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DerChirurg.90700302.eng.abstr
|
DerChirurg.90700302.eng.abstr
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[
{
"id": "DerChirurg.90700302.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A case of malignant mesothelioma of the tunica vaginalis testis is reported in a 77-year-old male patient . There was no history of asbestos exposure . Recurrent right hydrocele with a papillar inguinal mass was the main clinical feature . An inguinal radical orchiectomy with en bloc resection of the surrounding tissue was performed . The therapeutic options for this rare , but aggressive neoplasm are discussed . Because of the disappointing results of antineoplastic chemotherapy or radiation therapy , the importance of initial radical surgical treatment with complete excision is emphasized ."
],
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0,
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]
}
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"malignant"
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"mesothelioma"
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20,
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"id": "DerChirurg.90700302.eng.abstr-s1-t3",
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"testis"
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"db_id": "C0021358"
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"id": "DerChirurg.90700302.eng.abstr-s1-t4",
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"male"
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"id": "DerChirurg.90700302.eng.abstr-s1-t5",
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"history"
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"id": "DerChirurg.90700302.eng.abstr-s2-t2",
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"text": [
"asbestos"
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"id": "DerChirurg.90700302.eng.abstr-s3-t2",
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[] |
[] |
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DerChirurg.90700308.eng.abstr
|
DerChirurg.90700308.eng.abstr
|
[
{
"id": "DerChirurg.90700308.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We report the case of a 71-year-old patient who had a laryngectomy 16 years ago because of a laryngeal carcinoma and achieved voice restoration by esophageal speech . Now a squamous cell carcinoma of the esophagus had been diagnosed and was treated with a subtotal esophagectomy , stomach transposition , and collar anastomosis . Postoperatively , the patient remained esophageal speech without loss of quality ."
],
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[] |
[] |
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DerChirurg.90700310.eng.abstr
|
DerChirurg.90700310.eng.abstr
|
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"Since there are no data concerning the results/efficiency of research stipends in foreign countries , the aim of this study was to analyze the experience of German surgeons doing research work abroad . Seventy-four fellows ( residents ) in surgical training who conducted research outside Germany between 1986 and 1995 were interviewed using a detailed questionnaire . Back in Germany , the results and experience gained from research abroad led in the majority of cases to a PhD degree ( \" habilitation \" ) , a high number of publications , and intensified research efforts in the same field using the methods learned abroad . In Germany , better support for researchers in terms of better clinical and scientific perspectives is urgently needed according to numerous comments ."
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0,
779
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}
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] |
[] |
[] |
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DerChirurg.90700316.eng.abstr
|
DerChirurg.90700316.eng.abstr
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{
"id": "DerChirurg.90700316.eng.abstr-passage-0",
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"Methods to determine the mechanical properties of surgical wounds and sutures are valuable tools in wound healing research . So far standardized testing procedures have not been defined in the surgical literature , which reduces the comparability of results from different authors . Therefore we suggest a modified tensile testing procedure which follows German industrial standards ( DIN 53 455 ) . The experimental set-up includes an universal testing machine and special clamps . The dumbbell-shaped specimen consist of freshly prepared pig skin and the suture which is to be tested . Well-known mechanical properties of surgical sutures and wounds were used to approve the precision of the experimental set-up . Reproducible analysis of all tested sutures and wounds ( n = 120 ) was possible . We recommend testing procedures adapted to industrial standards to obtain comparable results in determination of mechanical properties of surgical wounds and sutures ."
],
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[
0,
965
]
]
}
] |
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[] |
[] |
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] |
DerChirurg.90700345.eng.abstr
|
DerChirurg.90700345.eng.abstr
|
[
{
"id": "DerChirurg.90700345.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Numerous inherited genetic changes predisposing to cancer have already been identified and the number is increasing . Accurate prediction of individual risk by means of molecular diagnosis implies clinical consequences in the treatment of cancer-predisposing syndromes . Using familial adenomatous polyposis ( FAP ) and hereditary non-polyposis colorectal cancer ( HNPCC ) as an example , we present here the underlying genetic changes that contribute to tumor development . These genetic alterations can be efficiently identified through molecular diagnostic techniques . Identification of the familial germline mutation permits one to distinguish mutation carriers from non-mutation carriers within affected families and results in individually tailored surveillance and prevention . Therefore , molecular diagnosis is making a contribution to the advances in preventive surgical therapy . The indications are discussed ."
],
"offsets": [
[
0,
923
]
]
}
] |
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}
] |
[] |
[] |
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DerChirurg.90700353.eng.abstr
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DerChirurg.90700353.eng.abstr
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"id": "DerChirurg.90700353.eng.abstr-passage-0",
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"Every year more than 250 000 patients suffer from ischemic ( 80 % ) or hemorragic ( 20 % ) stroke . Some 40 000 of these strokes are induced by stenosis or occlusion of the extracranial carotid artery . Several randomized studies ( NASCET , ECST , ACAS , etc. ) have proved that operative removal of high-grade carotid stenoses is an effective method in the primary and secondary prophylaxis of ischemic stroke . Operative therapy is significantly better than medical therapy with thrombocyte aggregation inhibitors . The prerequisite for effective operative prophylaxis is a low perioperative stroke rate . Even though the prophylactic value of carotid thrombarterectomy ( TEA ) is obvious , only about 5 % of all carotid-related strokes are prevented by this operation . Essential conditions for increased efficiency in carotid surgery are close cooperation with the neurologist and the internist , screening of patients with a high risk for ischemic stroke , sophisticated , mainly non-invasive diagnostics , and more operative capacity . Interventional methods ( stent , PTA ) have not yet been proved safe and effective . These methods should be employed only in special cases after interdisciplinary discussions or in randomized studies ."
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DerChirurg.90700364.eng.abstr
|
DerChirurg.90700364.eng.abstr
|
[
{
"id": "DerChirurg.90700364.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Prophylactic surgery on the musculoskeletal system has a wide range of indications , for example posttraumatic or non-traumatic malalignment of the lower extremities , joint instabilities or bony lesions with the risk of fracture and secondary malignant change . The goals of treatment include pain relief , improved function and redistribution of the physiological mechanical forces . Clinical experience over the past three decades has defined the current role of realignment of the lower limbs . Recent technological advances have further improved the surgical ability to assess and select patients who are candidates for realignment osteotomy or joint stabilization ."
],
"offsets": [
[
0,
671
]
]
}
] |
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{
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"text": [
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],
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221,
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DerChirurg.90700373.eng.abstr
|
DerChirurg.90700373.eng.abstr
|
[
{
"id": "DerChirurg.90700373.eng.abstr-passage-0",
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"Genetic predisposition is responsible for 5-10 % of all breast cancer . Within the past 10 years the major susceptibility genes for breast cancer , BRCA1 and BRCA2, have been identified . Both genes are considered to be tumor-suppressor genes , but their function is poorly understood . Current genetic testing for mutated BRCA1 and BRCA2 is the basis for estimating disease risk for women with a strong family history of breast cancer and will provide important information on the prevention and treatment of familial breast cancer ."
],
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0,
534
]
]
}
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[] |
[] |
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] |
DerChirurg.90700380.eng.abstr
|
DerChirurg.90700380.eng.abstr
|
[
{
"id": "DerChirurg.90700380.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Mammography is an established diagnostic procedure for breast cancer . Data concerning screening mammography are available from nine prospectively controlled trials , the largest series being presented from Sweden . Mammographic screening leads to a significant reduction of breast cancer of 30 % in women ages 50-59 years . In younger women ( 40-49 years ) the benefit accounts to only 20 % and has not proven to be statistically significant . Nevertheless , the major advantage of mammographic screening is detection of the non-palpable tumor = 10 mm in size . The treatment of these small breast carcinomas leads to long-term survival rates of > = 90 % . Mammographic screening programs have been introduced in the USA , Canada , Iceland and Sweden for women in their 5th decade of life . Starting yearly lifelong mammography-screening at the age of 40 , the theoretical cancer induction by radiation exposure does not exceed 0.1 % . Under highly qualified conditions , it should be possible to minimize false-positive and false-negative screening results . In Germany , screening-mammography is only introduced in patients at high risk for breast cancer . Based on medical data , mammography must be a part of screening for women with an average risk - starting at the age of 40 , although there are still open questions needing further clinical research ."
],
"offsets": [
[
0,
1360
]
]
}
] |
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"procedure"
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"id": "DerChirurg.90700380.eng.abstr-s2-t3",
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DerChirurg.90700384.eng.abstr
|
DerChirurg.90700384.eng.abstr
|
[
{
"id": "DerChirurg.90700384.eng.abstr-passage-0",
"type": "abstract",
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"For the histological verification of suspicious non-palpable small breast tumors , the three-dimensional breast biopsy applied as cylindrical extirpation using the ABBI system is the optimal solution at present . Because of the possibility of performing mammography during the operation , errors of localization can be corrected and incorrect incisions avoided . Taking the three radiomorphologically leading symptoms into consideration - suspicious microcalcification , focal shadow and structural irregularity - it can be stated that the digital mammography of the ABBI system is more sensitive than the conventional one for detecting microcalcification , but focal shadow and structural irregularity are detected less well by digital technique . These structures should be preoperatively marked by using sonography . After the complete removal of suspicious microcalcification checked by digital mammography during the operation , residual tumor might be found in a second excision when histologically invasive or intraductal tumor terminations reach the excision margin ( R1 resection ) . Thirteen invasive and 8 intraductal carcinomas were found in 80 cases of cylindrical extirpation using the ABBI system . In 7 procedures carried out to exclude an in-breast recurrence , 3 intraductal carcinomas and 1 invasive carcinoma were observed . In 8 of 12 invasive carcinomas and in 1 of 5 intraductal carcinomas , breast-conserving therapy was indicated . Two cases of invasive carcinoma fulfilled the criteria applied ( minimal tumor-free margin > 2 mm , no extensive intraductal component ) to use the ABBI cylinder as lumpectomy without a second excision to follow ."
],
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}
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[] |
[] |
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DerChirurg.90700400.eng.abstr
|
DerChirurg.90700400.eng.abstr
|
[
{
"id": "DerChirurg.90700400.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The situation of oncological surgery in Germany was evaluated by sending a questionnaire in January 1998 to 1979 registered surgical clinics . A total of 938 responded and stated that they are involved in that field . In 72 % of the departments oncological surgery adds up to 10-30 % of their overall work . The proportion of oncological surgery correlated to hospital size and is highest in university clinics . Colorectal surgery is 93 % and is the leading topographical field in oncological surgery . 73 % of the hospitals regularly perform gastric tumor surgery . The proportion of hospitals with breast surgery is surprisingly high ( 45 % ) . Many hospitals ( 54.6 % ) report neoadjuvant treatment regimens . Together with adjuvant therapy this rate amounts to 85.2 % . The diagnostic spectrum of the hospitals involved in the inquiry is statisfactory . However , the modern possibilities of network and telecommunication are not sufficiently used . A second opinion is required predominantly in their own department or clinic , but not between centers . The surgeon's position concerning the speciality \" surgical oncology \" is ambivalent : only 35.3 % of the department chiefs support this speciality - and over 90 % of the departments reject the structural independence of \" surgical oncology \" from \" visceral surgery \" ."
],
"offsets": [
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0,
1330
]
]
}
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] |
[] |
[] |
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DerChirurg.90700407.eng.abstr
|
DerChirurg.90700407.eng.abstr
|
[
{
"id": "DerChirurg.90700407.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The data of the German Prospective Multicenter Study of the Study Group Colorectal Carcinoma ( SGCRC ) were analyzed with regard to interinstitutional differences in 5-year survival by statistical methods adequate for ranking and observing anonymity . Furthermore , possible so-called surrogate endpoints that allow an assessment of definite outcome after surgical treatment earlier than after 5 years were also analyzed . This requires a separate analysis for rectal and colon carcinoma patients . For rectal carcinoma , the combination of the frequency of local tumor cell spillage during tumor resection ( iatrogenous tumor perforation and/or incision into or through tumor tissue ) and the rate of locoregional recurrences ( within 2 years after surgery ) could be demonstrated as realiable surrogate endpoint . For colon carcinoma , no reliable surrogate endpoint could be found . Surgical morbidity is not an indicator of definite outcome . A very low rate of surgical mortality does not ensure satisfactory long-term results in colorectal cancer surgery ."
],
"offsets": [
[
0,
1062
]
]
}
] |
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] |
DerChirurg.90700422.eng.abstr
|
DerChirurg.90700422.eng.abstr
|
[
{
"id": "DerChirurg.90700422.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Repair of incisional hernias requires the extensive implantation of alloplastic materials . The extent of the scar tissue is markedly regulated by the amount and structure of the incorporated material and is responsible for the increased rate of local wound complications . Correspondingly , minimization of the alloplastic implants should be favorable . In a randomized , prospective clinical study , the early results were compared after implantation of either a minimized , low-weight ( 26.8 g/m2) mesh with a pore size of 5 mm or a common , heavy-weight ( 90.2 g/m2 polypropylene ) mesh with a pore size of 0.8 mm . Indicators for clinical suitability were the rate and volume of seroma , subjective paraesthesia , physical capability , abdominal wall compliance , and the histologically analyzed tissue reaction of samples removed on the occasion of revision operations . As result , the optimized , low-weight mesh showed a remarkable decrease in the rate of seroma , patient complaints , less restriction of abdominal wall mobility , and improved abdominal wall compliance as verified by 3D stereography . These clinical findings corresponded to a pronounced decrease in inflammation and scar reaction , indicating improved incorporation of the alloplastic material . No other major complications except for one recurrence have been found ."
],
"offsets": [
[
0,
1347
]
]
}
] |
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"hernias"
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] |
[] |
[] |
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DerChirurg.90700431.eng.abstr
|
DerChirurg.90700431.eng.abstr
|
[
{
"id": "DerChirurg.90700431.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Eleven patients with high-grade mucosal dysplasia in a columnar-lined oesophagus and 2 patients with a squamous carcinoma ( uT1) underwent photodynamic therapy ( PDT ) and argon-plasma coagulation ( APC ) . For PDT , 5-aminolevulinic acid ( 5-ALA ) was given orally ( 60 mg/kg ) and treated endoscopically with a light dose of 150 J/cm2 ( 100 mW/cm2) at 635 nm 4-6 h later . A second PDT was performed under the same conditions 2-3 weeks later . Patients who received APC were treated 4 times on average to reach radical Barrett mucosa eradication . All patients were consistently given medication to suppress acid production . No complications occurred in either group . Follow-up endoscopies and multiple biopsies for 3-42 months showed squamous regeneration in the dysplastic columnar-lined oesophagus in all 11 patients . Two patients with squamous carcinoma were found to have a recurrence 9 and 12 months later . PDT with 5-ALA-induced endogenous porphyrins , as well as APC combined with omeprazole protection , can eradicate superficial high-grade dysplastic mucosa in Barrett's oesophagus . However , we did not succeed in destroying a manifest carcinoma ."
],
"offsets": [
[
0,
1165
]
]
}
] |
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[] |
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] |
DerChirurg.90700439.eng.abstr
|
DerChirurg.90700439.eng.abstr
|
[
{
"id": "DerChirurg.90700439.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Over a period of 11 years a total of 140 liver resections for non-colorectal , non-neuroendocrine hepatic metastases were performed in 127 patients ( 73 women , 54 men ; median age 53 years ) . There were 120 first , 14 second and 6 third liver resections . Primary tumors were : breast cancer ( n = 34 ) , leiomyosarcoma ( n = 20 ) , pancreatic cancer ( n = 16 ) , renal cell carcinoma ( n = 13 ) , melanoma ( n = 9 ) , gastric cancer ( n = 9 ) , lung cancer ( n = 6 ) and adrenal cancer ( n = 6 ) and miscellaneous tumors ( n = 14 ) . Extrahepatic tumor manifestation ( including synchronous primary tumors ) was found in 69/140 cases ( 49 % ) ; 61 of 120 patients with a first liver resection had extrahepatic tumor ( 51 % ) . In the 120 first liver resections , 82 ( 68 % ) R0, 13 ( 11 % ) R1 and 25 ( 21 % ) R2 excisions were possible . Median survival after first liver resection was 20 months ; after R0 resection a median survival of 28 months and after R1/2 resection of 8 months was achieved . The 5-year survival rate was 16 % for the total group , 24 % in patients with R0 resection and 0 % for R1/2 resections . After a second liver resection ( n = 14 ) there was a median survival of 28 months ( 5-year-survival-rate of 21 % ) for all patients and of 41 months ( 5-year survival rate 38 % ) after R0 resection . Morbidity and mortality after the first liver resection were 32.5 % and 5.8 % , respectively . In patients without extrahepatic tumor at the time of the first liver resection a median survival of 32 months ( 5-year survival rate 25 % ) and 7 months was achieved after R0 resection and R1/2 resection , respectively . In case of extrahepatic tumor the median survival was 24 months ( 5-year survival rate 23 % ) for R0 resection compared to 8 months after R1/2 resection . These data suggest that not the presence of extrahepatic tumor but rather the possibility of a R0 resection is most decisive for the prognosis after liver resection . We conclude that patients with liver metastases of non-colorectal , non-neuroendocrine tumors may benefit from liver resection . Similar to colorectal metastases , a second or third liver resection can be worthwhile in selected cases . Even in more unfavorable tumor entities , several cases of long-term survival were observed after surgical therapy . Therefore , the indication for liver resection should be considered carefully in every single case ."
],
"offsets": [
[
0,
2418
]
]
}
] |
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"id": "DerChirurg.90700439.eng.abstr-s1-t7",
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DerChirurg.90700447.eng.abstr
|
DerChirurg.90700447.eng.abstr
|
[
{
"id": "DerChirurg.90700447.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A national survey was conducted to determine the role of portosystemic shunt surgery and transjugular intrahepatic portosystemic shunt ( TIPS ) in Germany . A questionnaire was mailed to 1324 surgical units at 1273 hospitals , and 941 responses ( 74 % ) were received . Interventional endoscopy for variceal bleeding is carried out predominantly ( 73 % ) in medical departments . From 1992 to 1997 the annual number of surgical shunts dropped from 253 to 120 , whereas the respective numbers of TIPS increased from 202 to 920. In this 6-year period a total of 1042 shunts and 3575 TIPS were reported by 109 and 64 centers , respectively . TIPS was applied mainly in university hospitals ( 88.9 % ) , whereas shunt surgery was more broadly used in non-university hospitals ( 58.8 % ) . Clearly , prospective randomized comparisons of TIPS and surgical shunts are needed to reveal which treatment is best in patients with variceal bleeding stratified for mortality risk and stage of liver disease . However , the decreasing number and experience with shunt surgery may impede such studies . Probably , liver transplant centers which currently do only 41.2 % of shunt procedures are most familiar with surgery in portal hypertension and are therefore most appropriate to maintain quality and expertise in this palliative and demanding branch of surgery ."
