90700141.eng.abstr
|
[
{
"id": "DerChirurg.90700141.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In numerous tumors , metastasis can be limited to the liver . In non-resectable patients , regional treatment modalities , especially arterial cytostatic infusion , are favored in contrast to systemic chemotherapy , whereas intraportal or intraperitoneal application is not successful . Improved results with high response rates have been reported after development of intra-arterial ( i.a. ) long-term regimens with FUdR in patients with colorectal liver metastases using implantable pumps and ports . However , a survival benefit could only be demonstrated in comparison with a control group only treated symptomatically . Because of several reports on major local toxicity of i . a. FUdR treatment ( i.e. chemical hepatitis and biliary sclerosis ) several other effective i . a. 5-FU regimens have been developed . A randomized study has demonstrated superiority of i . a. 5-FU versus i . a. FUdR . In comparison with systemic treatment , superiority has only been demonstrated in patients with an intrahepatic tumor burden of 25 % . Publications about regional treatment of patients with breast , gastric cancer or carcinoid liver metastases are rare . Despite the high response rates reported , the benefit of arterial chemotherapy remains questionable . Overall , local long-term chemotherapy cannot be recommended outside of studies as a primary treatment . However , extensive experience and new drugs support the idea of conducting further regional studies ."
],
"offsets": [
[
0,
1467
]
]
}
] |
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DerChirurg.90700154.eng.abstr
|
DerChirurg.90700154.eng.abstr
|
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890
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}
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[] |
[] |
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DerChirurg.90700162.eng.abstr
|
DerChirurg.90700162.eng.abstr
|
[
{
"id": "DerChirurg.90700162.eng.abstr-passage-0",
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"text": [
"Within the past 30 years hepatocyte transplantation has been developed in rodents for the cure of acute and chronic liver failure . Organ shortage and the enormous costs of orthotopic liver transplantation have promoted intensive research in transplantation of isolated hepatocytes . Transplanted syngeneic hepatocytes survive indefinitively in rodents , allowing correction of various inherited liver enzyme defects or enhancing recipient survival in experimentally induced acute liver failure . The clinical application of hepatocyte transplantation has been recently demonstrated in a young patient suffering from Crigler-Najjar syndrome type I , with successful long-term survival of allogeneic hepatocytes . This review reports the historical development and the published data on experimental and clinical hepatocyte transplantation ."
],
"offsets": [
[
0,
840
]
]
}
] |
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DerChirurg.90700174.eng.abstr
|
DerChirurg.90700174.eng.abstr
|
[
{
"id": "DerChirurg.90700174.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The experience with laterolateral cavocavostomy for hepatovenous reconstruction in liver transplantation is reviewed with and without the use of a temporary portocaval shunt . A total of 65 liver transplantations were analyzed . In 49 transplantations a laterolateral cavocaval anastomosis was performed ( group I ) . In group II ( n = 16 ) the same technique was used after a temporary portal caval shunt was constructed . Mean arterial pressure ( mmHg ) : group I 128 +/- 34 ; group II 109 +/- 32. Cardiac output ( l/min ) decrease during the anhepatic phase was 2.3 +/- 1.9 and 1.2 +/- 1.5 , respectively ( P 0.05 ) . The peroperative blood loss measured as the number of packed cells transfused was 16.4 +/- 15.8 versus 1.2 +/- 2.3 ( P 0.04 ) and fresh frozen plasma 19.0 +/- 14.7 versus 3.7 +/- 4.0 ( P 0.02 ) . Course on ICU ( days ) , liver function tests , renal function and the need for reoperation because of bleeding were not statistically significantly different between the groups . One-year patient survival was 82.7 and 85.7 % , respectively . In conclusion , we found that despite preservation of the caval flow during hepatectomy , the additional use of a temporary portocaval shunt was advantageous with regard to peroperative hemorrhage and hemodynamic stability and can potentially facilitate implantation of the liver graft ."