],
"offsets": [
[
0,
1351
]
]
}
] |
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DerChirurg.90700453.eng.abstr
|
DerChirurg.90700453.eng.abstr
|
[
{
"id": "DerChirurg.90700453.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Background : Laparoscopic techniques are currently used for curative resection of colorectal cancer although long-term results from controlled clinical trials are not available yet that prove laparoscopic procedures are adequate . Methods : All patients who underwent a curative resection of a colorectal tumor from 1995 to 1997 were included in a prospective cohort study to evaluate the short- and long-term results . Results : Laparoscopic colorectal resections were accomplished in 68 patients . In only 3 patients was an adenoma ( stage 0 ) found , and 10 patients had multiple liver metastases at the time of palliative resection . An oncological resection was performed in 55 patients . The average age was 62.8 +/- 14.6 years ( 29 female and 26 male patients ) . Eleven right colectomies , 1 left colectomy , 21 sigmoid resections , 16 proctosigmoidectomies and 6 abdominoperineal resections were carried out . Two patients ( 3.6 % ) were lost during follow-up . The median follow-up was 27.1 months ( range 9.1-45.1 months ) . No port-site metastases were found . Two patients who are still alive after sigmoid resection suffered from a recurrence . The first patient underwent only limited lymphadenectomy because of synchronous malignant lymphoma . The second patient developed bilateral lung metastases . Only one patient died during the follow-up period because of myocardial infarction . Conclusion : Although the follow-up is short , it seems that the recurrence rate is low . Controlled multicenter clinical trials are currently performed to evaluate whether laparoscopic surgery is really adequate to treat colorectal cancer ."
],
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DerChirurg.90700456.eng.abstr
|
DerChirurg.90700456.eng.abstr
|
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{
"id": "DerChirurg.90700456.eng.abstr-passage-0",
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"text": [
"In a period of 4 years between March 1994 and March 1998 , 143 patients with gastroesophageal reflux disease ( GERD ) underwent laparoscopic antireflux surgery . According to manometric studies 76 patients had a short-floppy Nissen fundoplication , patients with impaired motility or paraesophageal hernias received a hemifundoplication ( Toupet = 42 , Dor/Thal = 25 ) . Recurrent reflux symptoms appeared in 6,3 % after mean 16,7 months follow-up ( Nissen = 2.6 % , Toupet = 2.3 % , Dor/Thal = 24 % , P 0.01 ) . Persistent dysphagia with reoperation occurred in 2.1 % ( Nissen = 2.6 % , Toupet = 2.3 % , Dor/Thal = 0 % , n . s. ) . The assessment of Visick's score at the latest control showed the following : Visick I = 63.6 % , Visick II = 30.1 % , Visick III = 6.3 % , Visick IV = 0 % . The outcome of the operation was rated \" excellent \" or \" good \" by 91.6 % of the patients ."
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[] |
[] |
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] |
DerChirurg.90700464.eng.abstr
|
DerChirurg.90700464.eng.abstr
|
[
{
"id": "DerChirurg.90700464.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Video-assisted thoracoscopic ( VAT ) debridement is gaining importance in the fibrino-purulent phase of empyema thoracis . However , evaluation of this access compared with mere chest tube drainage or thoracotomy remains unsatisfactory . A total of 356 parapneumonic empyemas from 1986 to 1997 were retrospectively analyzed concerning the results after primary treatment ( chest tube 225 , thoracotomy 80 , VAT 51 ) . The three groups did not differ significantly for gender and associated diseases . Median age of the chest tube drainage group ( 54 years ) was higher than for thoracotomy ( 43.5 years ) or VAT ( 39 years ) . Median duration of chest tube treatment after thoracotomy ( 7 days ) was shorter than after VAT ( 13 days ) or chest tube drainage ( 20 days ) ( P 0.0001 ) . The more invasive procedures were also superior to the lesser invasive treatment concerning duration of postoperative hospitalization , recurrence rate and treatment failures . In spite of its better results thoracotomy will be pushed back by VAT in the treatment of empyema thoracis . Acceptance of VAT is reflected in rising numbers of admissions . Based on these retrospective results we are planning a prospective multicenter trial to evaluate the indication for VAT in empyema thoracis ."
],
"offsets": [
[
0,
1277
]
]
}
] |
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31,
34
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"text": [
"empyema"
],
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104,
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"evaluation"
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DerChirurg.90700476.eng.abstr
|
DerChirurg.90700476.eng.abstr
|
[
{
"id": "DerChirurg.90700476.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The most common cause of portal hypertension in children with healthy livers is the prehepatic block . A 7-year-old girl had presented with portal vein thrombosis after umbilical vein catherization in the newborn period . She suffered from collateral circulation with recurrent bleeding episodes due to esophageal varices ( stage III-IV ) and developed hypersplenism . Ultrasound demonstrated an open branch of the left portal vein . Direct splenoportography showed an open and communicating superior mesenteric vein . Liver biopsy was normal . An autologous left jugular vein graft was used to create a bypass from the superior mesenteric vein to the umbilical portion of the left intrahepatic portal vein ( mesentericoportal Rex-shunt ) . Postoperatively , normal intrahepatic portal vein flow was demonstrated by ultrasound . After 2 years of follow-up , the patient is asymptomatic with no signs of portal hypertension . In contrast to classic portosystemic shunt operations , this bypass restores physiological portal vein flow , thus avoiding the possible consequences of longterm portosystemic shunting and low-grade encephalopathy ."
],
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0,
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]
]
}
] |
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] |
DerChirurg.90700485.eng.abstr
|
DerChirurg.90700485.eng.abstr
|
[
{
"id": "DerChirurg.90700485.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Surgical drapes made of cotton are under increasing competition with various disposable products and reusable draping systems ( e . g . , made of synthetic fabrics like polyester ) . When making a choice to use one of these medical devices in practical surgery , major aspects like handling , hygienic safety and costs , but also environmental effects have to be taken into account . In this study a mixed system for patient drapes ( reusable cotton drapes combined with a reduced set of impermeable single-use drapes made of cellulose/polyethylene ) was compared to a system that is only based on single-use drapes with regard to ecology [ life-cycle assessment ( LCA ) ] . The medical literature was reviewed to assess important medical aspects of the use of patient drapes , resulting in the statement that there are no conclusive arguments to support a clear hygienic superiority of one of these alternatives . Based on the conditions assumed and stated , the results of the LCA indicate that the mixed draping system is associated with two times more total energy consumption . In addition , more water is needed and more CO2 emissions are produced . However , draping with the single-use product results in more clinical waste . Regarding water pollution no system proved superior . It is difficult to compare and weigh various environmental aspects like the polluting cultivation of cotton in distant countries ( reusable drapes ) and the higher figure of transportation necessary to deliver the single-use product within Germany . It is an important disadvantage of the mixed system that it combines the ecological burden of both cotton drapes and the single-use alternative ."
],
"offsets": [
[
0,
1684
]
]
}
] |
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},
{
"id": "DerChirurg.90700485.eng.abstr-s5-r19-t10.1-t3.1",
"type": "measures",
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"id": "DerChirurg.90700485.eng.abstr-s8-r1-t2.1-t1.2",
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"id": "DerChirurg.90700485.eng.abstr-s11-r2-t3.1-t2.1",
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] |
DerChirurg.90700493.eng.abstr
|
DerChirurg.90700493.eng.abstr
|
[
{
"id": "DerChirurg.90700493.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The assessment center ( AC ) , which played an important role in the recruitment of officers at the beginning of the century , nowadays is used in the business for the selection of managers . Also in the medical institutions the AC is of increasing significance , since the accentuation of economic aspects have led to a change in the qualities expected of a physician in chief . Usually the AC in the classic form is not applied ; more often , hospitals take advantage of professional counselors who obviously use the basic elements of the AC . Physicians who are concerned are recommended to study the essence of the AC ."
],
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0,
623
]
]
}
] |
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14
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}
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"id": "DerChirurg.90700493.eng.abstr-s2-t1",
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"id": "DerChirurg.90700493.eng.abstr-s2-t2",
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"id": "DerChirurg.90700493.eng.abstr-s2-t3",
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"id": "DerChirurg.90700493.eng.abstr-s4-t2",
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] |
[] |
[] |
[
{
"id": "DerChirurg.90700493.eng.abstr-s1-r1-t1.1-t3.1",
"type": "isa",
"arg1_id": "DerChirurg.90700493.eng.abstr-s4-t1",
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},
{
"id": "DerChirurg.90700493.eng.abstr-s1-r2-t1.1-t3.1",
"type": "measures",
"arg1_id": "DerChirurg.90700493.eng.abstr-s4-t1",
"arg2_id": "DerChirurg.90700493.eng.abstr-s3-t3",
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},
{
"id": "DerChirurg.90700493.eng.abstr-s2-r1-t1.1-t3.1",
"type": "issue_in",
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{
"id": "DerChirurg.90700493.eng.abstr-s3-r1-t5.1-t1.1",
"type": "manages",
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"id": "DerChirurg.90700493.eng.abstr-s3-r2-t5.1-t1.1",
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{
"id": "DerChirurg.90700493.eng.abstr-s3-r3-t3.1-t1.1",
"type": "uses",
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},
{
"id": "DerChirurg.90700493.eng.abstr-s3-r4-t3.1-t1.1",
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}
] |
DerChirurg.90700513.eng.abstr
|
DerChirurg.90700513.eng.abstr
|
[
{
"id": "DerChirurg.90700513.eng.abstr-passage-0",
"type": "abstract",
"text": [
"To summarize , J-shaped and W-shaped ileal pouches serve as adequate neorectal reservoirs after proctocolectomy . These pouches anastomosed directly to the anal canal are as distensible and capacious and as readily evacuated as the rectum in health . However , the use of S- or H-shaped ileal pouches , which have efferent limbs positioned between the pouch and the anal canal , sometimes leads to outflow obstruction and incomplete evacuation . There is little doubt that neorectums made of ileum can allow patients to have entirely \" normal \" patterns of fecal continence . Nonetheless , with pouch distension , large-amplitude , propulsive pouch contractions occur . These large pressure waves bring on the urge to defecate . They stress the anal sphincters more acutely than either the infrequent , small-amplitude , nonpropulsive contractions or clustered contractions of the healthy rectum . Nonetheless , patients learn to recognize the different signals heralding the impending need for evacuation from the ileal pouch and deal with them . Jejunal pouches , because of their greater distensibility and larger capacity , and the greater frequency of interdigestive migrating myoelectric complexes ( MMCs ) occurring in them , hold the promise of being a better rectal substitute than ileal pouches . They are more difficult to construct , however . Colonic pouches , when anastomosed to the anal canal after rectal resection , also act as adequate fecal reservoirs . Their main drawback is the inability of some patients to empty them . Small ( 5 cm ) colonic pouches seem to empty better than larger ( 10-15 cm ) ones . Jejunal pouches and colonic segments used as gastric substitutes after gastrectomy provide a better reservoir for ingested food than straight jejunal segments . The main drawback of the pouches is their inability to triturate the solid content of a meal and to regulate the rate of its emptying into the small intestine . Liquids and solids likely empty from these pouches at the same rate , in contrast to the slower emptying rate of solids from the healthy stomach . This likely leads to maldigestion of solids , perhaps contributing to the weight loss often found after gastrectomy ."
],
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0,
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]
]
}
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"id": "DerChirurg.90700513.eng.abstr-s2-t1",
"type": "umlsterm",
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{
"id": "DerChirurg.90700513.eng.abstr-s2-t2",
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"text": [
"health"
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{
"id": "DerChirurg.90700513.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"limbs"
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"id": "DerChirurg.90700513.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
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],
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]
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"db_id": "C0012359"
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"id": "DerChirurg.90700513.eng.abstr-s6-t1",
"type": "umlsterm",
"text": [
"pressure"
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"id": "DerChirurg.90700513.eng.abstr-s7-t1",
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{
"id": "DerChirurg.90700513.eng.abstr-s7-t2",
"type": "umlsterm",
"text": [
"anal sphincters"
],
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"id": "DerChirurg.90700513.eng.abstr-s14-t2",
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"id": "DerChirurg.90700513.eng.abstr-s15-t1",
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"id": "DerChirurg.90700513.eng.abstr-s15-t2",
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"id": "DerChirurg.90700513.eng.abstr-s15-t3",
"type": "umlsterm",
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{
"id": "DerChirurg.90700513.eng.abstr-s17-t1",
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"id": "DerChirurg.90700513.eng.abstr-s17-t4",
"type": "umlsterm",
"text": [
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{
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]
}
] |
[] |
[] |
[
{
"id": "DerChirurg.90700513.eng.abstr-s14-r1-t1.1-t2.1",
"type": "uses",
"arg1_id": "DerChirurg.90700513.eng.abstr-s17-t1",
"arg2_id": "DerChirurg.90700513.eng.abstr-s17-t2",
"normalized": []
},
{
"id": "DerChirurg.90700513.eng.abstr-s15-r1-t3.1-t1.1",
"type": "part_of",
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"arg2_id": "DerChirurg.90700513.eng.abstr-s17-t1",
"normalized": []
},
{
"id": "DerChirurg.90700513.eng.abstr-s15-r2-t2.1-t1.1",
"type": "part_of",
"arg1_id": "DerChirurg.90700513.eng.abstr-s17-t2",
"arg2_id": "DerChirurg.90700513.eng.abstr-s17-t1",
"normalized": []
},
{
"id": "DerChirurg.90700513.eng.abstr-s16-r1-t1.1-t2.2",
"type": "location_of",
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"arg2_id": "DerChirurg.90700513.eng.abstr-s17-t2",
"normalized": []
},
{
"id": "DerChirurg.90700513.eng.abstr-s16-r2-t1.1-t2.2",
"type": "affects",
"arg1_id": "DerChirurg.90700513.eng.abstr-s17-t1",
"arg2_id": "DerChirurg.90700513.eng.abstr-s17-t2",
"normalized": []
},
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DerChirurg.90700520.eng.abstr
|
DerChirurg.90700520.eng.abstr
|
[
{
"id": "DerChirurg.90700520.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Reconstruction of the intestinal passage after a total gastrectomy is usually based on a direct esophagojejunostomy with end-to-side implantation of the afferent loop . The second principle of reconstruction is based on preservation of the duodenal passage . Long-term problems such as weight loss and malnutrition are further considerations that lead to the concept that gastric reconstruction should have the form of a reservoir . In addition to the construction of the reservoir itself , the clinical concern of avoiding gastroesophageal reflux is a further requirement for the choice of reconstruction type . Diversion of the duodenal content via a Roux-en-Y end-to-side anastomosis is considered to be the standard procedure . Interposition of a sufficiently long duodenal loop with maintenance of the duodenal passage also has the effect of preventing duodenal reflux . A theoretical advantage of this procedure is the linking of the motility of the duodenum with that of the interposed segment with improved synchronization of the aboral nutrient passage . When one considers complicated reconstructive procedures , the present literature suggests construction of a pouch is definitely functionally superior to the simple esophagojejunostomy . Whether the duodenal passage should be maintained or whether a Roux-Y technique should be used is a question that is still open for discussion ."
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] |
[] |
[] |
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DerChirurg.90700530.eng.abstr
|
DerChirurg.90700530.eng.abstr
|
[
{
"id": "DerChirurg.90700530.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The ileoanal pouch procedure ( IAPP ) was the most remarkable breakthrough in the surgical therapy of ulcerative colitis ( UC ) and familial adenomatous polyposis ( FAP ) in the last 20 years . The underlying disease is under control , the function preserved and the quality of life markedly improved . Alternative procedures ( terminal ileostomy , ileorectal anastomosis ) are only indicated in special cases . In the last 16 years we have operated on 662 patients ( n = 493 UC ; n = 169 FAP ) with an ileoanal J-pouch , short rectal cuff , complete mucosectomy and hand-sewn anastomosis . Normally there is a good function for UC and FAP patients after IAPP . Surgical experience , technical modifications concerning the pouch design and the pouch-anal anastomosis , and a differentiated indication lead to a further improvement of these complex procedures with consecutive reduction of complications . Specific complications concerned mainly the pouch-anal anastomosis ( fistulas , abscesses , consecutive stenosis ) and inflammation of the pouch mucosa ( pouchitis ) . A multivariate analysis showed , that increasing experience of the specialized center is a significant factor reducing inflammatory problems at the anastomosis . The cumulative incidence of pouchitis was 29 % . In general there is no problem in successful treatment . But patients with chronic pouchitis are a problematic group ( 6.2 % ) . Chronic pouchitis is difficult to treat . It is likely that there exists an inflammation dysplasia carcinoma sequence for the ileal pouch mucosa , analogous to the colorectum . Recently we diagnosed the first case of a real ileum pouch carcinoma with associated epithelial dysplasias following chronic pouchitis . Therefore patients with chronic pouchitis must be followed up by endoscopy and random biopsies in a surveillance program . Patients with UC and FAP can gain the life quality of healthy controls , if postoperative complications can be avoided or treated successfully . For the further development of the procedure and the individual long-term success a qualified follow-up and therapy of complications is essential . Both can be carried out only by a specialized center ."
],
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[
0,
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}
] |
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DerChirurg.90700543.eng.abstr
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DerChirurg.90700543.eng.abstr
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"The tendency towards sphincter-preserving resection for distal rectal cancers has led to a revival of the technique of coloanal anastomosis ( CAA ) in recent years . In order to improve functional results , creation of a colonic J-pouch in conjunction with a coloanal anastomosis ( CPA ) was proposed . Two different operation techniques exist : i ) Double-stapling with the anastomosis close to the dentate line and ii ) intersphincteric resection with the anastomosis located immediately at the dentate line . A long rectal remnant after double-stapling leads to urgency in 15 % of the patients due to stool retention in the atonic remnant . No propulsive motility patterns were recorded from the pouch which is emptyed passively by upper colonic peristalsis . Therefore colonic pouches should be fashionned of descending colon and should not exceed a length of 6 cm in order to prevent stool fragmentation . Under these conditions the average stool frequency is reduced from 2-6 /d after CAA to 1-3 /d after CPA . This effect is maximal during the first postoperative months , but is still significant after 3 years . Colonic pouch construction also leads , due to better blood supply and prevention of pelvic hematomas , to a significant decrease of the anastomotic insufficiency rate from 10,0 % after CAA to 5,4 % after CPA . Therefore creation of a colonic J-pouch should be combined with coloanal reconstruction if the oncologic situation allows a sphincter-preserving procedure ."