],
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[
0,
1347
]
]
}
] |
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] |
[] |
[] |
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DerChirurg.90700179.eng.abstr
|
DerChirurg.90700179.eng.abstr
|
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"Despite the important role of lymph node infiltration for the classification and prognosis of non-small-cell lung cancer ( NSCLC ) , no standards exist to evaluate the quality of mediastinal lymphadenectomy . Researches at several centers are not convinced that complete ipsilateral lymphadenectomy is necessary . We investigated 270 consecutive patients undergoing a potential curative operation for NSCLC including complete ipsilateral lymph node dissection in order to ascertain whether or not there is a correlation between tumor localization and lymph node infiltration . Patients were classified into the UICC ( 1987 ) stages I ( n = 115 ) , II ( n = 42 ) , and IIIa ( n = 113 ) . In patients with N1-positive lymph nodes ( n = 61 ) we found higher 5-year survival for patients with only intrapulmonary lymph node infiltration ( 39 % ) than for patients with hilar infiltration ( 21 % ) . Patients with N2 disease showed skip metastases in up to 81 % of cases . We found that no tumor location predicted the lymph node infiltration . Due to the variability of lymph node infiltration and the frequently occurring skip metastases , complete ipsilateral lymphadenectomy should be the standard for curative operations for NSCLC ."
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] |
[] |
[] |
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] |
DerChirurg.90700184.eng.abstr
|
DerChirurg.90700184.eng.abstr
|
[
{
"id": "DerChirurg.90700184.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In a porcine model , ten animals with a mean body weight of 18.9 ( 15-24 ) kg were exposed either to intravenous boli of 10 , 20 , and 30 ml argon ( n = 5 ) or CO2 gas ( n = 5 ) . Gas embolism with argon led to increased pulmonary artery pressure ( P > 0.001 ) and induced a decrease in end tidal CO2 ( P 0.001 ) and reduced cardiac output ( P 0.001 ) with a consecutive decrease in mean arterial pressure ( P 0.05 ) . One animal died in cardiac shock after a 20 ml argon gas embolism and another after a 30 ml argon bolus . A third animal recovered after resuscitation with noradrenaline after a 30 ml argon bolus . Animals in the CO2 group receiving 10 , 20 , or 30 ml bolus neither required resuscitation nor died . Hemodynamic parameters were not affected by a 10 to 30 ml bolus of CO2 gas . Thus , gases with a low solubility in blood like argon should not be used during procedures with an increased risk of gas embolism ."
],
"offsets": [
[
0,
928
]
]
}
] |
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] |
DerChirurg.90700190.eng.abstr
|
DerChirurg.90700190.eng.abstr
|
[
{
"id": "DerChirurg.90700190.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Between 1984 and 1996 we performed a Mason gastroplasty for the treatment of morbid obesity : 14 patients ( average age 40 ( 26-48 ) years , body mass index ( BMI ) 48 ( 37-71 ) kg/m2, excessive body weight 67 ( 41-116 ) kg ) . Since the end of 1996 we now apply adjustable laparoscopic gastric banding ( lab band ) : 73 patients ( average age 39 ( 22-64 ) years , BMI 45 ( 32-69 ) kg/m2, excessive body weight 66 ( 41-116 ) kg ) . We compared the early and late results of both methods . Early results : no relevant morbidity or mortality for neither method . Late/intermediate results : reoperation rate for both methods 15 % . After an average of 3.7 years the excessive body weight loss ( EWL ) for gastroplasty was 54 ( 22-96 ) % . The EWL after lab band for 24 patients after 12 months was 47 ( 11-127 ) % and for 8 patients after 18 months 51 ( 28-139 ) % . Since the introduction of the lap band the number of bariatric operations has greatly increased . Nevertheless , the perioperative complication rate has remained low , and the long-term outcome is similar for both methods ."
],
"offsets": [
[
0,
1088
]
]
}
] |
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}
] |
[] |
[] |
[
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] |
DerChirurg.90700196.eng.abstr
|
DerChirurg.90700196.eng.abstr
|
[
{
"id": "DerChirurg.90700196.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The application of an adjustable silicone gastric band is a very efficient and long-term method to reduce the weight in morbid obesity . The surgical technique is exacting ; standardization of the procedure diminishes the complication rate . 370 patients with morbid obesity underwent the laparoscopic application of a gastric band between May 1996 and September 1997. Two different kinds of gastric bands were used in these surgeries . The data are shown in two series . The total morbidity rate was 16.8 % , in series II 4.5 % . The mortality rate was 0 % . The average loss of weight came to 12 kg ( 5.3 % ) after 4 weeks , 18 % after 3 months , 37.4 % after 6 months and 48.4 % after 1 year ."