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[] |
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DerChirurg.90700552.eng.abstr
|
DerChirurg.90700552.eng.abstr
|
[
{
"id": "DerChirurg.90700552.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The choice of the best reconstruction technique following resection of either the stomach or the rectum remains a matter of discussion . While there is no problem in reconnecting intestinal segments , which do not serve as a reservoir , there are many different operation techniques to replace the stomach and rectum , producing significantly different functional results . The ileocecal segment offers an excellent intestinal reservoir combined with an antireflux mechanism , thus presenting an ideal replacement for the stomach . For replacement of the rectal reservoir as well , the ileocecal segment may be used in the first line of treatment . Method : The ileocecal segment was used in 20 patients following gastric resection and lymphadenectomy to reconstruct the intestinal passage between the esophagus and the duodenal stump ( group A ) . In some further 44 patients ( group B ) the ileocecal segment was used to replace the rectum between the descending colon and the dentate line following resection for very low-grade rectal cancer . Mortality and morbidity were investigated in both groups . In group A quality of life , weight loss , dumping and reflux symptoms were evaluated . In group B continence , discrimination , defecation quality , urge and the patient satisfaction were investigated . All data were recorded prospectively . Results : Early and late mortality were not different compared to other reconstruction types . In each group one patient died within 60 days postoperatively due to myocardial infarction . The morbidity following stomach replacement was 20 % , following rectal replacement 4.6 % during hospitalization and 13.8 % during follow-up , respectively . One patient complained about heartburn , but endoscopically no pathology was detected in any patient . Three months postoperatively the patients ' weight remained stable or started to increase . Three months following rectal replacement 87 % of the patients were continent with further improvement over 2 years . Soiling mainly during the night remained over 2 years in 44 % . 88 % of the patients were completely satisfied 2 years postoperatively . Conclusion : The replacement of either the stomach or the rectum using the ileocecal segment with an adequate surgical technique is safe and produces excellent functional outcome regarding the reconstruction of the intestinal passage as well as the reservoir function of the primary organ . Furthermore , preservation of the duodenal passage after gastrectomy may prevent dysregulation of the endocrine and exocrine pancreatic hormones ."
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[] |
[] |
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"id": "DerChirurg.90700552.eng.abstr-s20-r1-t4.1-t2.1",
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}
] |
DerChirurg.90700566.eng.abstr
|
DerChirurg.90700566.eng.abstr
|
[
{
"id": "DerChirurg.90700566.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Patients suffering from long-untreated malignomas of the chest or abdominal wall may require plastic surgery due to extensive defects after tumor resection . Despite a variety of pedicled or free myocutaneous flaps , there are defects in which these reconstructional options may not be indicated . In these patients , the omental flaps are a valid alternative . Since a secondary split skin graft is mandatory with the omentum flap , antibacterial and granulation-enhancing xerodressings are required for wound bed conditioning . We report one patient in whom the omentum flap was used for coverage of an extensive defect after resection of a widespread basal cell carcinoma at the lateral thorax and abdominal wall . After wound conditioning with silver-impregnated activated charcoal xerodressing ( Actisorb ) in combination with a hydroactive polymer dressing ( Allevyn ) , secondary skin grafting was performed . In this patient fibrosis and calcification of the omentum led to stable abdominal wall coverage even without the application of a synthetic mesh ."
],
"offsets": [
[
0,
1063
]
]
}
] |
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{
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"plastic"
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"surgery"
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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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DerChirurg.90700582.eng.abstr
|
DerChirurg.90700582.eng.abstr
|
[
{
"id": "DerChirurg.90700582.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In a 20-year period ( 1974-1993 ) , 4230 patients underwent surgery of the gallbladder . Acute cholecystitis was the indication for emergency laparotomy in 869 patients ( 20,5 % ) . Retrospective analysis demonstrated that after adjustment for age , sex , and mode of surgery - elective versus emergency - advanced age is not a risk factor contributing to mortality in uncomplicated cases of emergency surgery . Cases of acute cholecystitis complicated by perforation , peritonitis , and/or the presence of concrements in the biliary duct are associated with an increased mortality , however . We were able to demonstrate that advanced age is a risk factor in complicated cases and contributes to increased post-surgical mortality ."
],
"offsets": [
[
0,
732
]
]
}
] |
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] |
[] |
[] |
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DerChirurg.90700588.eng.abstr
|
DerChirurg.90700588.eng.abstr
|
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{
"id": "DerChirurg.90700588.eng.abstr-passage-0",
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"We report a truck driver with severe soft tissue contusion of both legs who developed atypical heparin-induced thrombocytopenia ( HIT ) after a thrombosis prophylaxis with unfractionated heparin ; despite a thrombosis the patient showed a systemic allergic reaction to heparin in combination with elevation of thrombocytes and positive heparin-dependent antibodies . Six days after the initial trauma deep vein thrombosis of the left lower leg was diagnosed and fasciotomy was performed , preventing an imminent compartment syndrome . Another 5 days later the patient developed exanthema of the trunk and upper extremities and urticaria on his face , as well as severe headache . His platelet count increased from 134 000/µl to 258 000/µl. After exclusion of other causes for these symptoms , a reaction to heparin-dependent antibodies ( heparin-platelet-factor 4 complex ) was demonstrated 2 days later . Thrombosis prophylaxis was changed to hirudin ( Refludan ) and elevation of thrombocytes to 445 000/µl was noted . Shortly after rinsing of an intravenous line with less than 50 IE unfractionated heparin at day 36 after trauma the patient developed an anaphylactic shock , which could be managed with cortisone . We suggest that in HIT the thrombocytopenia may represent only one form of an allergic reaction to heparin . The cause of the thrombembolic event is an antigen-antibody reaction to heparin taking place on the surface of the thrombocyte . This is similar in all forms of systemic reaction to heparin application , even though the symptoms may vary . As thrombocytopenia may not be the main symptom of a heparin-induced antibody reaction - in our hospital only 5 of 10 patients with HIT - the disease should rather be named \" heparin allergy \" . We suggest a new classification of different pattern of heparin allergy types I-IV . The new types I and II are similar to HIT types I and II . Type III is the reaction of antibodies without decrease of thrombocytes , and type IV the reaction of antibodies associated with systemic allergic symptoms ."
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[] |
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DerChirurg.90700595.eng.abstr
|
DerChirurg.90700595.eng.abstr
|
[
{
"id": "DerChirurg.90700595.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Intestinal , renal , spinal or peripheral arterial ischemia or failure of branch artery recanalization following initial prosthetic repair of thoracoabdominal aortic dissection is still a problem , with high morbidity and mortality . Five consecutive patients with acute thoracoabdominal aortic dissection ( two type A dissections , three type B dissections ) suffering from concomitant intestinal , renal , spinal and acute peripheral arterial ischemia are reported . Considering the anatomical and pathophysiological basis of thoracoabdominal aortic dissection and concomitant organ ischemia , the aortic fenestration procedure as a primary or secondary operative approach succeeded in restoring blood flow in all cases without complications . Assessment of the long-term results after 3 years revealed that all patients are doing well without any residual complaints . We conclude that in the case of persistent or secondary onset of aortic branch artery ischemia following initial prosthetic repair of either type A or type B dissection , aortic fenestration can be recommended immediately as a staged operative approach . Primary abdominal aortic fenestration is justified in acute type B dissection when end-organ ischemia becomes the focus of clinical deterioration ."
],
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0,
1274
]
]
}
] |
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[] |
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DerChirurg.90700602.eng.abstr
|
DerChirurg.90700602.eng.abstr
|
[
{
"id": "DerChirurg.90700602.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Thoracic actinomycosis is a rare disease often mistaken for malignancy . Untreated actinomycosis is associated with high mortality , the disease should , thus , be considered early . We report the case of a 58-year-old male patient who was referred to us for a suspected thoracic sarcoma . He had 6-month a history of hemoptysis , and there was severe deterioration in his general health . Only in a roundabout way was the diagnosis of thoracic actinomycosis established ; it was caused by an aspirated chicken bone , as found by bronchoscopy . All symptoms rapidly regressed by antibiotic therapy and definitive healing was obtained . In the diagnostic work up of thoracic masses that may represent inflammatory diseases , lymphoma , thymus-associated , sarcomatous and germ-cell tumors , bronchoscopy is of primary diagnostic importance ."
],
"offsets": [
[
0,
840
]
]
}
] |
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] |
[] |
[] |
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DerChirurg.90700605.eng.abstr
|
DerChirurg.90700605.eng.abstr
|
[
{
"id": "DerChirurg.90700605.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A 36-year-old female patient was transferred to our unit for surgical treatment of a biliary tract obstruction . ERC disclosed an obliteration of the common hepatic duct involving the hepatic bifurcation . Primary sclerotic cholangitis and carcinoma of the bile duct could not be confirmed histologically in the biopsy specimens . Tumor markers and autoimmune antibodies were normal . Histological examination of the ductus choledochus during the operation was not conclusive and a malignant lymphoma was considered . The macroscopic appearance comprised obliterative alterations extending to the right hepatic duct . Therefore , resection of the extrahepatic bile duct , right hemihepatectomy and hepaticojejunostomy were performed . The final histological statement revealed a lymphoepithelial carcinoma . The postoperative course of the patient was uneventful , and the patient is in good condition without any signs of recurrent disease 12 months after the operation . This tumor has been described as occurring as a neoplasm of the stomach and salivary glands exclusively and as being of low-grade malignancy . Additional histological evaluations confirmed the diagnosis of lymphoepithelial carcinoma ."
],
"offsets": [
[
0,
1207
]
]
}
] |
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] |
DerChirurg.90700608.eng.abstr
|
DerChirurg.90700608.eng.abstr
|
[
{
"id": "DerChirurg.90700608.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We present a necrosis of the big toe in a 20-year-old woman with an ingrowing toenail after wedge-shaped excision in the big toe . The reason for the necrosis was a tourniquet that was left in place after the operation . The ischemia , which lasted for 2 days , resulted in subtotal necrosis of the big toe . Six weeks after the operation the patient underwent microsurgical reconstruction . This is a report on the treatment of this complication from the beginning . Early surgical intervention is advocated ."
],
"offsets": [
[
0,
510
]
]
}
] |
[
{
"id": "DerChirurg.90700608.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"necrosis"
],
"offsets": [
[
13,
21
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0027540"
}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"toe"
],
"offsets": [
[
33,
36
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0040357"
}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"woman"
],
"offsets": [
[
54,
59
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0043210"
}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"toe"
],
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[
125,
128
]
],
"normalized": [
{
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}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"ingrowing toenail"
],
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[
68,
85
]
],
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{
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"db_id": "C0027343"
}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"necrosis"
],
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[
150,
158
]
],
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{
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"db_id": "C0027540"
}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"tourniquet"
],
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[
165,
175
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0040519"
}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"operation"
],
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[
209,
218
]
],
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{
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"db_id": "C0543467"
},
{
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}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"ischemia"
],
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[
225,
233
]
],
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{
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"db_id": "C0022116"
}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"necrosis"
],
"offsets": [
[
283,
291
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0027540"
}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"toe"
],
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[
303,
306
]
],
"normalized": [
{
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}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"operation"
],
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329,
338
]
],
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{
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},
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}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"patient"
],
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[
343,
350
]
],
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{
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}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s5-t1",
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"treatment"
],
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416,
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]
],
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},
{
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}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"complication"
],
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434,
446
]
],
"normalized": [
{
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"db_id": "C0009566"
}
]
},
{
"id": "DerChirurg.90700608.eng.abstr-s6-t1",
"type": "umlsterm",
"text": [
"surgical"
],
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[
474,
482
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038895"
}
]
}
] |
[] |
[] |
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"arg2_id": "DerChirurg.90700608.eng.abstr-s5-t2",
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}
] |
DerChirurg.90700627.eng.abstr
|
DerChirurg.90700627.eng.abstr
|
[
{
"id": "DerChirurg.90700627.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In addition to psychological stress , stomas may lead to metabolic consequences . Colostomies normally cause only minor physiological problems ; however , patients with ileostomies are at risk for severe metabolic disturbances . The small intestine essentially manages the balance of water and electrolytes and the absorption of nutrition . In special circumstances such as \" high output \" or short-bowel syndrome , dangerous consequences like kidney disorders may arise . Basic therapeutic strategies such as enteral or parenteral substitution are discussed ."
],
"offsets": [
[
0,
560
]
]
}
] |
[
{
"id": "DerChirurg.90700627.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"stress"
],
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[
29,
35
]
],
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{
"db_name": "UMLS",
"db_id": "C0038435"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"stomas"
],
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[
38,
44
]
],
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{
"db_name": "UMLS",
"db_id": "C0332862"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"psychological stress"
],
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15,
35
]
],
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{
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}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"Colostomies"
],
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[
82,
93
]
],
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{
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"db_id": "C0009410"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"minor"
],
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[
114,
119
]
],
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{
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}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"patients"
],
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[
155,
163
]
],
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{
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"db_id": "C0030705"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"ileostomies"
],
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[
169,
180
]
],
"normalized": [
{
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"db_id": "C0020883"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"risk"
],
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188,
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]
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{
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}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"intestine"
],
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[
239,
248
]
],
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{
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"db_id": "C0021853"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"balance"
],
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[
273,
280
]
],
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{
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"db_id": "C0014653"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"water"
],
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[
284,
289
]
],
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{
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"db_id": "C0020311"
},
{
"db_name": "UMLS",
"db_id": "C0043047"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"electrolytes"
],
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[
294,
306
]
],
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{
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"db_id": "C0013832"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"absorption"
],
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[
315,
325
]
],
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{
"db_name": "UMLS",
"db_id": "C0000854"
},
{
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"db_id": "C0220777"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s3-t6",
"type": "umlsterm",
"text": [
"nutrition"
],
"offsets": [
[
329,
338
]
],
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{
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"db_id": "C0392209"
},
{
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"db_id": "C0028707"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s3-t7",
"type": "umlsterm",
"text": [
"small intestine"
],
"offsets": [
[
233,
248
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021852"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"short-bowel"
],
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[
393,
404
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021853"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"syndrome"
],
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[
405,
413
]
],
"normalized": [
{
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"db_id": "C0039082"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"kidney"
],
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[
444,
450
]
],
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{
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}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"disorders"
],
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[
451,
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]
],
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{
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"db_id": "C0012634"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s4-t5",
"type": "umlsterm",
"text": [
"short-bowel syndrome"
],
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393,
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]
],
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}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s4-t6",
"type": "umlsterm",
"text": [
"kidney disorders"
],
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444,
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]
],
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{
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"db_id": "C0022658"
}
]
},
{
"id": "DerChirurg.90700627.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"therapeutic"
],
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[
479,
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]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0039796"
}
]
}
] |
[] |
[] |
[
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"type": "associated_with",
"arg1_id": "DerChirurg.90700627.eng.abstr-s5-t1",
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{
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{
"id": "DerChirurg.90700627.eng.abstr-s3-r2-t3.1-t6.2",
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{
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{
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{
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{
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{
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{
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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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] |
DerChirurg.90700635.eng.abstr
|
DerChirurg.90700635.eng.abstr
|
[
{
"id": "DerChirurg.90700635.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Over a period of 12 years , 73 patients received a continent ileostomy . 19 Kock pouches were primarily constructed due to contraindications against the ileoanal pouch , 30 ileostomies were converted due to psychological rejection of the incontinent stoma and 9 ileoanal pouches for dysfunction . 15 Kock pouches had to be corrected for nipple valve complications . Perioperative complications ( 14/73 ) were related to the Kock pouch in only one third of cases . Surgical late complications of the nipple valve function decreased with technical modifications from 41.1 % to 20.0 % and then to 4.8 % . They could always be dealt with surgically . Pouchitis was observed in 26.8 % of cases of ulcerative colitis ( 11/41 ) , and in 6/15 patients with Crohn's disease ( 40.0 % ) complicated ileal recurrences developed . The definitive rate of success over the time was 98.1 % in ulcerative colitis and familial adenomatous polyposis ( 53/54 ) and 63.2 % in other conditions ( 12/19 ) . Continent ileostomy has become universal and safe method for conversion of any previous operation ."
],
"offsets": [
[
0,
1083
]
]
}
] |
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{
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"period"
],
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7,
13
]
],
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"db_id": "C0025344"
}
]
},
{
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"patients"
],
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31,
39
]
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"db_id": "C0030705"
}
]
},
{
"id": "DerChirurg.90700635.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"ileostomy"
],
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[
61,
70
]
],
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{
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"db_id": "C0020883"
}
]
},
{
"id": "DerChirurg.90700635.eng.abstr-s2-t1",
"type": "umlsterm",
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"contraindications"
],
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123,
140
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],
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"db_id": "C0079164"
}
]
},
{
"id": "DerChirurg.90700635.eng.abstr-s2-t2",
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"ileostomies"
],
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[
173,
184
]
],
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"db_id": "C0020883"
}
]
},
{
"id": "DerChirurg.90700635.eng.abstr-s2-t3",
"type": "umlsterm",
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"rejection"
],
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221,
230
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"db_id": "C0035015"
}
]
},
{
"id": "DerChirurg.90700635.eng.abstr-s2-t4",
"type": "umlsterm",
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"stoma"
],
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250,
255
]
],
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"db_id": "C0332862"
}
]
},
{
"id": "DerChirurg.90700635.eng.abstr-s2-t5",
"type": "umlsterm",
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],
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283,
294
]
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"db_id": "C0031847"
}
]
},
{
"id": "DerChirurg.90700635.eng.abstr-s2-t6",
"type": "umlsterm",
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"Kock pouches"
],
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[
76,
88
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],
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"db_name": "UMLS",
"db_id": "C0086512"
}
]
},
{
"id": "DerChirurg.90700635.eng.abstr-s2-t7",
"type": "umlsterm",
"text": [
"ileoanal pouch"
],
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[
153,
167
]
],
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{
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"db_id": "C0086448"
}
]
},
{
"id": "DerChirurg.90700635.eng.abstr-s2-t8",
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"ileoanal pouches"
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262,
278
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],
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}
]
},
{
"id": "DerChirurg.90700635.eng.abstr-s3-t1",
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"nipple"
],
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337,
343
]
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}
]
},
{
"id": "DerChirurg.90700635.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"complications"
],
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350,
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]
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}
]
},
{
"id": "DerChirurg.90700635.eng.abstr-s3-t3",
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],
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],
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}
]
},
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"id": "DerChirurg.90700635.eng.abstr-s4-t1",
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]
},
{
"id": "DerChirurg.90700635.eng.abstr-s4-t2",
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},
{
"id": "DerChirurg.90700635.eng.abstr-s5-t1",
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{
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{
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"recurrences"
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]
}
] |
[] |
[] |
[
{
"id": "DerChirurg.90700635.eng.abstr-s1-r1-t3.1-t1.1",
"type": "affects",
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{
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{
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DerChirurg.90700643.eng.abstr
|
DerChirurg.90700643.eng.abstr
|
[
{
"id": "DerChirurg.90700643.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The implantation of preternatural orifices is a procedure frequently performed by the visceral surgeon in spite of the advances of modern surgery concerning preservation of continence . In order to avoid unnecessary complications , certain strict principles of operating technique must be followed . The cumulative rate of complications is found to be at least 50 % . Especially prolapse , peristomal hernias and stenoses are of profound surgical relevance . A well-implanted and adequately cared for stoma will have a positive influence on a patient's quality of life ."