],
"offsets": [
[
0,
696
]
]
}
] |
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] |
[] |
[] |
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DerChirurg.90700211.eng.abstr
|
DerChirurg.90700211.eng.abstr
|
[
{
"id": "DerChirurg.90700211.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In esophageal cancer blunt dissection of the esophagus is reasonable in high-risk patients . Manual dissection can compromise the heart and reduce blood pressure . This can be avoided by laparoscopically assisted transmediastinal dissection of the esophagus . We describe the operative procedure and report on a patient with coronary heart disease who suffered from cancer of the cardia spreading into the esophagus as well as into the stomach . Esophagogastrectomy was performed with jejunal replacement ."
],
"offsets": [
[
0,
506
]
]
}
] |
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] |
[] |
[] |
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] |
DerChirurg.90700214.eng.abstr
|
DerChirurg.90700214.eng.abstr
|
[
{
"id": "DerChirurg.90700214.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A 25-year-old woman delivered a healthy baby in the 34th week of gestation by caesarean section due to placental abruption and fetal bradycardia . On the following day she developed dyspnea , tachycardia , hypotension and rising serum transaminase levels . After exclusion of a pulmonary embolism , the abdominal CT scan and cavography revealed a subcapsular hematoma of the entire dorsal liver surface and compression of the retrohepatic vena cava . During laparotomy a spontaneous rupture of the liver capsule with intraperitoneal hemorrhage was found . The dorsal liver was decapsulated and the subcapsular hematoma completely removed . The postoperative course was uneventful ."
],
"offsets": [
[
0,
681
]
]
}
] |
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]
],
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],
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]
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},
{
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],
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],
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},
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},
{
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],
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},
{
"id": "DerChirurg.90700214.eng.abstr-s3-t4",
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DerChirurg.90700233.eng.abstr
|
DerChirurg.90700233.eng.abstr
|
[
{
"id": "DerChirurg.90700233.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Preoperative planning of liver resections in patients with liver tumors is based on sonography , computed tomography and magnetic resonance imaging . A new three-dimensional ( 3D ) visualization program was developed based on CT data . This visualization program was used for preoperative planning in 6 patients with liver tumors in problematic intrahepatic localizations . In 5 out of 6 patients the liver resection could be performed as preoperatively planned . The intraoperative findings agreed with the 3D visualization in all these patients . 3D Visualization of the liver allowed clear and interactive planning of liver resections and improved the preparation of complex liver resections ."
],
"offsets": [
[
0,
696
]
]
}
] |
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DerChirurg.90700239.eng.abstr
|
DerChirurg.90700239.eng.abstr
|
[
{
"id": "DerChirurg.90700239.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The operability of a liver tumour depends on its three-dimensional relation to the intrahepatic vascular trees which define autonomously functioning liver ( sub- ) segments . The aim of our study was to establish a computer-based three-dimensional volumetric operation planning system for the liver . Methods : Using data from routine helical CT scans the three tissue subclasses of liver parenchyma , liver vessels and liver tumour were segmented semiautomatically . A dedicated segmenting tool was established using region growing algorithms in combination with an \" intelligent \" border finder . Visualisation is performed by the \" Heidelberg Raytracer \" . The vascular trees are visualised as 3D graphs . Pseudoconnections between portal and hepatic venous trees are separated automatically . Security margins are calculated and the system presents a virtual resection proposal . Results : The 3D anatomy of the liver can be visualised in high quality resulting in good depth perception . Security margins are demonstrated . Dependent liver parenchyma can be recognised automatically on the basis of the vascular trees . The system offers a individualised resection proposal including the tumour , security margin and dependent liver parenchyma . Conclusion : Three-dimensional presentation of the individual liver anatomy of a given patient facilitates the perception of the pathology . Virtual reality combined with artifical intelligence allows calculation of complete resection protocols , which can be quantified and modified interactively . This will make operation planning more objective ; patient selection may be improved , and in cases of difficult tumour localisation different resection strategies may be tested . Thus virtual reality in liver surgery will improve teaching , surgical training and planning . It may lead to improved surgical care ."