],
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0,
570
]
]
}
] |
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] |
[] |
[] |
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},
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"type": "issue_in",
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"arg2_id": "DerChirurg.90700643.eng.abstr-s5-t2",
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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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"type": "isa",
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DerChirurg.90700664.eng.abstr
|
DerChirurg.90700664.eng.abstr
|
[
{
"id": "DerChirurg.90700664.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Lung resection offers the best prospect of long-term survival in patients with nonmetastatic pulmonary neoplasia . In view of the dismal prognosis of unresected bronchial cancer , surgical resection should be encouraged even in patients with reduced cardiopulmonary function . Accurate estimation of the postoperative cardiopulmonary function is therefore desirable to avoid ( a ) refusal of potentially curative treatment and ( b ) severe postoperative disability . The origins of postresection morbidity and mortality are multifactorial . Thus , no single pulmonary function test or hemodynamic measurement can accurately and reliably predict postoperative cardiorespiratory complications . Criteria of functional operability should be based on percent of predicted value , so that patient's age , sex , and height will be taken into consideration . Exercise testing offers the advantage that both pulmonary and cardiac risk can be evaluated simultaneously . The high predictive value of maximal oxygen uptake ( VO2max ) in assessing postoperative morbidity and mortality is established . The calculation of predicted postoperative lung function ( ppo ) is of importance . The postoperative values for the forced expiratory volume in one second ( FEV1-ppo), the transfer factor ( TL , CO-ppo ) , and VO2max-ppo can be predicted by using the same formula . Patients with nearly normal lung function ( FEV1, TL , CO > 75 % predicted ) and no concomitant cardiac disease can undergo lung resection right up to pneumonectomy without further diagnostic procedures . In the others , FEV1-ppo and TL , CO-ppo should be estimated first by taking into account the number of segments to be resected . Patients with values 30 % predicted are usually regarded as being inoperable , whereas values > 40 % predicted qualify for resection without the need for further diagnostics . VO2max 10 ml/kg/min or 40 % predicted are prohibitive for surgery . If VO2max is > 20 ml/kg/min or > 75 % predicted , functional operability without limitation is given . For those cases where diagnostic uncertainty still remains , FEV1-ppo, TL , CO-ppo , and VO2max-ppo can be calculated by means of quantitative lung scans . Patients with either FEV1-ppo and TL , CO-ppo 30 % predicted or VO2max-ppo 8 ml/kg/min or 35 % predicted are deemed inoperable ."
],
"offsets": [
[
0,
2324
]
]
}
] |
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{
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"Lung"
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"survival"
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DerChirurg.90700674.eng.abstr
|
DerChirurg.90700674.eng.abstr
|
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"In this prospective clinical study we examined the intravenous application of salmon-calcitonin in eight patients with severe phantom limb pain ( Visual Analogue Scale = 50-100 ) . The patients presented at the Acute Pain Service ( APS ) section of the Second Department of Surgery , University of Cologne . Six of eight patients ( 75 % ) had no phantom limb pain after 10 days of intravenous treatment with salmon-calcitonin ( maximum of five cycles of calcitonin infusion ) . Systematic follow-up examinations after 3 , 6 and 12 months showed long-term success . Patient satisfaction was examined with a numeric rating scale ( NRS 1-6 ) between the single infusion cycles . When patient satisfaction was low , the physician modified the time period or drug dosage between infusions . This study shows good or excellent results in patient satisfaction for six of eight patients ( 75 % ) . A prospective randomized trial is required to verify the excellent results of intravenous salmon-calcitonin in a larger population . Alternative pharmacological and operative treatments of phantom limb pain are critically reviewed and assessed ."
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}
] |
[] |
[] |
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DerChirurg.90700682.eng.abstr
|
DerChirurg.90700682.eng.abstr
|
[
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"id": "DerChirurg.90700682.eng.abstr-passage-0",
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"text": [
"Systemic opioids and thoracic epidural analgesia are common techniques used to provide post-operative analgesia following thoracoscopy ( video-assisted thoracic surgery ) . The aim of the present prospective randomised study was to evaluate the efficacy of two less invasive analgesic techniques , intercostal blocks ( ICB ) and interpleural analgesia ( IPA ) . After approval from the ethics committee and informed consent from the patients , 36 patients scheduled for thoracoscopic surgery were randomly assigned to a group for postoperative pain management : group ICB : intercostal blocks of the segments involved with 5 ml 0.5 % bupivacaine at the end of surgery and 6 h later ; group IPA : interpleural analgesia with 20 ml 0.25 % bupivacaine applied every 4 h using a catheter placed during surgery near the apex of the interpleural space ; control group : IV-opiod-PCA with piritamide . Patients in the ICB and IPA groups had access to pain relief by PCA with piritramide as well . Additional medication for all groups if the analgesia was insufficient consisted of metamizol . There were no significant differences in piritramide consumption between the two regional analgesia groups and the control group up to the 3rd and 7th postoperative day . Up to the 7th day piritramide consumption in group ICB was 78 mg , in group IPA 75 mg and 80 mg in the control group . Patients in group ICB showed significantly less pain at rest measured by the visual analogue scale ( VAS ) on the 1st postoperative day ( U-test , P 0.05 ) , but otherwise there were no statistical differences regarding pain scores . Respiratory parameters such as forced vital capacity , forced expiratory volume , peak flow and the Tiffeneau test ( FVC , FEV1, PF , FEV1/FVC) were reduced significantly after thoracoscopy and showed a slow recovery in all three groups without significant intergroup differences . Thoracoscopic surgery causes less and shorter lasting pain in comparison to thoracotomy . Nevertheless , effective pain management is necessary . We could not demonstrate a significant reduction in piritramide consumption for the techniques of regional analgesia tested here ( ICB , IPA ) . We conclude that the use of these techniques is not complementary after thoracoscopy , since an opioid ( PCA with piritramide ) combined with a non-opioid ( metamizol ) resulted in satisfactory analgesia ."
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] |
DerChirurg.90700690.eng.abstr
|
DerChirurg.90700690.eng.abstr
|
[
{
"id": "DerChirurg.90700690.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The majority of lesions of the spinal accessory nerve occur as an iatrogenic injury after lymph node biopsy in the posterior cervical triangle ( trigonum colli laterale ) . In most cases the accessory nerve palsy is not recognised immediately after the injury . Therefore surgical repair is often performed too late to regain sufficient function of the paralytic trapezius muscle . Later than 6 months after the injury , reconstruction seems to be hopeless . However , \" timely \" reconstructions often have poor results . Exact knowledge of anatomy , postoperative check of the trapezius muscle and , if an accessory nerve injury has occurred , early reconstructive procedures ( neurolysis , reconstruction of nerve continuity ) may on the one hand prevent iatrogenic lesions of the nerve and on the other hand improve the reconstructive result . A series of 6 patients with an injury of the spinal accessory nerve after lymph node biopsy is reported . In 2 cases primary coaptation , in 3 cases interpositional nerve grafting and in 1 case neurotisation was performed . Clinical recovery was achieved in 3 of the 6 cases ."
],
"offsets": [
[
0,
1123
]
]
}
] |
[
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53
]
],
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}
]
},
{
"id": "DerChirurg.90700690.eng.abstr-s1-t2",
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"injury"
],
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[
77,
83
]
],
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}
]
},
{
"id": "DerChirurg.90700690.eng.abstr-s1-t3",
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"text": [
"lymph"
],
"offsets": [
[
90,
95
]
],
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{
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}
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},
{
"id": "DerChirurg.90700690.eng.abstr-s1-t4",
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"biopsy"
],
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101,
107
]
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]
},
{
"id": "DerChirurg.90700690.eng.abstr-s1-t5",
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"text": [
"posterior"
],
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115,
124
]
],
"normalized": [
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},
{
"id": "DerChirurg.90700690.eng.abstr-s1-t6",
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"text": [
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],
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},
{
"id": "DerChirurg.90700690.eng.abstr-s1-t7",
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],
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38,
53
]
],
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},
{
"id": "DerChirurg.90700690.eng.abstr-s1-t8",
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],
"offsets": [
[
90,
100
]
],
"normalized": [
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"db_id": "C0024204"
}
]
},
{
"id": "DerChirurg.90700690.eng.abstr-s1-t9",
"type": "umlsterm",
"text": [
"spinal accessory nerve"
],
"offsets": [
[
31,
53
]
],
"normalized": [
{
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}
]
},
{
"id": "DerChirurg.90700690.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"nerve"
],
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DerChirurg.90700694.eng.abstr
|
DerChirurg.90700694.eng.abstr
|
[
{
"id": "DerChirurg.90700694.eng.abstr-passage-0",
"type": "abstract",
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"Background : In a prospective trial ( October 1996 - April 1998 ) the effect of octreotide and tamoxifen on the recurrence of pancreatic carcinoma after R0 resection was evaluated . Methods : Patients with a local recurrence after curative resection of ductal adenocarcinoma of the pancreas were treated with 100 µg of octreotide three times a day and tamoxifen 20 mg once daily . The median survival time , quality of life ( EORTC-QLQ-30) and side effects of the octreotide-tamoxifen group were compared with a historic cohort ( n = 14 ) of patients treated in our department ( 9/95-9/96 ) according to the \" best supportive care \" concept . Results : Recurrences were diagnosed after R0 resection in a mean time of 13 +/- 6.8 months . Patients treated with octreotide and tamoxifen had a significantly ( P 0.05 ) longer median survival time ( 7 months ; range : 3-12 ) vs 3.5 months ; range : 1.5-5). The octreotide-tamoxifen group suffered less from lack of appetite , nausea , fatigue , and pain and needed fewer analgesies . The only side effect of the octreotide-tamoxifen therapy was moderate diarrhoe in 2 patients at the beginning of the therapy . Conclusion : Since combined therapy with octreotide and tamoxifen can be administered comfortably for outpatient treatment , this seems to represent progress in the palliative therapy of pancreatic cancer ."
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[] |
[] |
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] |
DerChirurg.90700700.eng.abstr
|
DerChirurg.90700700.eng.abstr
|
[
{
"id": "DerChirurg.90700700.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Hemorrhagic proctitis is a rare , but severe complication of radiation therapy in the treatment of several pelvic malignancies . Administration of topical steroids , anti-inflammatory agents or laser therapy and rectal instillation of 4 % formalin have been described as a method of treating this complication . A dog model was established to study the safest volume and duration of administration of formalin , the histological changes in the rectal mucosa , and rectal compliance following this treatment . Method : Twenty-one mongrel dogs were assigned randomly to seven groups . Three dogs received a rectal formalin bolus of 400 ml for 1 h ; in the other six groups formalin was instilled in 30 ml aliquots to a total volume of 400 ml . Serum levels of formalin were obtained at designated time intervals , rectal compliance was evaluated pre- and post-formalin instillation , and rectal mucosa was analyzed for blood-vessel density and mucosal injury at different time points . Results : Serum formalin in the bolus group reached toxic levels , while sequential instillation caused no serum toxicity in any dog . Rectal compliance and mucosal thickness were not affected by formalin , but there was a decrease in the angiogenesis score , and mild proctitis was seen in the acute and 1-week group ."
],
"offsets": [
[
0,
1303
]
]
}
] |
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}
] |
DerChirurg.90700705.eng.abstr
|
DerChirurg.90700705.eng.abstr
|
[
{
"id": "DerChirurg.90700705.eng.abstr-passage-0",
"type": "abstract",
"text": [
"With the help of thick , transparent finger cross sections , it was shown that fibers of the extensor aponeurosis insert distal to the avulsed fragment of the distal phalanx . The consequence for hand surgery is not to expose the fragment through a dorsal incision , but through a mid-lateral one . In this way , the distant parts of the aponeurosis distal to the fracture remain intact , and there is no break in the continuation of the dorsal extension plate ."
],
"offsets": [
[
0,
462
]
]
}
] |
[
{
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"finger"
],
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]
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}
]
},
{
"id": "DerChirurg.90700705.eng.abstr-s2-t1",
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"hand"
],
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"id": "DerChirurg.90700705.eng.abstr-s2-t2",
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]
},
{
"id": "DerChirurg.90700705.eng.abstr-s3-t1",
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{
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] |
[] |
[] |
[
{
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"type": "issue_in",
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},
{
"id": "DerChirurg.90700705.eng.abstr-s2-r2-t1.1-t2.1",
"type": "issue_in",
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"arg2_id": "DerChirurg.90700705.eng.abstr-s3-t2",
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},
{
"id": "DerChirurg.90700705.eng.abstr-s3-r1-t2.1-t1.1",
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}
] |
DerChirurg.90700713.eng.abstr
|
DerChirurg.90700713.eng.abstr
|
[
{
"id": "DerChirurg.90700713.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Based on the case report of a 51 year-old patient presenting with a lymphoepithelioma like gastric cancer , we discuss the diagnostic challenge to differentiate this entity from gastric non-Hodgkin lymphoma . Since high-level lymphoid stromal reactions are rarely associated with gastric adenocarcinoma , misinterpretation can occur easily . In addition to the lymphoepithelioma like gastric cancer that is often associated with a demonstrable EBV association of the tumor cells , synchronous development of gastric carcinoma and lymphoma must be considered . Establishment of a correct diagnosis requires multiple , deep and multifocally sampled gastric biopsies , and immunohistochemical and molecular techniques to supplement conventional histology . Only through this procedure are correct characterization and classification of these unusual gastric neoplasms possible ."
],
"offsets": [
[
0,
875
]
]
}
] |
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{
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"id": "DerChirurg.90700713.eng.abstr-s1-t4",
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{
"id": "DerChirurg.90700713.eng.abstr-s1-t7",
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"id": "DerChirurg.90700713.eng.abstr-s3-t2",
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"id": "DerChirurg.90700713.eng.abstr-s3-t4",
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},
{
"id": "DerChirurg.90700713.eng.abstr-s3-t5",
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"id": "DerChirurg.90700713.eng.abstr-s3-t6",
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{
"id": "DerChirurg.90700713.eng.abstr-s3-t7",
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]
},
{
"id": "DerChirurg.90700713.eng.abstr-s4-t2",
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{
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{
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{
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},
{
"id": "DerChirurg.90700713.eng.abstr-s5-t3",
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{
"id": "DerChirurg.90700713.eng.abstr-s5-t4",
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}
] |
[] |
[] |
[
{
"id": "DerChirurg.90700713.eng.abstr-s1-r1-t1.1-t5.1",
"type": "uses",
"arg1_id": "DerChirurg.90700713.eng.abstr-s5-t1",
"arg2_id": "DerChirurg.90700713.eng.abstr-s3-t5",
"normalized": []
},
{
"id": "DerChirurg.90700713.eng.abstr-s3-r1-t3.1-t1.1",
"type": "affects",
"arg1_id": "DerChirurg.90700713.eng.abstr-s5-t3",
"arg2_id": "DerChirurg.90700713.eng.abstr-s5-t1",
"normalized": []
},
{
"id": "DerChirurg.90700713.eng.abstr-s3-r2-t3.1-t8.1",
"type": "result_of",
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"arg2_id": "DerChirurg.90700713.eng.abstr-s3-t8",
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},
{
"id": "DerChirurg.90700713.eng.abstr-s3-r3-t3.1-t4.1",
"type": "result_of",
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"arg2_id": "DerChirurg.90700713.eng.abstr-s5-t4",
"normalized": []
},
{
"id": "DerChirurg.90700713.eng.abstr-s3-r4-t1.1-t9.1",
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DerChirurg.90700721.eng.abstr
|
DerChirurg.90700721.eng.abstr
|
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{
"id": "DerChirurg.90700721.eng.abstr-passage-0",
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"In contrast to childhood intussusception , the clinical signs of intussusception in adults are nonspecific . Generally organic alterations of the small bowel cause intussusception in adults . In this case report on a retrograde jejunojejunal intussusception in a 61-year-old male , following removal of an intraoperatively placed intestinal tube for ileus therapy , the clinical symptoms , diagnostic methods and therapy for intussusception are described . Sonography is not only the diagnostic tool of choice in childs , but also led to the correct diagnosis in this case . In contrast to childhood intussusception , operative treatment is preferred in adults ."
],
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0,
662
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]
}
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[] |
[] |
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DerChirurg.90700747.eng.abstr
|
DerChirurg.90700747.eng.abstr
|
[
{
"id": "DerChirurg.90700747.eng.abstr-passage-0",
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"text": [
"Radiology of the pharyngoesophageal segment in patients with dysphagia relies on evaluation of both morphology and function . Video- or cineradiographic techniques are necessary . Retention of contrast material above the cricopharyngeal muscle can be due to small pseudodiverticula or true diverticula . Both phenomena are due to dysfunction in the pharyngoesophageal segment . To develop into a true diverticulum it is probably necessary to have a congenital defect between the muscle layers in the pharyngoesophageal segment ."
],
"offsets": [
[
0,
528
]
]
}
] |
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DerChirurg.90700753.eng.abstr
|
DerChirurg.90700753.eng.abstr
|
[
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],
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[
0,
500
]
]
}
] |
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[] |
[] |
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DerChirurg.90700757.eng.abstr
|
DerChirurg.90700757.eng.abstr
|
[
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"text": [
"A Zenker's diverticulum ( ZD ) is a posterior diverticulum with its neck proximal to the cricopharyngeal muscle . Patients typically present after the age of 60 with symptoms ranging from weeks to years . The classical treatment in the past was surgical , which is still the case in the US . They treat them in general with open myotomy and diverticulectomy . Since the 1950 s ENT physicians treat them with rigid endoscopes and cut the bridge between the ZD and the esophagus . This method is widely used throughout western Europe . However , many symptomatic elderly patients are poor surgical/ENT candidates . In 1995 , two groups from Brazil and The Netherlands reported their first results with a gastroscopic treatment , in which the ZD bridge is cutt with a precut needle/monopolar forceps . Recently , argon plasma coagulation has also been introduced in this field . All these treatments seem effective . Comparative trials between these approaches are now long overdue , since all these modalities will work in the hands of experienced \" Zenker specialists \" ."