],
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}
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DerChirurg.90700253.eng.abstr
|
DerChirurg.90700253.eng.abstr
|
[
{
"id": "DerChirurg.90700253.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The management of 178 patients with liver trauma ( 132 male , 46 female ; mean age 34 years ( range 3-88 ) presenting from January 1979 to August 1996 is reviewed . There were 165 cases of blunt trauma and 13 cases of penetrating injury . 110 cases were classified as simple injuries ( grade I or II ) and 68 cases as complex injuries ( grade III to V ) . The overall mortality was 32 % ( 57 patients ) . The mortality for true hepatic injury was 15.7 % . None of the patients with penetrating injuries died . Mortality was inflenced by the type of liver injury and the number of associated injuries . The postoperative complication rate was 55 % . The most-frequent postoperative complications related to the hepatic injury were intrahepatic or subcapsular hematoma ( 12.9 % ) and postoperative bleeding ( 9.6 % ) . Intraabdominal abscess formation was seen in 2.8 % . Operative therapy for liver injuries depends on the grade of the injury . The majority of liver injuries can be managed by simple techniques , including electrocautery and application of hemostatic agents . In complex injuries hepatotomy , direct vessel ligation , and debridement of necrotic tissue is the method of choice ( Pachter's procedure ) . In non-controlled bleeding , perihepatic picking is a standard method ."
],
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DerChirurg.90700259.eng.abstr
|
DerChirurg.90700259.eng.abstr
|
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"Retrospectively analyzing the history of three patients with gastrointesinal stromal tumors ( GIST ) treated over a period of 1 year in the surgical department of our regional hospital , we tried to answer the following questions : using the current recommendations in the literature , how are the macro- and microscopic features and clinical presentation to be interpreted ? Which prognostic and therapeutic conclusions should we draw , giving special consideration to practice-orientated management of such cases . The patients were 65 , 75 and 88 years old respectively , and in each case the GIST manifested as recurrent gastrointestinal bleeding . During surgical treatment four gastric tumors ranging in cross section between 2.5 and 8 cm were found . The GIST diagnosis was established after light microscopic and immunohistochemical examinations . Going through the current literature , a large number of structural and immunohistochemical criteria have come to light for determining its classification and potential malignancy . On the other hand , very few subsequent recommendations concerning therapy and prognosis can be found and follow-up recomendations are almost unavailable . We conclude that GISTs are difficult to diagnose because of their locality and that their clinical behavior is uncertain . The potential malignancy , on the other hand , requires a well-founded diagnostic procedure in the form of the best possible pre-therapeutic staging . Furthermore , initially radical surgical treatment should be adopted and the follow-up should be adapted to the risk involved . The latter is arbitrary and further clinical studies are required ."
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1663
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}
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},
{
"id": "DerChirurg.90700259.eng.abstr-s9-r4-t3.1-t1.1",
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] |
DerChirurg.90700265.eng.abstr
|
DerChirurg.90700265.eng.abstr
|
[
{
"id": "DerChirurg.90700265.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The present investigation reviews the history of 673 patients having undergone surgical treatment for 1301 BCC of the face between 1977 and 1992 at our department . Based on this series the features with bearing on the surgical strategy , such as type , size and location of the lesions , will be outlined . Emphasis is put on the variants of local flap reconstruction and skin grafting techniques , particularly in the problem zones of the nose and eyelids , where no excess skin for closure of the defect is available . Throughout the whole series histologic control of the adequacy of marginal and deep tumor resection was performed . It became obvious that the required ranges for clearance to tumor edges and removal in depth cannot be predefined arbitrarily or on pure clinical judgement . Frequently a two-stage procedure of resection and repair will be necessitated . Recurrences during the mandatory follow-up were thoroughly reassessed to identify the reason for failure ( e . g . accuracy of histologic category , multifocal growth , predisposition ) and related to the time span from primary excision . Our series confirms that morphologically controlled surgical excision of the BCC of the face and subsequent application of reconstructive techniques produces both safe oncologic and esthetic results ."