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0,
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}
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] |
[] |
[] |
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DerChirurg.90700763.eng.abstr
|
DerChirurg.90700763.eng.abstr
|
[
{
"id": "DerChirurg.90700763.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Following resection of liver metastases the overall prognosis still remains limited because of the lack of adjuvant therapy . The number of explorative laparotomies , non-radical resections and complications needs to be reduced . One hundred and ten laparotomies in 97 patients with liver metastases were performed with the intention to cure between October 1993 and February 1998. In a prospective analysis we reviewed : patient characteristics , characteristics of primary tumors and metastases , part and extent of liver resection , radicality , complications and mortality . Additionally , a prospective study about the value of ultrasonography and CT scan concerning the evaluation of preoperative liver findings was undertaken between January 1995 and February 1998. Altogether , resection of liver metastases was achieved in 75 cases ( 68.2 % ) . Nineteen patients ( 25.3 % ) had postoperative complications . Two patients ( 2.7 % ) died following liver resection . Thirty-five operations ( 31.8 % ) had to be finished as only an explorative laparotomy . The major reason for these restricted operations was in 15 patients ( 42.9 % ) regional recurrence or peritoneal metastases . Preoperative determination of the liver finding ( quantity , localization and size ) by ultrasonography and CT scan achieved an accuracy of 68.9 % each . The results of this analysis show that resection of liver metastases can be accomplished with minor morbidity and mortality . The high number of explorative laparotomies still remains a central problem in the surgery of liver metastases . By the introduction of duplex sonography and contrast-medium-enhanced helical CT scan , liver pathology can be defined more precisely in the preoperative evaluation . However , preoperative detection of regional recurrence or peritoneal metastases remains difficult ."
],
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] |
DerChirurg.90700771.eng.abstr
|
DerChirurg.90700771.eng.abstr
|
[
{
"id": "DerChirurg.90700771.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Intestinal neuronal dysplasia ( IND ) was initially described as a developmental abnormality of the submucous plexus in children . In recent years this abnormality has also been observed in adults with chronic constipation . The aim of this study was a morphometric characterization of this disease . The investigation was performed with 10 adults with IND , compared with 10 healthy control probands . The best diagnostic indicator of IND proved to be the detection of 6-10 giant ganglia with more than 7 nerve cells in 15 biopsy sections . IND is an interesting cause of chronic constipation which can be histologically verified ."
],
"offsets": [
[
0,
632
]
]
}
] |
[
{
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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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DerChirurg.90700777.eng.abstr
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DerChirurg.90700777.eng.abstr
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"A diagnostic scoring system , recently published by Ohmann et al. in this journal , was validated by analyzing the clinicopathological data of a consecutive series of 2,359 patients , admitted for suspicion of acute appendicitis . The results of the scoring system were compared to the results of clinical evaluation by junior ( provisional ) and senior surgeons ( final clinical diagnosis ) . To assess the diagnostic ability of the score , the accuracy and positive predictive value were defined as the major diagnostic performance parameters ; the rate of theoretical negative laparotomies and that of diagnostic errors served as the major procedural performance parameters . Of 2,359 patients admitted for suspected acute appendicitis , 662 were proven to have acute appendicitis by histology , for a prevalence of 28 % . The overall sensitivity , specificity , positive predictive value , negative predictive value , and accuracy of the provisional clinical diagnosis were 0.50 , 0.94 , 0.77 , 0.83 , and 0.82 ; 0.93 , for the score 0.63 , 0.93 , 0.77 , 0.86 and 0.84 , and for the final clinical diagnosis 0.90 , 0.94 , 0.85 , 0.96 , and 0.93 , respectively . Of the main diagnostic performance parameter , the accuracy of the score was signifianctly better than that of provisional clinical diagnosis ( P 0.05 , 2 test ) . The score yielded a rate of negative appendecomies and laparotomies of 14.3 and 12.3 % . With respect to the rate of overlooked cases of acute apendicitis , the score demonstrated a superior performance , with only 6 cases missed ( 0.9 % ) . However , the number of patients with acute appendicitis , including those with perforated disease , who were not identified by the score , was almost four times that of the final clinical diagnosis ( 245 vs 63 ) . With regard to the main procedural performance parameter , the score resulted in a significantly smaller number of diagnostic errors than the provisional clinical investigator ( P 0.05 , 2 test ) . The results of this study indicate that the diagnostic scoring system might be helpful when experienced investigators or additional diagnostic modalities such as ultrasonography are not available . It may therefore be of value in the preclinical evaluation of patients with suspected acute appendicitis and may be instrumental as a quality control tool and in clinical guidelines ."
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] |
DerChirurg.90700785.eng.abstr
|
DerChirurg.90700785.eng.abstr
|
[
{
"id": "DerChirurg.90700785.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The laparoscopic creation of ileostomas and colostomas can be performed in a quick , safe and technically effective manner . The advantages of the minimally invasive approach are low morbidity and mortality , minimal blood loss and fast recovery in these mostly multimorbid patients as well as shorter time of hospitalization . We report on a total of 20 patients who underwent laparoscopic creation of colostoma in 19 cases and creation of ileostoma in one case in a period of 2 years . There were no intraabdominal complications and no lethal outcome . All patients reached their preoperative level of mobilization at the 2nd postoperative day . The indications for the laparoscopic enterostomy are described ."
],
"offsets": [
[
0,
712
]
]
}
] |
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183,
192
]
],
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}
]
},
{
"id": "DerChirurg.90700785.eng.abstr-s2-t2",
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],
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]
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}
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},
{
"id": "DerChirurg.90700785.eng.abstr-s2-t3",
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}
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"patients"
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[] |
[] |
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DerChirurg.90700795.eng.abstr
|
DerChirurg.90700795.eng.abstr
|
[
{
"id": "DerChirurg.90700795.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Persistent sciatic artery as a rare entity results from lack of regression of the femoral artery blood supply of the leg and is often combined with an abnormally developed superficial femoral artery . We describe the case of a complete , persistent sciatic artery with peripheral ischemia caused by thrombo-embolism from buttock aneurysmal formation . Combined therapy of catheter fibrinolysis , followed by proximal and distal ligation of sciatic artery and peripheral bypass procedure , restored regular leg perfusion ."
],
"offsets": [
[
0,
521
]
]
}
] |
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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.90700795.eng.abstr-s3-t7",
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},
{
"id": "DerChirurg.90700795.eng.abstr-s3-t8",
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},
{
"id": "DerChirurg.90700795.eng.abstr-s3-t9",
"type": "umlsterm",
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352,
368
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],
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{
"db_name": "UMLS",
"db_id": "C0033972"
}
]
}
] |
[] |
[] |
[
{
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DerChirurg.90700800.eng.abstr
|
DerChirurg.90700800.eng.abstr
|
[
{
"id": "DerChirurg.90700800.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The diffuse angiomatosis of the spleen is a rare splenic proliferation . Spontaneous rupture is the main , potentially lethal complication , found in 25 % of cases . The problem with these vascular tumors is preoperative diagnosis , because they are asymptomatic for a long time . First-choice therapy is limited resection . In the case of rupture , splenectomy is a life-saving procedure . We report on a 56-year-old woman with a spontaneous splenic rupture as the first symptom of diffuse angiomatosis of the spleen . Exceptional features of splenic hemangiomas , causes of spontaneous rupture and the therapy are described ."
],
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[
0,
627
]
]
}
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[] |
[] |
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DerChirurg.90700807.eng.abstr
|
DerChirurg.90700807.eng.abstr
|
[
{
"id": "DerChirurg.90700807.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Gastrointestinal stromal tumors ( GIST ) , which form a rare group of neoplasias of the gastrointestinal tract , have not yet been fully investigated . Although good progress has been made in their diagnosis , classification of these lesions with regard to their histogenesis and biological behavior remains problematic . Between 1994 and 1998 , 18 GIST patients underwere operation in the Department of Surgery . Twelve of these patients ( 67 % ) had stromal tumors in the stomach , and six ( 33 % ) had intestinal stromal tumors . The primary tumor could be removed in all patients with R0 resection . Six patients developed hematogenous liver metastasis , with the size of their primary tumor exceeding 10 cm . Extrahepatic distant metastases were not found in any case . Lymphadenectomy showed that lymph node metastases did not occur . Histological evaluation was made according to the guidelines of Lewin , Weinstein and Riddell . Currently established therapy is limited to complete surgical resection of the primary tumor and its metastases . Adjuvant or neoadjuvant chemotherapy approaches have failed ."
],
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}
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}
] |
[] |
[] |
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] |
DerChirurg.90700813.eng.abstr
|
DerChirurg.90700813.eng.abstr
|
[
{
"id": "DerChirurg.90700813.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A 24-year-old healthy man developed Clostridium perfringens myonecrosis with severe sepsis after plating of a closed femoral fracture . The leg could be preserved by complete resection of the fascia from all muscle compartments of the leg , including the pelvitrochanteric and the iliopsoas muscles , radical removal of necrotic muscle tissue , dissection of the para-aortal infrarenal lymphatics , daily débridements over 2 weeks , and systemic antibiotic therapy . The plate was removed because of a second septic episode followed by temporary stabilization with external fixation . After soft-tissue healing , plate fixation was carried out . The patient developed significant deficit of knee flexion ( 0 °/0/20 ° ) due to heterotopic ossification of the quadriceps femoris muscle that could be improved by partial resection of heterotopic bone formation . In the same operation the bony defect of the femur was filled with autologous bone graft . The fracture healed 10 months after the accident . The patient can work full time in his previous profession as a mechanic , but again needs operative mobilization of the knee joint , including open arthrolysis and quadriceps plasty ."
],
"offsets": [
[
0,
1185
]
]
}
] |
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{
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"id": "DerChirurg.90700813.eng.abstr-s8-r10-t6.1-t3.1",
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}
] |
DerChirurg.90700818.eng.abstr
|
DerChirurg.90700818.eng.abstr
|
[
{
"id": "DerChirurg.90700818.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Traumatic atlanto-axial instabilities are rare entities in cervical spine injuries . There may be only subtle abnormal findings by plain radiographs , frequently resulting in a missed or delayed diagnosis . We report a polytraumatized patient with severe maxillofacial injuries , where preliminary radiological studies failed to verify rotatory instability of the atlanto-axial joint . A definite diagnosis was only established by further imaging studies , including CT scan reformations ."
],
"offsets": [
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0,
489
]
]
}
] |
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]
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{
"id": "DerChirurg.90700818.eng.abstr-s1-t3",
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},
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"id": "DerChirurg.90700818.eng.abstr-s3-t3",
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"id": "DerChirurg.90700818.eng.abstr-s3-t4",
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"id": "DerChirurg.90700818.eng.abstr-s4-t2",
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"id": "DerChirurg.90700818.eng.abstr-s4-t3",
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] |
[] |
[] |
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"type": "location_of",
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"id": "DerChirurg.90700818.eng.abstr-s1-r2-t1.1-t2.1",
"type": "location_of",
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"id": "DerChirurg.90700818.eng.abstr-s3-r1-t2.1-t2.2",
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{
"id": "DerChirurg.90700818.eng.abstr-s3-r2-t4.1-t2.2",
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{
"id": "DerChirurg.90700818.eng.abstr-s3-r3-t4.1-t2.1",
"type": "location_of",
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"arg2_id": "DerChirurg.90700818.eng.abstr-s4-t2",
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DerChirurg.90700823.eng.abstr
|
DerChirurg.90700823.eng.abstr
|
[
{
"id": "DerChirurg.90700823.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Even though many decision-aids have been developed in the past , the application of these systems in clinical practice is still rare . There are many reasons for this , including the reservations of potential users . A survey in three university surgery clinics was conducted to assess the experience and attitudes towards decision-aids among physicians . Seventy-two of the 102 physicians approached ( 71 % ) filled out and returned the short questionnaire that was sent to them . More than half of the 72 survey participants already use decision-aids . Among them , guidelines are used most often ( 46 % ) , whereas other instruments ( algorithms , scores , decision trees ) are used less frequently ( 10-17 % ) . Computer-based decision-aids are hardly used at all ( 7 % ) . These results are in contrast to the strong request for more decision-aids , especially for computer-based systems ( 40 % ) . Physicians who already use decision-aids are more interested in additional systems . More than 70 % of all participants are interested in more information about the topic . The standardized question about attitudes towards computer-based decision-aids reveals more positive than negative appraisal , whereas the answers to open questions focus more on objections . The substantial differences between the three survey locations in parts of the survey results show that attitudes towards decision-aids are influenced by the way the instruments are introduced and the way the users are informed and involved in the process of implementation . A successful implementation of decision-aids in clinical practice should therefore try to integrate the future users as much as possible ."
],
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0,
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]
}
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"id": "DerChirurg.90700823.eng.abstr-s5-t2",
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"id": "DerChirurg.90700823.eng.abstr-s6-t1",
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"id": "DerChirurg.90700823.eng.abstr-s6-t2",
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] |
[] |
[] |
[
{
"id": "DerChirurg.90700823.eng.abstr-s3-r1-t1.1-t3.1",
"type": "method_of",
"arg1_id": "DerChirurg.90700823.eng.abstr-s13-t1",
"arg2_id": "DerChirurg.90700823.eng.abstr-s12-t3",
"normalized": []
},
{
"id": "DerChirurg.90700823.eng.abstr-s3-r2-t5.1-t3.1",
"type": "issue_in",
"arg1_id": "DerChirurg.90700823.eng.abstr-s6-t5",
"arg2_id": "DerChirurg.90700823.eng.abstr-s12-t3",
"normalized": []
},
{
"id": "DerChirurg.90700823.eng.abstr-s3-r3-t1.1-t3.1",
"type": "issue_in",
"arg1_id": "DerChirurg.90700823.eng.abstr-s13-t1",
"arg2_id": "DerChirurg.90700823.eng.abstr-s12-t3",
"normalized": []
},
{
"id": "DerChirurg.90700823.eng.abstr-s3-r4-t1.1-t3.2",
"type": "measures",
"arg1_id": "DerChirurg.90700823.eng.abstr-s13-t1",
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"normalized": []
},
{
"id": "DerChirurg.90700823.eng.abstr-s3-r5-t5.1-t1.1",
"type": "manages",
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DerChirurg.90700847.eng.abstr
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DerChirurg.90700847.eng.abstr
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[] |
[] |
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DerChirurg.90700858.eng.abstr
|
DerChirurg.90700858.eng.abstr
|
[
{
"id": "DerChirurg.90700858.eng.abstr-passage-0",
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DerChirurg.90700876.eng.abstr
|
DerChirurg.90700876.eng.abstr
|
[
{
"id": "DerChirurg.90700876.eng.abstr-passage-0",
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"text": [
"The marked reduction in recurrence rates following reinforcement of the abdominal wall by meshes in incisional hernia has promoted their increasingly widespread use . The primary suture in technique failed more than half of the cases ; therefore , the closure method needs to be changed and improved , particularly with regard to a possibly underlying defect in collagen metabolism . After more than 100 years of mesh development they are mainly placed in a sublay or onlay position , ePTFE , polyester and polypropylene are preferred . In any case the mesh has to overlap the defect sufficiently because of wound contraction . On the basis of our experience and reports in the literature , the advantages and disadvantages of various mesh techniques and mesh materials are discussed . However , because long-term studies are missing , the relevance of the cumulative risk for long-term complications such as mesh migration and fistula formation , the extent of patient complaints or the potential risk of a persistent foreign-body reaction cannot yet be ascertained . Nevertheless , because there are no surgical alternatives , meshes represent an improvement in hernia surgery that cannot be overestimated ."
],
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0,
1209
]
]
}
] |
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DerChirurg.90700888.eng.abstr
|
DerChirurg.90700888.eng.abstr
|
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] |
[] |
[] |
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}
] |
DerChirurg.90700897.eng.abstr
|
DerChirurg.90700897.eng.abstr
|
[
{
"id": "DerChirurg.90700897.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Wound healing is a complex cascade of biochemical and cellular events designed to achieve restoration of tissue integrity following injury . Immune cells are critical for the outcome of healing . Much has been learned about the individual events that are involved in this process . Knowledge is scant , however , about the spatial and temporal interweaving of these events and how one step sets the stage for subsequent observed phenomena . Imbalance of stimulating and inhibiting factors causes failure of healing . Immunosuppressive states interfere with a normal immune response and impair wound repair . Clinically , new therapeutic approaches to modulate impaired healing are based on a knowledge of immune regulation of wound healing ."
],
"offsets": [
[
0,
741
]
]
}
] |
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{
"id": "DerChirurg.90700897.eng.abstr-s6-t3",
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"id": "DerChirurg.90700897.eng.abstr-s7-t2",
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"id": "DerChirurg.90700897.eng.abstr-s7-t3",
"type": "umlsterm",
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"id": "DerChirurg.90700897.eng.abstr-s7-t4",
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{
"id": "DerChirurg.90700897.eng.abstr-s7-t5",
"type": "umlsterm",
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}
]
}
] |
[] |
[] |
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] |
DerChirurg.90700915.eng.abstr
|
DerChirurg.90700915.eng.abstr
|
[
{
"id": "DerChirurg.90700915.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The present study analyzes the outcome of 51 patients aged more than 65 years , who were admitted between 1993 and 1997 to a specific burns unit with the possibility of intensive care medicine including respirator therapy and hemofiltration . The results were compared to an historical control group treated between 1980 and 1990. The overall survival rate was 54 % . Analyzing the patients ' mortality , an increase in the number of nurses , improvement of enteral nutrition and wound monitoring had more influence on the survival rates than respirator therapy , hemofiltration and catecholamines . This is in contrast to our experience with younger individuals . The positive influence of intensive care on survival was restricted only to a small number of cases . The group of patients who died on the intensive care unit showed a relatively long median survival time of 24 days . Septic multiorgan failure was the main cause of death ."
],
"offsets": [
[
0,
939
]
]
}
] |
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"id": "DerChirurg.90700915.eng.abstr-s1-t2",
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}
] |
[] |
[] |
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{
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DerChirurg.90700923.eng.abstr
|
DerChirurg.90700923.eng.abstr
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[
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"id": "DerChirurg.90700923.eng.abstr-passage-0",
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"The expansion of minimally invasive surgery worldwide provokes an intensive interest of all surgical disciplines in gaining possibilities for research , learning and teaching by operating on human corpses . Despite the fact that German anatomical institutes in general have the infrastructure to realise such clinical cooperations , at present they may offer such opportunities only to a restricted degree , since the concentration on student teaching and anatomic research limits the capacity of the staff for a commitment in this field of applied science . To provide a basis for future estimations of the efforts necessary to perform solo surgery on the human cadaver , especially with emphasis on research , quality control and teaching , this article reports on practical experiences with such a project named \" ANAtoMIC \" , identifying minimal conditions which have to be realised ."