],
"offsets": [
[
0,
1315
]
]
}
] |
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"surgical"
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{
"id": "DerChirurg.90700265.eng.abstr-s3-t2",
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"id": "DerChirurg.90700265.eng.abstr-s3-t3",
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{
"id": "DerChirurg.90700265.eng.abstr-s3-t5",
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{
"id": "DerChirurg.90700265.eng.abstr-s3-t6",
"type": "umlsterm",
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450,
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{
"id": "DerChirurg.90700265.eng.abstr-s3-t8",
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"defect"
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{
"id": "DerChirurg.90700265.eng.abstr-s3-t9",
"type": "umlsterm",
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373,
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"id": "DerChirurg.90700265.eng.abstr-s4-t1",
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"id": "DerChirurg.90700265.eng.abstr-s4-t2",
"type": "umlsterm",
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"control"
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"id": "DerChirurg.90700265.eng.abstr-s4-t3",
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"tumor"
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"id": "DerChirurg.90700265.eng.abstr-s5-t2",
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"id": "DerChirurg.90700265.eng.abstr-s6-t2",
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}
] |
[] |
[] |
[
{
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"type": "performs",
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{
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{
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{
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{
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{
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},
{
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},
{
"id": "DerChirurg.90700265.eng.abstr-s3-r5-t7.1-t8.1",
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{
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},
{
"id": "DerChirurg.90700265.eng.abstr-s3-r7-t1.1-t7.1",
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{
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{
"id": "DerChirurg.90700265.eng.abstr-s3-r9-t2.1-t8.1",
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DerChirurg.90700270.eng.abstr
|
DerChirurg.90700270.eng.abstr
|
[
{
"id": "DerChirurg.90700270.eng.abstr-passage-0",
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"text": [
"The role of laparoscopic cholecystectomy on patients with histologically confirmed acute cholecystitis is still controversial . From January 1992 to December 1996 , 228 cholecystectomies were performed for acute cholecystitis and a total of 104 patients were operated on conventionally and 124 patients underwent laparoscopic surgery . In a prospective study we compared the conventional with the laparoscopic technique . The results indicated that in 19 patients ( 15.3 % ) treated initially with the laparoscopic technique , a switch to laparotomy was required . The operating duration was lower for conventional cholecystectomy ( 75 min versus 95 min ) . However , surgical and nonsurgical complication rates were similar in both groups . The period of hospitalization was shorter in laparoscopic operations . According to these results we believe that laparoscopic cholecystectomy in patients with acute cholecystitis is a safe and effective procedure . The patients will benefit from the advantages of laparoscopic surgery without increased morbidity ."
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}
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[] |
[] |
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DerChirurg.90700285.eng.abstr
|
DerChirurg.90700285.eng.abstr
|
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"At our hospital , closed dislocations of the elbow without neurovascular or osseous lesion are treated conservatively after successful reduction in the absence of a tendency to redislocation . Indications for surgery are irreducible dislocations and those with a tendency to redislocation as well as open soft tissue injuries , neurovascular and osseous concomitant injuries . During a period of 10 years 113 patients were treated according to this strategy . Of these patients , 46 had simple dislocations of the elbow and 67 suffered from dislocations with osseous lesions . In 95 patients follow-ups could be performed after a mean period of 55 months . In more than 75 % of cases good or excellent functional results were documented ; unfavourable results were seen only in patients with osseous lesions . Nearly all of the patients had a stable elbow joint at the end of therapy ."
],
"offsets": [
[
0,
885
]
]
}
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[] |
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DerChirurg.90700290.eng.abstr
|
DerChirurg.90700290.eng.abstr
|
[
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"id": "DerChirurg.90700290.eng.abstr-passage-0",
"type": "abstract",
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"Background : Approximately 50 % of children with a clinical unilateral inguinal hernia display a patent processus vaginalis on the contralateral side ; half of these children subsequently develop an inguinal hernia . The management of this problem is still controversial . The purpose of this study was to evaluate the usefulness of intraoperative laparoscopy in a no-puncture technique through the opened hernia sack . Method : In 112 children ( age 6 months to 7 years ) with clinical unilateral hernia laparoscopy ( 5 mm laparoscope , 30 ° and 70 ° ) . In cases of a wide-open contralateral internal inguinal ring ( type III ) open surgical exploration was performed . Results : Nineteen patients ( 17 % ) fulfilled the laparoscopic criteria of a type III ring ; the diagnose was confirmed during open contralateral exploration . Fourteen of these patients were younger than two years . The median time for laparoscopy was 6 min ( 3-11 min ) . No complications associated with the laparoscopy were observed . Conclusions : Intraoperative laparoscopy during unilateral hernia repair allows the identification of patients who profit from bilateral open surgery during the same operation with little additional operating time and so far with no resulting complications . Application of this method may avoid a second hospitalization and operation , as well as an unnecessary routine bilateral open exploration . As an additional source of information through excellent visualization of the abdominal cavity , this method proved helpful to examine incarcerated bowel after repositioning ."