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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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] |
DerChirurg.90700929.eng.abstr
|
DerChirurg.90700929.eng.abstr
|
[
{
"id": "DerChirurg.90700929.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A few months ago an endovascular implantable PTFE stent graft became commercially available . Since May 1998 we have treated 15 patients with extensive vascular occlusion at the femoropopliteal level . The implantation is carried out via a single inguinal approach in combination with conventional vascular surgical techniques like orthograde ringstripping of the superficial femoral artery , local TEA and patch-grafting of the femoral bifurcation , angioplasty , local lysis , etc. The self-expanding thin-walled PTFE stent prothesis appears to be a viable alternative to the femoropopliteal P1 bypass and can be performed under local anesthesia , percutaneously or through a small inguinal incision . The implantation can be carried out with minimal tissue trauma ."
],
"offsets": [
[
0,
768
]
]
}
] |
[
{
"id": "DerChirurg.90700929.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"PTFE"
],
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[
45,
49
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032611"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"stent"
],
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[
50,
55
]
],
"normalized": [
{
"db_name": "UMLS",
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}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s1-t3",
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"text": [
"graft"
],
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[
56,
61
]
],
"normalized": [
{
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"db_id": "C0332835"
},
{
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"db_id": "C0040733"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"May"
],
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[
100,
103
]
],
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{
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}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s2-t2",
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"patients"
],
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[
128,
136
]
],
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{
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}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"implantation"
],
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[
206,
218
]
],
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{
"db_name": "UMLS",
"db_id": "C0029976"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"single"
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[
240,
246
]
],
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"db_id": "C0087136"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"surgical"
],
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[
307,
315
]
],
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{
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"db_id": "C0038895"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"techniques"
],
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[
316,
326
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0025664"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"artery"
],
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[
384,
390
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0003842"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s3-t6",
"type": "umlsterm",
"text": [
"TEA"
],
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[
399,
402
]
],
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{
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"db_id": "C0039400"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s3-t7",
"type": "umlsterm",
"text": [
"angioplasty"
],
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[
451,
462
]
],
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{
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"db_id": "C0162577"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s3-t8",
"type": "umlsterm",
"text": [
"self-expanding"
],
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488,
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]
],
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{
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}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s3-t9",
"type": "umlsterm",
"text": [
"PTFE"
],
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[
515,
519
]
],
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{
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"db_id": "C0032611"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s3-t10",
"type": "umlsterm",
"text": [
"stent"
],
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[
520,
525
]
],
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{
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"db_id": "C0038257"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s3-t11",
"type": "umlsterm",
"text": [
"anesthesia"
],
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[
637,
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]
],
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{
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"db_id": "C0002903"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s3-t12",
"type": "umlsterm",
"text": [
"femoral artery"
],
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[
376,
390
]
],
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{
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"db_id": "C0015801"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s3-t13",
"type": "umlsterm",
"text": [
"local anesthesia"
],
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[
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]
],
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{
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"db_id": "C0002934"
},
{
"db_name": "UMLS",
"db_id": "C0002921"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"implantation"
],
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[
708,
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]
],
"normalized": [
{
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}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"tissue"
],
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]
],
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{
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"db_id": "C0040300"
}
]
},
{
"id": "DerChirurg.90700929.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"trauma"
],
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[
760,
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]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021501"
},
{
"db_name": "UMLS",
"db_id": "C0043251"
}
]
}
] |
[] |
[] |
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{
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{
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"id": "DerChirurg.90700929.eng.abstr-s3-r17-t13.1-t2.1",
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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.90700929.eng.abstr-s4-r4-t2.1-t1.1",
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},
{
"id": "DerChirurg.90700929.eng.abstr-s4-r5-t3.1-t2.1",
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"arg2_id": "DerChirurg.90700929.eng.abstr-s4-t2",
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},
{
"id": "DerChirurg.90700929.eng.abstr-s4-r6-t3.1-t1.1",
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"arg2_id": "DerChirurg.90700929.eng.abstr-s4-t1",
"normalized": []
}
] |
DerChirurg.90700935.eng.abstr
|
DerChirurg.90700935.eng.abstr
|
[
{
"id": "DerChirurg.90700935.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We report a case of successful operative therapy of a 12-year-old child with fecal incontinence ( Kelly-Holschneider score : 2 points ) . In the german-speaking area it was the first implantation of an artificial bowel sphincter in a child . The operative procedure , clinical results and anorectal measurements are described ."
],
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[
0,
327
]
]
}
] |
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{
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"therapy"
],
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41,
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]
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}
]
},
{
"id": "DerChirurg.90700935.eng.abstr-s1-t2",
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]
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}
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{
"id": "DerChirurg.90700935.eng.abstr-s1-t3",
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"operative therapy"
],
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}
]
},
{
"id": "DerChirurg.90700935.eng.abstr-s1-t4",
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"fecal incontinence"
],
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[
77,
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]
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"db_id": "C0015732"
}
]
},
{
"id": "DerChirurg.90700935.eng.abstr-s2-t1",
"type": "umlsterm",
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"implantation"
],
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"id": "DerChirurg.90700935.eng.abstr-s2-t2",
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"bowel"
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}
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{
"id": "DerChirurg.90700935.eng.abstr-s2-t3",
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"child"
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"id": "DerChirurg.90700935.eng.abstr-s3-t1",
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"procedure"
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"id": "DerChirurg.90700935.eng.abstr-s3-t2",
"type": "umlsterm",
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{
"id": "DerChirurg.90700935.eng.abstr-s3-t3",
"type": "umlsterm",
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"db_id": "C0543467"
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{
"db_name": "UMLS",
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}
]
}
] |
[] |
[] |
[
{
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"type": "occurs_in",
"arg1_id": "DerChirurg.90700935.eng.abstr-s3-t3",
"arg2_id": "DerChirurg.90700935.eng.abstr-s3-t1",
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},
{
"id": "DerChirurg.90700935.eng.abstr-s1-r2-t1.1-t3.1",
"type": "treats",
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"arg2_id": "DerChirurg.90700935.eng.abstr-s3-t3",
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},
{
"id": "DerChirurg.90700935.eng.abstr-s1-r3-t1.1-t3.1",
"type": "associated_with",
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},
{
"id": "DerChirurg.90700935.eng.abstr-s1-r4-t3.1-t1.1",
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{
"id": "DerChirurg.90700935.eng.abstr-s2-r1-t1.1-t3.1",
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},
{
"id": "DerChirurg.90700935.eng.abstr-s2-r2-t2.1-t1.1",
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},
{
"id": "DerChirurg.90700935.eng.abstr-s3-r1-t2.1-t1.1",
"type": "measures",
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},
{
"id": "DerChirurg.90700935.eng.abstr-s3-r2-t1.1-t2.1",
"type": "measures",
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"arg2_id": "DerChirurg.90700935.eng.abstr-s3-t2",
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}
] |
DerChirurg.90700939.eng.abstr
|
DerChirurg.90700939.eng.abstr
|
[
{
"id": "DerChirurg.90700939.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Esophagectomy for esophageal carcinoma is associated with significant morbidity . Long-term survival rates are usually poor . Common problems in the early postoperative period are pulmonary complications and leakage at the collar anastomosis causing local infection , sepsis and subsequent anastomotic strictures . There are only a few reports in the literature about benign ulcerations in the gastric tube after resection of the esophagus for carcinoma . We report a patient with a huge benign ulcer in the gastric tube penetrating into the right lung 9 years after esophagectomy for carcinoma . Several aspects of possible etiologic factors and different prophylactic approaches as well as therapeutic aspects are discussed ."
],
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[
0,
727
]
]
}
] |
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{
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],
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}
]
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{
"id": "DerChirurg.90700939.eng.abstr-s1-t2",
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"text": [
"esophageal"
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"db_id": "C0014852"
}
]
},
{
"id": "DerChirurg.90700939.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"carcinoma"
],
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29,
38
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"db_name": "UMLS",
"db_id": "C0007097"
}
]
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{
"id": "DerChirurg.90700939.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"morbidity"
],
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"db_id": "C0220880"
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"db_id": "C0026538"
}
]
},
{
"id": "DerChirurg.90700939.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"survival"
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"db_id": "C0220921"
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}
]
},
{
"id": "DerChirurg.90700939.eng.abstr-s2-t2",
"type": "umlsterm",
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{
"id": "DerChirurg.90700939.eng.abstr-s3-t2",
"type": "umlsterm",
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"db_id": "C0025344"
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]
},
{
"id": "DerChirurg.90700939.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
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"db_id": "C0009566"
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]
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{
"id": "DerChirurg.90700939.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"infection"
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"db_id": "C0021311"
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{
"id": "DerChirurg.90700939.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"sepsis"
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268,
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"db_id": "C0243026"
}
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{
"id": "DerChirurg.90700939.eng.abstr-s3-t6",
"type": "umlsterm",
"text": [
"postoperative period"
],
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155,
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"db_id": "C0032790"
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]
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{
"id": "DerChirurg.90700939.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
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{
"id": "DerChirurg.90700939.eng.abstr-s4-t2",
"type": "umlsterm",
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{
"id": "DerChirurg.90700939.eng.abstr-s4-t3",
"type": "umlsterm",
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"db_id": "C0546837"
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"db_id": "C0014876"
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"id": "DerChirurg.90700939.eng.abstr-s4-t4",
"type": "umlsterm",
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"type": "umlsterm",
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{
"id": "DerChirurg.90700939.eng.abstr-s5-t2",
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"type": "umlsterm",
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"id": "DerChirurg.90700939.eng.abstr-s5-t4",
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{
"id": "DerChirurg.90700939.eng.abstr-s5-t6",
"type": "umlsterm",
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585,
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"db_id": "C0007097"
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{
"id": "DerChirurg.90700939.eng.abstr-s6-t1",
"type": "umlsterm",
"text": [
"prophylactic"
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"db_id": "C0009653"
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"id": "DerChirurg.90700939.eng.abstr-s6-t2",
"type": "umlsterm",
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{
"id": "DerChirurg.90700939.eng.abstr-s6-t3",
"type": "umlsterm",
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692,
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"db_id": "C0039798"
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]
}
] |
[] |
[] |
[
{
"id": "DerChirurg.90700939.eng.abstr-s1-r1-t2.1-t3.1",
"type": "degree_of",
"arg1_id": "DerChirurg.90700939.eng.abstr-s6-t2",
"arg2_id": "DerChirurg.90700939.eng.abstr-s6-t3",
"normalized": []
},
{
"id": "DerChirurg.90700939.eng.abstr-s1-r2-t2.1-t1.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90700939.eng.abstr-s6-t2",
"arg2_id": "DerChirurg.90700939.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "DerChirurg.90700939.eng.abstr-s1-r3-t4.1-t1.1",
"type": "conceptual_part_of",
"arg1_id": "DerChirurg.90700939.eng.abstr-s5-t4",
"arg2_id": "DerChirurg.90700939.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "DerChirurg.90700939.eng.abstr-s1-r4-t1.1-t3.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90700939.eng.abstr-s6-t1",
"arg2_id": "DerChirurg.90700939.eng.abstr-s6-t3",
"normalized": []
},
{
"id": "DerChirurg.90700939.eng.abstr-s1-r5-t1.1-t2.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90700939.eng.abstr-s6-t1",
"arg2_id": "DerChirurg.90700939.eng.abstr-s6-t2",
"normalized": []
},
{
"id": "DerChirurg.90700939.eng.abstr-s1-r6-t3.1-t2.1",
"type": "degree_of",
"arg1_id": "DerChirurg.90700939.eng.abstr-s6-t3",
"arg2_id": "DerChirurg.90700939.eng.abstr-s6-t2",
"normalized": []
},
{
"id": "DerChirurg.90700939.eng.abstr-s1-r7-t3.1-t1.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90700939.eng.abstr-s6-t3",
"arg2_id": "DerChirurg.90700939.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "DerChirurg.90700939.eng.abstr-s3-r1-t5.1-t2.1",
"type": "result_of",
"arg1_id": "DerChirurg.90700939.eng.abstr-s5-t5",
"arg2_id": "DerChirurg.90700939.eng.abstr-s6-t2",
"normalized": []
},
{
"id": "DerChirurg.90700939.eng.abstr-s3-r2-t2.1-t5.1",
"type": "result_of",
"arg1_id": "DerChirurg.90700939.eng.abstr-s6-t2",
"arg2_id": "DerChirurg.90700939.eng.abstr-s5-t5",
"normalized": []
},
{
"id": "DerChirurg.90700939.eng.abstr-s3-r3-t2.1-t3.1",
"type": "result_of",
"arg1_id": "DerChirurg.90700939.eng.abstr-s6-t2",
"arg2_id": "DerChirurg.90700939.eng.abstr-s6-t3",
"normalized": []
},
{
"id": "DerChirurg.90700939.eng.abstr-s3-r4-t2.1-t1.1",
"type": "conceptual_part_of",
"arg1_id": "DerChirurg.90700939.eng.abstr-s6-t2",
"arg2_id": "DerChirurg.90700939.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "DerChirurg.90700939.eng.abstr-s3-r5-t5.1-t3.1",
"type": "degree_of",
"arg1_id": "DerChirurg.90700939.eng.abstr-s5-t5",
"arg2_id": "DerChirurg.90700939.eng.abstr-s6-t3",
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},
{
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},
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},
{
"id": "DerChirurg.90700939.eng.abstr-s5-r3-t2.1-t5.1",
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{
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},
{
"id": "DerChirurg.90700939.eng.abstr-s5-r10-t6.1-t5.1",
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{
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"id": "DerChirurg.90700939.eng.abstr-s5-r16-t3.1-t5.1",
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}
] |
DerChirurg.90700946.eng.abstr
|
DerChirurg.90700946.eng.abstr
|
[
{
"id": "DerChirurg.90700946.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The traumatic pulmonary hernia is a rare and uncommon observation . We report a case of a 52-year-old patient who had a car accident . Beside multiple polytraumatic injuries we were able to diagnose an incarcerated pulmonary hernia . Hernia size , incarceration and the respiratory insufficiency of the patient necessitating immediate surgical intervention . We relocated the hernia into the chest and stabilized the thoracic wall . The postoperative course was uneventful ."
],
"offsets": [
[
0,
474
]
]
}
] |
[
{
"id": "DerChirurg.90700946.eng.abstr-s1-t1",
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"hernia"
],
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[
24,
30
]
],
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}
]
},
{
"id": "DerChirurg.90700946.eng.abstr-s1-t2",
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],
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54,
65
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}
]
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{
"id": "DerChirurg.90700946.eng.abstr-s2-t1",
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],
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102,
109
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],
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}
]
},
{
"id": "DerChirurg.90700946.eng.abstr-s2-t2",
"type": "umlsterm",
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"car"
],
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120,
123
]
],
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{
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},
{
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}
]
},
{
"id": "DerChirurg.90700946.eng.abstr-s2-t3",
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],
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124,
132
]
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}
]
},
{
"id": "DerChirurg.90700946.eng.abstr-s3-t1",
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"injuries"
],
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[
165,
173
]
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},
{
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}
]
},
{
"id": "DerChirurg.90700946.eng.abstr-s3-t2",
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"hernia"
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225,
231
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}
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"Hernia"
],
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234,
240
]
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}
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},
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"id": "DerChirurg.90700946.eng.abstr-s4-t2",
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"patient"
],
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[
303,
310
]
],
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}
]
},
{
"id": "DerChirurg.90700946.eng.abstr-s4-t3",
"type": "umlsterm",
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"surgical"
],
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[
335,
343
]
],
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{
"db_name": "UMLS",
"db_id": "C0038895"
}
]
},
{
"id": "DerChirurg.90700946.eng.abstr-s4-t4",
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"respiratory insufficiency"
],
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270,
295
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],
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{
"id": "DerChirurg.90700946.eng.abstr-s5-t1",
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],
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376,
382
]
],
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}
]
},
{
"id": "DerChirurg.90700946.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"chest"
],
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[
392,
397
]
],
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{
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}
]
},
{
"id": "DerChirurg.90700946.eng.abstr-s6-t1",
"type": "umlsterm",
"text": [
"postoperative"
],
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[
437,
450
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032790"
}
]
}
] |
[] |
[] |
[
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"normalized": []
},
{
"id": "DerChirurg.90700946.eng.abstr-s1-r2-t1.1-t2.1",
"type": "associated_with",
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},
{
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},
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},
{
"id": "DerChirurg.90700946.eng.abstr-s2-r3-t2.1-t3.1",
"type": "causes",
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"arg2_id": "DerChirurg.90700946.eng.abstr-s4-t3",
"normalized": []
},
{
"id": "DerChirurg.90700946.eng.abstr-s2-r4-t2.1-t1.1",
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},
{
"id": "DerChirurg.90700946.eng.abstr-s2-r5-t3.1-t2.1",
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},
{
"id": "DerChirurg.90700946.eng.abstr-s2-r6-t1.1-t2.1",
"type": "uses",
"arg1_id": "DerChirurg.90700946.eng.abstr-s6-t1",
"arg2_id": "DerChirurg.90700946.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "DerChirurg.90700946.eng.abstr-s3-r1-t1.1-t1.2",
"type": "result_of",
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"arg2_id": "DerChirurg.90700946.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerChirurg.90700946.eng.abstr-s4-r1-t1.1-t2.1",
"type": "occurs_in",
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"arg2_id": "DerChirurg.90700946.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "DerChirurg.90700946.eng.abstr-s4-r2-t3.1-t2.1",
"type": "occurs_in",
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"normalized": []
},
{
"id": "DerChirurg.90700946.eng.abstr-s4-r3-t1.1-t3.1",
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},
{
"id": "DerChirurg.90700946.eng.abstr-s4-r4-t1.1-t3.1",
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},
{
"id": "DerChirurg.90700946.eng.abstr-s4-r5-t3.1-t1.1",
"type": "result_of",
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"arg2_id": "DerChirurg.90700946.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "DerChirurg.90700946.eng.abstr-s4-r6-t3.1-t1.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90700946.eng.abstr-s4-t3",
"arg2_id": "DerChirurg.90700946.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "DerChirurg.90700946.eng.abstr-s5-r1-t2.1-t1.1",
"type": "location_of",
"arg1_id": "DerChirurg.90700946.eng.abstr-s5-t2",
"arg2_id": "DerChirurg.90700946.eng.abstr-s6-t1",
"normalized": []
}
] |
DerChirurg.90700949.eng.abstr
|
DerChirurg.90700949.eng.abstr
|
[
{
"id": "DerChirurg.90700949.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Solitary fibrous tumors of the pleura ( SFTP ) are very rare neoplasms . The majority of these tumors are benign , but about 10-20 % fulfill the criteria of malignancy . The clinical presentation varies according to the size and intrathoracic localization . In early stages , often asymptomatic , the tumors may grow to an enormous size and then cause symptoms such as cough , chest pain and dyspnea , but also paraneoplastic syndromes such as hypoglycemia or digital clubbing . Between 1981 and June 1998 we treated in our institution 16 SFTP in 14 patients ( 4 M , 10 F , average age at first operation 58 years ) . Eight patients showed symptoms , whereas in the other cases the tumors were found on routine chest X-rays . The usually pedunculated SFTP were completely resected without complications . Two patients developed malignant recurrences , which infiltrated the right upper lung lobe and the diaphragm respectively . In these cases the tumor was resected together with the adjacent structures . Since late recurrences are more often malignant than primary SFTPs long-term follow-up is mandatory even in benign lesions ."
],
"offsets": [
[
0,
1131
]
]
}
] |
[
{
"id": "DerChirurg.90700949.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"tumors"
],
"offsets": [
[
17,
23
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0027651"
}
]
},
{
"id": "DerChirurg.90700949.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"pleura"
],
"offsets": [
[
31,
37
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032225"
}
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DerChirurg.90700953.eng.abstr
|
DerChirurg.90700953.eng.abstr
|
[
{
"id": "DerChirurg.90700953.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In 1700 , the French surgeon Alexandre de Littré described for the first time a new form of inguinal hernia . This hernia varied from the known forms of hernias in its clinical course and in the postmortem examination results performed by Littrè himself . The characteristic feature of this hernia was the fact that the entire circumference of the bowel wall was not part of the hernial sac , but only the antimesenteric part of the intestinal wall . The underlying pathomechanism was explained 100 years later by Meckel . In a scientific paper about hernias some years earlier , Richter described the intestinal wall hernia , and this initiated the confusing use of the clinical entity known as the Richter-Littré hernia in Germany . In this case report we describe the historic development of this entity ."
],
"offsets": [
[
0,
808
]
]
}
] |
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] |
[] |
[] |
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DerChirurg.90700971.eng.abstr
|
DerChirurg.90700971.eng.abstr
|
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{
"id": "DerChirurg.90700971.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Although the case for thyroid surgery is based on morphologic and physiologic criteria , it is mainly based on individual therapeutic goals . The goals are influenced by various biographic , medical and personal facts and by many environmental conditions . Thus , there is no rationale for cataloguing indications . With the euthyroid goitre the indication for surgery is usually given by the size of the thyroid gland , especially since it has become clear in various studies that with drug therapy the achievable size reduction is rather small . With Graves ' disease the pros and cons of the three main methods , surgery , medical treatment or radioiodine , have to be considered in each case . Surgery is mainly indicated when the goal is a rapid and reliable normalization of the hormonal status . Thyroid autonomy is a clear-cut case for radioiodine . Only isolated autonomous nodules can equally well be treated by surgery . In addition , a case for surgery is given when besides the autonomy a large goitre is present . A special indication is iodine-induced thyrotoxicosis that cannot be normalized by medical treatment . All kinds of thyroid carcinoma , with very few exceptions , usually have to be operated on as the first choice ."
],
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}
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[] |
[] |
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DerChirurg.90700987.eng.abstr
|
DerChirurg.90700987.eng.abstr
|
[
{
"id": "DerChirurg.90700987.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In benign goiter , thyroidectomy is only indicated in patients with nodular alterations of the complete thyroid gland . There is no evidence indicating that total thyroidectomy could improve the postoperative results in patients with Graves ' disease . In Germany , thyroidectomy with cervicocentral lymph node dissection is the standard procedure for all differentiated thyroid carcinomas . However , there are no data to prove that this approach is superior to less radical procedures . Avoidance of reoperations and optimal conditions for effective postoperative radioiodine therapy are arguments for this aggressive strategy . In patients with medullary carcinoma or with detected ret-proto-oncogene mutations , thyroidectomy with cervicocentral lymphadenectomy should be the initial operation . The cervicolateral and mediastinal compartments should be dissected when clinically obvious lymph node metastases are present in patients with differentiated carcinomas . In patients with medullary carcinomas , persistently increased calcitonin levels after the initial operation are sufficient indication for this procedure . Thyroidectomy is an important part of the multimodal approach in patients with anaplastic carcinomas . The operative technique of thyroidectomy is presented as well as the technique of cervical lymphadenectomy in consideration of the lymphatic drainage of the thyroid gland ."
],
"offsets": [
[
0,
1402
]
]
}
] |
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DerChirurg.90700999.eng.abstr
|
DerChirurg.90700999.eng.abstr
|
[
{
"id": "DerChirurg.90700999.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Developments in thyroid surgery during the last 20 years have reduced the number of complications significantly with rates from the literature of less than 1 % of laryngeal nerve paralysis and hypoparathyroidism . Specific problems are connected , however , with patients presenting with recurrent goitres , requiring extended operations for Graves ' disease and for malignant diseases . Our own experience in almost 6,000 operations during the last 12 years comfirms the results from the literature with regard to more complicated thyroid surgery . Thus , laryngeal nerve paralysis in recurrent thyroid surgery is between 2 and 8 % , depending on the extent of surgery , which is necessary . In surgical treatment of hyperthyroidism , permanent laryngeal nerve paralysis may be reduced to less than 1 % , while hypoparathyroidism is still a severe problem in patients with Graves ' disease , and due to the necessity for an extensive operation is approximately 2 % in all cases . The same is true for patients with thyroid malignancies who suffer from permanent laryngeal nerve paralysis in 2-5 % and permanent hypoparathyroidism in 1-4 % , the range related to primary , secondary completion , or recurrent operation . The danger of postoperative bleeding still deserves special attention because it may be followed by life-threatening acute asphyxia . It is essential that surgeons also take care of all operative consequences at least by recommendating additional treatment ."
],
"offsets": [
[
0,
1479
]
]
}
] |
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] |
DerChirurg.90701014.eng.abstr
|
DerChirurg.90701014.eng.abstr
|
[
{
"id": "DerChirurg.90701014.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A total of 186 consecutive patients underwent open tension-free inguinal hernia repair , either on one or both sides . Overall , 220 hernias were repaired under local anesthesia conditions after intraoperatively classifying the size of the hernia . The follow-up investigation took place as planned in 165 hernias . The mean follow-up time was 15.5 months , with a range from 6.6 to 30.8 months , and the follow-up rate was 75.0 % . During this first follow-up it was especially interesting to read the patients , self-assessment concerning their physical restrictions during the first month after the operation . Furthermore , we were interested in learing about the objective and subjective operation-linked consequences in the patients , inguinal region . Most patients ( 89.7 % ) were able to do sports and drive their car ; 86.1 % were able to manage their usual physical activity 4 weeks after the operation . Focusing on the operation site , patients complained about chronic unpleasant effects , such as mild pain ( 21.2 % ) , local hypoesthesia ( 12.1 % ) , weather-dependent changes in sensitivity ( 7.2 % ) , moderate pain ( 3.6 % ) , inguinal syndrome ( 1.8 % ) and hyperesthesia ( 1.2 % ) . Persistent swelling in the parainguinal region was found in 1.8 % of the patients and only one recurrence was found ( 0.6 % ) . In the analysis we found that mild chronic pain was not related to the time period after the operation and the age or sex of the patient , but there was a correlation with the size of the hernia . Patients with small hernias significantly more often experienced chronic pain than patients with bigger hernias . These results suggest that open tension-free inguinal hernia repair according to Lichtenstein appears to be overtreatment in patients with small inguinal hernias ."
],
"offsets": [
[
0,
1806
]
]
}
] |
[
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],
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35
]
],
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}
]
},
{
"id": "DerChirurg.90701014.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"open"
],
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46,
50
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],
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},
{
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"hernia"
],
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73,
79
]
],
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{
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],
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]
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},
{
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],
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DerChirurg.90701020.eng.abstr
|
DerChirurg.90701020.eng.abstr
|
[
{
"id": "DerChirurg.90701020.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Introduction : It was our aim to evaluate the results of laparoscopic transabdominal preperitoneal hernia repair ( TAPP ) with regard to recurrent hernias treated in our department . Methods : Included were 276 operations for first or subsequent recurrence of inguinal hernia previously treated with suture repair . All final repairs were carried out using the TAPP technique . The data were collected prospectively . The patients were examined 2 weeks and 1 year postoperatively . The rate of follow-up amounted to 78.1 % at 1 year after operation . Results : Perioperative complications were monitored prospectively and divided into intraoperative , minor and major . The overall complication rate amounted to 9 % , major complications 5.3 % . The re-recurrence rate was 0.4 % . Conclusions : Because of the general advantages of laparoscopic surgery and the low recurrence rate we prefer laparoscopic hernioplasty using the TAPP technique ."
],
"offsets": [
[
0,
943
]
]
}
] |
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"id": "DerChirurg.90701020.eng.abstr-s1-t2",
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"text": [
"hernia"
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"id": "DerChirurg.90701020.eng.abstr-s2-t4",
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] |
[] |
[] |
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DerChirurg.90701031.eng.abstr
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DerChirurg.90701031.eng.abstr
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] |
DerChirurg.90701036.eng.abstr
|
DerChirurg.90701036.eng.abstr
|
[
{
"id": "DerChirurg.90701036.eng.abstr-passage-0",
"type": "abstract",
"text": [
"An easy venous access improves the quality of life of patients who need prolonged intravenous therapy . In the case of vena cava superior syndrome the classic access in the jugular or subclavian vein can be difficult or even impossible . We report on seven implantations of Port-a-Cath in the inferior vena cava for patients presenting contra-indications to classic venous access to the vena cava superior ( five cases of vena cava superior compression syndrome , one tracheostomy and one extended tumor of thoracic wall ) . We describe the operative technique and we analyze the indications , the results and the complications of this rarely used technique ."
],
"offsets": [
[
0,
659
]
]
}
] |
[
{
"id": "DerChirurg.90701036.eng.abstr-s1-t1",
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"life"
],
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[
46,
50
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0376558"
}
]
},
{
"id": "DerChirurg.90701036.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"patients"
],
"offsets": [
[
54,
62
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerChirurg.90701036.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"therapy"
],
"offsets": [
[
94,
101
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0087111"
},
{
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] |
[] |
[] |
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] |
DerChirurg.90701042.eng.abstr
|
DerChirurg.90701042.eng.abstr
|
[
{
"id": "DerChirurg.90701042.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Introduction : In order to investigate whether operative technique determines the 5-year recurrence and survival rates , we analysed the results obtained by two surgical departments using two different operative techniques . Department A : Removal of the tumour and a number of lymph nodes ; department B : En-bloc resection in accordance with the requirements of standardised tumour surgery . Patients and methods : The surgical results obtained with all patients with colorectal carcinoma operated on between 1984 and 1988 ( department A : 152 colon and 53 rectal carcinomas ; department B : 124 colon and 177 rectal carcinomas ) . Results : The local recurrence rate achieved by department A was signicantly higher ( colon carcinoma : department A 25 % ; department B 10 % ; rectal carcinoma : department A 54 % ; department B 16 % ) . The 5-year survival rate for colon carcinoma was 65 % in department A , and 66 % in department B , the corresponding figures for rectal carcinoma being 49 % and 72 % , respectively . Conclusion : The results indicate that carcinoma of the colorectum should be operated on only at an institution that complies with the standards required for surgery of colorectal carcinoma ."
],
"offsets": [
[
0,
1213
]
]
}
] |
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{
"id": "DerChirurg.90701042.eng.abstr-s1-t2",
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"recurrence"
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{
"id": "DerChirurg.90701042.eng.abstr-s1-t3",
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"survival"
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104,
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{
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"surgical"
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"id": "DerChirurg.90701042.eng.abstr-s2-t2",
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"lymph"
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{
"id": "DerChirurg.90701042.eng.abstr-s2-t3",
"type": "umlsterm",
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"tumour"
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377,
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{
"id": "DerChirurg.90701042.eng.abstr-s2-t4",
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"surgery"
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[] |
[] |
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] |
DerChirurg.90701050.eng.abstr
|
DerChirurg.90701050.eng.abstr
|
[
{
"id": "DerChirurg.90701050.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Arterial port systems are frequently used in the adjuvant and palliative therapy of colorectal hepatic metastasis . Specific complications are rarely documented in literature . The perforation of an arterial Port-a-cath followed by duodenal fistula is an uncommon complication of regional hepatic chemotherapy . Besides systemic disorders caused by the chemotherapeutic agents , such as vomiting , sickness , or gastritis and duodenitis , gastroduodenal ulcers can occur as a local complication of treatment . Thrombosis of the hepatic artery or occlusion of the port device are the most common reasons for withdrawal of treatment in our series . Based on our experience and the case report of a duodenal fistula we recommend angiography of the port system prior to each cycle of chemotherapy ."
],
"offsets": [
[
0,
794
]
]
}
] |
[
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DerChirurg.90701053.eng.abstr
|
DerChirurg.90701053.eng.abstr
|
[
{
"id": "DerChirurg.90701053.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Introduction : Pheochromocytoma during pregnancy is rare and represents a high risk for mother and fetus . Due to the variable clinical presentation it may be mistaken for preeclampsia . Case : A 34-year-old primiapara with hypertension up to 240/120 mmHg . After diagnosis of a pheochromocytoma its resection together with lymph node metastasis in the 17th week of gestation was performed . Conclusion : The definitive diagnosis is confirmed by elevation of serum catecholamines and their metabolites in a 24-h urine collection . Localization during pregnancy can be made by ultrasound and MRI . The definitive treatment is surgical removal after administration of adrenergic blockers . If discovered later in pregnancy , delivery by elective caesarean section followed by tumor resection is recommended . Since about 10 % of pheochromocytomas are malignant , postpartum screening is required to detect and treat extraadrenal or metastatic tumors by MIBG scintigraphy , chemotherapy or surgical procedures ."
],
"offsets": [
[
0,
1008
]
]
}
] |
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DerChirurg.90701082.eng.abstr
|
DerChirurg.90701082.eng.abstr
|
[
{
"id": "DerChirurg.90701082.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Bilateral neck exploration is the standard procedure in primary hyperparathyroidism . Using a bilateral approach , preoperative localization studies are not mandatory . A localized single gland disease is the basis for a minimally invasive procedure . Therefore preoperative localization techniques play an important role in planning ( minimally invasive ) first time exploration for primary hyperparathyroidism . The combination of 99 mTc-SestaMIBI scintigraphy with ultrasound allows correct localization of the parathyroid adenoma in 86 % of all single gland diseases . Multiple gland disease could be predicted in isolated cases only . Computerized tomography and magnetic resonance imaging could not improve the results . Surgery for persistent or recurrent hyperparathyroidism should only be performed after positive localization studies ."
],
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[
0,
845
]
]
}
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[] |
[] |
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DerChirurg.90701089.eng.abstr
|
DerChirurg.90701089.eng.abstr
|
[
{
"id": "DerChirurg.90701089.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Nearly all patients with chronic renal failure exhibit some degree of secondary hyperparathyroidsm ( sHPT ) , defined as parathyroid hyperplasia and elevated serum parathyroid hormone ( PTH ) levels . Despite improvements in the medical management of patients with sHPT continue to develop progressive bone disease manifested by osteitis fibrosa cystica , soft tissue calcification and myopathy , pruritus , bone and joint pain and calciphylaxis may accompany the bone disorder . When medical therapy fails , parathyroidectomy becomes necessary . This is not sufficiently explained by the failure to administer calcitriol to control serumphosphat and calcium concentration or to deliver sufficient dialysis . The continuos increase of the proportion of patients exhibiting severe uncontrolled HPT with increasing time of dialysis points to a more basic underlying biological problem ; an even higher proportion of patients shows also nodular , rather than diffuse hyperplasia . It was commonly believed that after restoration of normal renal function with successfull transplantation , the hyperplastic parathyroid glands would involute and return to normal function state . After renal transplantation some patients continue to have a HPT . This disease entity is recognized and termed as tertiary Hyperparathyroidism ( tHPT ) . After establishing a diagnosis of hyperparathyroid bone disease , in patients with sHPT and tHPT a parathyroidectomy ( PTX ) frequently becomes necessary to decrease the mass of the hyperplastic parathyroid tissue . The surgical procedure remains controversial . Some surgeons prefere subtotal PTX , others prefere total PTX with autotransplantation of a small amount of tissue to the arm , because the transplantated tissue can be removed in the event of a recurrent HPT . Successfull surgical intervention for sHPT and tHPT significantly reduces preoperative symptoms and leeds to restoration of bone desease and therefor supports PTX for patients with s and tHPT . In our experience total PTX with autograft has proven to be a satisfactory procedure . Subtotal PTX is also an effective procedure and the choice of operative technique should be left to the surgeon ."
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DerChirurg.90701102.eng.abstr
|
DerChirurg.90701102.eng.abstr
|
[
{
"id": "DerChirurg.90701102.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The aim of surgical intervention in the treatment of primary hyperparathyroidism ( pHPT ) is the achievement of normocalcemia and euparathyreosis . Despite improved diagnostic procedures containing comparatively modified pre- and intraoperative methods to determine the position of the parathyroid glands and the most efficient operative technique including minimal-invasive surgery thereof , success cannot be guaranteed . Therefore , we should strive to avoid reintervention by ensuring a hemorrhage-free , atraumatic , anatomical-orientated operation and providing positive preconditions for reoperation . Success is based on the four pillars of the HPT surgery : history , embryology with anatomy , neck surgery and experience . By means of this principle and the results of surgical treatment in 1634 patients with pHPT from 1982 until 1998 , we demonstrate a standardized operative technique of pHPT ."