],
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}
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DerChirurg.90700294.eng.abstr
|
DerChirurg.90700294.eng.abstr
|
[
{
"id": "DerChirurg.90700294.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Background : Dorsoposterior and/or perineal access to pelvic connective tissue spaces has lost its importance due to improved transabdominal techniques . Because of the development of minimally invasive surgery towards \" soft-tissue endoscopy \" we were interested in whether the video-assisted technique could give new impetus to the perineal approach . Successful experiments on corpses were followed by the first clinical application . Methods : After the dilation of the retrorectal , rectovaginal and rectoprostatical spaces with a dissecting balloon , pneumoextraperitoneum was established and all extraperitoneal structures of the pelvis could be dissected . Results : In the experimental and in the clinical situation the spaces could be perfectly surveyed . Experimentally , complete , circular preparation of the rectum was achieved . Parts of the bladder , vagina and prostate were visualized ventrally . Laterally both ureters and the paraproctal and iliacal vessels could be dissected . In the clinical application the retrorectal space could be dilated without problems and it could be rinsed and drained . Postoperatively no complications were recorded . The patient could be discharged on the 17th postoperative day . Conclusion : The described method is suitable for clinical use . Besides the described indication , further surgical applications exists ."
],
"offsets": [
[
0,
1371
]
]
}
] |
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]
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{
"id": "DerChirurg.90700294.eng.abstr-s1-t3",
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"connective tissue"
],
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],
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"id": "DerChirurg.90700294.eng.abstr-s4-t2",
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[] |
[] |
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] |
DerChirurg.90700298.eng.abstr
|
DerChirurg.90700298.eng.abstr
|
[
{
"id": "DerChirurg.90700298.eng.abstr-passage-0",
"type": "abstract",
"text": [
"An insulinoma is the most common pancreatic endocrine tumor . Typical is the presence of a solitary tumor . In 10 % of the cases an insulinoma may occur in multiple sites , especially in MEN syndrome . Malignant insulinomas appear in 10 % of cases . Insulinomas occur at every age , but mainly about the 50th year . Because of its small size ( a diameter of 1-2 cm ) diagnostic localization is often difficult . With costly imaging techniques such as CT and MRI , only 60 % of the adenomas can be detected preoperatively . If reoperation is a possibility , CT and MRI are advisable . Based on our own experience and the reports of other authors , we advise the combination of transabdomial ultrasound and endosonography for the primary operation . With these methods 90 % of the adenomas can be localized preoperatively . If the clinical and biochemical insulinoma diagnosis is definite , explorative laparotomy is indicated even without preoperative morphological tumor detection . With intraoperative ultrasound and systematic palpation more than 97 % of insulinomas can be found and resected . We report the case of a 54-year-old woman with unsuccessful preoperative localization in spite of extensive clinical , biochemical and imaging procedures over a 6-month period ."
],
"offsets": [
[
0,
1274
]
]
}
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"id": "DerChirurg.90700298.eng.abstr-s13-r5-t1.1-t3.1",
"type": "uses",
"arg1_id": "DerChirurg.90700298.eng.abstr-s13-t1",
"arg2_id": "DerChirurg.90700298.eng.abstr-s13-t3",
"normalized": []
},
{
"id": "DerChirurg.90700298.eng.abstr-s13-r6-t1.1-t3.2",
"type": "uses",
"arg1_id": "DerChirurg.90700298.eng.abstr-s13-t1",
"arg2_id": "DerChirurg.90700298.eng.abstr-s13-t3",
"normalized": []
},
{
"id": "DerChirurg.90700298.eng.abstr-s13-r7-t3.2-t2.1",
"type": "conceptual_part_of",
"arg1_id": "DerChirurg.90700298.eng.abstr-s13-t3",
"arg2_id": "DerChirurg.90700298.eng.abstr-s13-t2",
"normalized": []
},
{
"id": "DerChirurg.90700298.eng.abstr-s13-r8-t3.1-t5.1",
"type": "conceptual_part_of",
"arg1_id": "DerChirurg.90700298.eng.abstr-s13-t3",
"arg2_id": "DerChirurg.90700298.eng.abstr-s13-t5",
"normalized": []
},
{
"id": "DerChirurg.90700298.eng.abstr-s13-r9-t1.1-t2.1",
"type": "performs",
"arg1_id": "DerChirurg.90700298.eng.abstr-s13-t1",
"arg2_id": "DerChirurg.90700298.eng.abstr-s13-t2",
"normalized": []
},
{
"id": "DerChirurg.90700298.eng.abstr-s13-r10-t5.1-t3.1",
"type": "measures",
"arg1_id": "DerChirurg.90700298.eng.abstr-s13-t5",
"arg2_id": "DerChirurg.90700298.eng.abstr-s13-t3",
"normalized": []
}
] |
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