],
"offsets": [
[
0,
907
]
]
}
] |
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] |
DerChirurg.90701126.eng.abstr
|
DerChirurg.90701126.eng.abstr
|
[
{
"id": "DerChirurg.90701126.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Introduction : The persistence rate of primary hyperparathyroidism after cervical exploration was estimated and early diagnosis and reoperation were evaluated in a prospective study . Methods : Between 1 August 1987 and 31 October 1998 , 370 patients underwent surgery . The postoperative course is known in 94.6 % of these patients ( follow-up 1 month-10 years , median 24 months ) . Results : Cervical exploration was successful in 97.5 % ( n = 353 ) of the 361 patients with the first manifestation of primary hyperparathyroidism and in all patients with recurrence or persistence of the disease after initial operation elsewhere . In persistent primary hyperparathyroidism serum calcium levels remained elevated 4 days after surgery ( n = 9 , 2.5 % ) . Localization studies , preferably with 99mTc-MIBI-scintigraphy were attempted during the first postoperative week and could be performed in 4 patients . Four patients wished the procedure to be performed later . Conclusion : Within one week after the initial intervention the diagnosis of persistent primary hyperparathyroidism can be established and localization studies as well as cervical reexploration can be carried out . An interval of 3 months from the initial operation to reexploration of the perithyroid area is recommended if the reexploration is impossible within one week . Mediastinal reoperations or surgical interventions in the neck sparing the perithyroid area may be carried out without consideration of specific intervals ."
],
"offsets": [
[
0,
1500
]
]
}
] |
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47,
66
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{
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] |
[] |
[] |
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DerChirurg.90701131.eng.abstr
|
DerChirurg.90701131.eng.abstr
|
[
{
"id": "DerChirurg.90701131.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The frequency of medico-legal issues after surgery is rising . Knowledge of the character and frequency of such problems following surgery of the thyroid gland is scant . Analysis of 21,515 cases of adverse effects after medical treatment from 1975 through 1998 identified 222 cases ( 1 % ) of litigation following surgery for thyroid diseases . The frequency of litigation problems rose exponentially during this interval . Malpractice was confirmed in 36 cases ( 16 % ) . The litigation was directed against the surgeon in 95 % of cases , the anesthesiologist in 2 % , both of them in 3 % and the ear-nose-throat surgeon in one case . Eighty-nine percent of the 222 cases occurred after routine thyroid surgery . Typical complications such as recurrent nerve palsy ( 50 % ) , hypoparathyroidism ( 14 % ) , bleeding ( 3 % ) , and late goiter recurrence ( 1 % ) accounted for 63 % of the presumed but for only 31 % of ascertained malpractice cases . Atypical complications such as other neurologic deficits ( 10 % ) , infections ( 5 % ) , residual nodules ( 4 % ) , scar problems ( 5 % ) accounted for 37 % of the suspected but for 70 % of confirmed malpractice cases . Deficiencies in obtaining informed consent were present in only 11 % . Malpractice was more frequently judged to be present , if a second operation was necessary ( P 0.001 ) , if the goal of the operation had been missed ( P 0.001 ) , or if any kind of complication was followed by a fault in postoperative care ( P 0.001 ) ."
],
"offsets": [
[
0,
1495
]
]
}
] |
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DerChirurg.90701139.eng.abstr
|
DerChirurg.90701139.eng.abstr
|
[
{
"id": "DerChirurg.90701139.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Morbidity and mortality after reversal of Hartmann's procedure following perforated sigmoid diverticulitis are high and the rate of intestinal restoration is low . Aim : To investigate whether laparoscopically assisted reversal of Hartmann's procedure is technically feasible and whether the laparoscopic procedure offers any benefit to the patient . Method : Nineteen patients were investigated . The postoperative course was followed prospectively . All patients were reinvestigated 9 months after surgery . Results : Laparoscopic reversal of Hartmann's procedure was attempted in 19 patients . One patient did not want the laparoscopic technique . In two cases ( 11 % ) conversion to the conventional technique was necessary ; thus , 16 patients were operated laparoscopically . Median operative time was 114 ( 65-180 ) min . With the exception of three wound infections no immediate postoperative complications were noticed . Patients ' convalescence was fast . First evacuation took place 3.3 ( 3-5 ) days after surgery , complete oral nutrition 3.6 ( 3-5 ) days after surgery . Duration of postoperative hospitalisation was 7.5 ( 5-12 ) days . One patient developed later a clinically significant anastomotic stricture which needed endoscopic dilatation . Conclusion : Laparoscopically assisted Hartmann's reversal is technically demanding but feasible . Postoperative morbidity is low , duration of hospitalisation short , convalescence fast . Thus , good arguments exist for performing reversal of Hartmann's procedures laparoscopically ."
],
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0,
1546
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]
}
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"id": "DerChirurg.90701139.eng.abstr-s17-t1",
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"db_id": "C0184661"
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"db_name": "UMLS",
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]
}
] |
[] |
[] |
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},
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"type": "performs",
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},
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}
] |
DerChirurg.90701144.eng.abstr
|
DerChirurg.90701144.eng.abstr
|
[
{
"id": "DerChirurg.90701144.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We present five patients with serious ischemia of the fingers caused by intra-arterial injection injury , trauma , rheumatoid arthritis , chronic myeloid leukemia with thrombocytosis and thoracic-outlet syndrome . The treatment consisted of thrombectomy and intra-arterial lysis if possible and intra-arterial infusion of 80 µg PGE1/24 h in combination with 25,000 U of heparin/24 h for 6-10 days . PGE1 and heparin were administered through a 3-F catheter introduced surgically into a forearm artery . In three cases a complete remission was possible , in the other two cases the therapy led to significant improvement . No side effects or complications were noticed ."
],
"offsets": [
[
0,
669
]
]
}
] |
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{
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24
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}
]
},
{
"id": "DerChirurg.90701144.eng.abstr-s1-t2",
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"text": [
"ischemia"
],
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38,
46
]
],
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]
},
{
"id": "DerChirurg.90701144.eng.abstr-s1-t3",
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"text": [
"fingers"
],
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54,
61
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],
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"db_id": "C0016129"
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]
},
{
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96
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}
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{
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}
]
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{
"id": "DerChirurg.90701144.eng.abstr-s1-t6",
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106,
112
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"db_id": "C0021501"
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{
"db_name": "UMLS",
"db_id": "C0043251"
}
]
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{
"id": "DerChirurg.90701144.eng.abstr-s1-t7",
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"text": [
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{
"id": "DerChirurg.90701144.eng.abstr-s1-t8",
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"text": [
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"db_id": "C0023418"
}
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{
"id": "DerChirurg.90701144.eng.abstr-s1-t9",
"type": "umlsterm",
"text": [
"thrombocytosis"
],
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[
168,
182
]
],
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{
"db_name": "UMLS",
"db_id": "C0836924"
}
]
},
{
"id": "DerChirurg.90701144.eng.abstr-s1-t10",
"type": "umlsterm",
"text": [
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203,
211
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{
"id": "DerChirurg.90701144.eng.abstr-s1-t11",
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"db_id": "C0021487"
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{
"id": "DerChirurg.90701144.eng.abstr-s1-t12",
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115,
135
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],
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"db_id": "C0003873"
}
]
},
{
"id": "DerChirurg.90701144.eng.abstr-s1-t13",
"type": "umlsterm",
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162
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"db_id": "C0023470"
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]
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{
"id": "DerChirurg.90701144.eng.abstr-s1-t14",
"type": "umlsterm",
"text": [
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],
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162
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],
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"db_id": "C0023473"
}
]
},
{
"id": "DerChirurg.90701144.eng.abstr-s2-t1",
"type": "umlsterm",
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"treatment"
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218,
227
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"db_id": "C0087111"
},
{
"db_name": "UMLS",
"db_id": "C0039798"
}
]
},
{
"id": "DerChirurg.90701144.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"thrombectomy"
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241,
253
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"db_id": "C0162578"
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},
{
"id": "DerChirurg.90701144.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
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[
295,
318
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],
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"db_id": "C0021439"
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]
},
{
"id": "DerChirurg.90701144.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"PGE1"
],
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[
399,
403
]
],
"normalized": [
{
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"db_id": "C0002335"
}
]
},
{
"id": "DerChirurg.90701144.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"heparin"
],
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408,
415
]
],
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"db_id": "C0019134"
}
]
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{
"id": "DerChirurg.90701144.eng.abstr-s3-t3",
"type": "umlsterm",
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"catheter"
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"db_id": "C0085590"
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},
{
"id": "DerChirurg.90701144.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"forearm"
],
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486,
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"db_id": "C0016536"
}
]
},
{
"id": "DerChirurg.90701144.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"artery"
],
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494,
500
]
],
"normalized": [
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"db_name": "UMLS",
"db_id": "C0003842"
}
]
},
{
"id": "DerChirurg.90701144.eng.abstr-s4-t1",
"type": "umlsterm",
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"therapy"
],
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581,
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"db_id": "C0087111"
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"db_name": "UMLS",
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{
"id": "DerChirurg.90701144.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"complications"
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641,
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"db_id": "C0009566"
}
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{
"id": "DerChirurg.90701144.eng.abstr-s5-t2",
"type": "umlsterm",
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"side effects"
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625,
637
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0001688"
}
]
}
] |
[] |
[] |
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{
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{
"id": "DerChirurg.90701144.eng.abstr-s1-r5-t5.1-t14.1",
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{
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{
"id": "DerChirurg.90701144.eng.abstr-s1-r7-t5.1-t13.1",
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{
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{
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{
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{
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"arg1_id": "DerChirurg.90701144.eng.abstr-s3-t4",
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DerChirurg.90701149.eng.abstr
|
DerChirurg.90701149.eng.abstr
|
[
{
"id": "DerChirurg.90701149.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Heparin-induced thrombocytopenia type II ( HIT type II ) is an immunoglobulin-mediated , drug-induced side effect for heparin-treated patients with thromboembolic complications . With an incidence of 1-3 % , mortality of 20 % it and permanent disability for another 20 % is a clinically relevant disorder . With heparin treatment or prophylaxis frequent platelet count monitoring is necessary . With HIT type II the thrombocytopenia is often a harbinger of thromboembolic complications in the venous or arterial system . If HIT type II is suspected , further heparin exposure is to be stopped immediately and another anticoagulant therapy should be started . The two anticoagulant options in Germany are discussed . At the same time the diagnosis should be confirmed by laboratory testing , including testing for cross-reactivity with danaparoid . Further therapy depends on the symptoms . In the case of clinical relevance of this disorder we should think about prophylaxis : strict indications for perioperative prophylaxis only use of low-molecular-weight heparin ( LMWH ) for routine prophylaxis , use of LMWH for thrombosis treatment and early change to cumarine ."
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[] |
[] |
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DerChirurg.90701156.eng.abstr
|
DerChirurg.90701156.eng.abstr
|
[
{
"id": "DerChirurg.90701156.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Medical treatment of injured patients by international missions of non-governmental organisations in crisis areas and out-of-area operations by troops , and also national disasters require special trauma management . Deviations from peacetime surgical guidelines are obligatory because of long-distance medical evacuation , the possibility of gaps in supply and the typical pattern of war injuries . Massive contamination combined with the high risk of infection is one typical attribute of wounds inflicted during a war or a disaster . In contrast to peacetime surgical guidelines , aggressive wound débridement is often needed . Timely and prophylactically prescription of a broad-spectrum antibiotic with a long half-life has great importance in the treatment of these wounds . Suitable antibiotics for these indications are : piperacillin/tazobactam and ceftriazon . Nevertheless the use of antimicrobial agents will only be effective with early surgical débridement ."
],
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0,
972
]
]
}
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[] |
[] |
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] |
DerChirurg.90701168.eng.abstr
|
DerChirurg.90701168.eng.abstr
|
[
{
"id": "DerChirurg.90701168.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The results of a retrospective study concerning percutaneous catheter drainage of 62 intra-abdominal abscesses in 60 patients were demonstrated , including the procedure and complications . For the first access a thin needle was used to perform an aspiration biopsy under sonographic control . We placed a pigtail or van Sonnenberg catheter by Seldinger or trocar technique into the abscesses . The primary success rate of percutaneous drainage was 85 % . Complications occurred in 6.4 % of the cases with a mortality of 0 % . This method is an acceptable alternative to surgery for many patients . Ultrasound-guided percutaneous catheter drainage is the method of choice for uncomplicated abscesses , especially in the critically ill patient ."
],
"offsets": [
[
0,
744
]
]
}
] |
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]
],
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{
"id": "DerChirurg.90701168.eng.abstr-s1-t2",
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"catheter"
],
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[
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69
]
],
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{
"id": "DerChirurg.90701168.eng.abstr-s1-t3",
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},
{
"id": "DerChirurg.90701168.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"abscesses"
],
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[
101,
110
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],
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{
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"procedure"
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}
]
},
{
"id": "DerChirurg.90701168.eng.abstr-s1-t7",
"type": "umlsterm",
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174,
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{
"id": "DerChirurg.90701168.eng.abstr-s1-t8",
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17,
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},
{
"id": "DerChirurg.90701168.eng.abstr-s1-t9",
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"text": [
"intra-abdominal abscesses"
],
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[
85,
110
]
],
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{
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"db_id": "C0243001"
}
]
},
{
"id": "DerChirurg.90701168.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"needle"
],
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218,
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]
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]
},
{
"id": "DerChirurg.90701168.eng.abstr-s2-t2",
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"text": [
"aspiration"
],
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{
"id": "DerChirurg.90701168.eng.abstr-s2-t3",
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"id": "DerChirurg.90701168.eng.abstr-s7-r14-t6.1-t1.1",
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},
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"id": "DerChirurg.90701168.eng.abstr-s7-r15-t6.1-t3.2",
"type": "uses",
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},
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"id": "DerChirurg.90701168.eng.abstr-s7-r16-t6.1-t3.2",
"type": "performs",
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"arg2_id": "DerChirurg.90701168.eng.abstr-s7-t3",
"normalized": []
},
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"id": "DerChirurg.90701168.eng.abstr-s7-r17-t3.2-t7.1",
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{
"id": "DerChirurg.90701168.eng.abstr-s7-r18-t1.1-t7.1",
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"arg2_id": "DerChirurg.90701168.eng.abstr-s7-t7",
"normalized": []
},
{
"id": "DerChirurg.90701168.eng.abstr-s7-r19-t3.2-t6.1",
"type": "associated_with",
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},
{
"id": "DerChirurg.90701168.eng.abstr-s7-r20-t7.1-t6.1",
"type": "occurs_in",
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"id": "DerChirurg.90701168.eng.abstr-s7-r21-t3.2-t5.1",
"type": "associated_with",
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"arg2_id": "DerChirurg.90701168.eng.abstr-s7-t5",
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},
{
"id": "DerChirurg.90701168.eng.abstr-s7-r22-t1.1-t5.1",
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{
"id": "DerChirurg.90701168.eng.abstr-s7-r23-t7.1-t3.2",
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"id": "DerChirurg.90701168.eng.abstr-s7-r24-t7.1-t5.1",
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{
"id": "DerChirurg.90701168.eng.abstr-s7-r26-t6.1-t1.1",
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"arg2_id": "DerChirurg.90701168.eng.abstr-s7-t1",
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},
{
"id": "DerChirurg.90701168.eng.abstr-s7-r27-t7.1-t3.1",
"type": "associated_with",
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"arg2_id": "DerChirurg.90701168.eng.abstr-s7-t3",
"normalized": []
}
] |
DerChirurg.90701172.eng.abstr
|
DerChirurg.90701172.eng.abstr
|
[
{
"id": "DerChirurg.90701172.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Spontaneous intramural rupture of the oesophagus is a rare cause of acute pain in the chest and upper abdomen . A case of spontaneous intramural oesophageal rupture in an 82-year-old woman is reported . Symptoms , diagnostic investigation , aetiology and therapy of the lesion were demonstrated ."
],
"offsets": [
[
0,
296
]
]
}
] |
[
{
"id": "DerChirurg.90701172.eng.abstr-s1-t1",
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"text": [
"rupture"
],
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[
23,
30
]
],
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{
"db_name": "UMLS",
"db_id": "C0035955"
}
]
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"oesophagus"
],
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[
38,
48
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0546837"
},
{
"db_name": "UMLS",
"db_id": "C0014876"
}
]
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"cause"
],
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[
59,
64
]
],
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{
"db_name": "UMLS",
"db_id": "C0015127"
}
]
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"pain"
],
"offsets": [
[
74,
78
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030193"
}
]
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"chest"
],
"offsets": [
[
86,
91
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0039992"
}
]
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"abdomen"
],
"offsets": [
[
102,
109
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0000726"
}
]
},
{
"id": "DerChirurg.90701172.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"oesophageal"
],
"offsets": [
[
145,
156
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0014852"
}
]
},
{
"id": "DerChirurg.90701172.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"rupture"
],
"offsets": [
[
157,
164
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0035955"
}
]
},
{
"id": "DerChirurg.90701172.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"woman"
],
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[
183,
188
]
],
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{
"db_name": "UMLS",
"db_id": "C0043210"
}
]
},
{
"id": "DerChirurg.90701172.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"Symptoms"
],
"offsets": [
[
203,
211
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0683368"
}
]
},
{
"id": "DerChirurg.90701172.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"diagnostic"
],
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[
214,
224
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0348026"
}
]
},
{
"id": "DerChirurg.90701172.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"aetiology"
],
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[
241,
250
]
],
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{
"db_name": "UMLS",
"db_id": "C0007463"
}
]
},
{
"id": "DerChirurg.90701172.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"therapy"
],
"offsets": [
[
255,
262
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0087111"
},
{
"db_name": "UMLS",
"db_id": "C0039798"
}
]
}
] |
[] |
[] |
[
{
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"type": "location_of",
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"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-r2-t1.1-t2.1",
"type": "disrupts",
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},
{
"id": "DerChirurg.90701172.eng.abstr-s1-r3-t2.1-t1.1",
"type": "location_of",
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},
{
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"type": "adjacent_to",
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"arg2_id": "DerChirurg.90701172.eng.abstr-s1-t6",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-r5-t2.1-t3.1",
"type": "associated_with",
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{
"id": "DerChirurg.90701172.eng.abstr-s1-r6-t1.1-t2.1",
"type": "result_of",
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},
{
"id": "DerChirurg.90701172.eng.abstr-s1-r7-t2.1-t5.1",
"type": "adjacent_to",
"arg1_id": "DerChirurg.90701172.eng.abstr-s3-t2",
"arg2_id": "DerChirurg.90701172.eng.abstr-s1-t5",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-r8-t5.1-t2.1",
"type": "adjacent_to",
"arg1_id": "DerChirurg.90701172.eng.abstr-s1-t5",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t2",
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},
{
"id": "DerChirurg.90701172.eng.abstr-s1-r9-t3.1-t2.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90701172.eng.abstr-s3-t3",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t2",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-r10-t5.1-t2.1",
"type": "location_of",
"arg1_id": "DerChirurg.90701172.eng.abstr-s1-t5",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t2",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-r11-t3.1-t1.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90701172.eng.abstr-s3-t3",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-r12-t2.1-t1.1",
"type": "result_of",
"arg1_id": "DerChirurg.90701172.eng.abstr-s3-t2",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-r13-t6.1-t2.1",
"type": "adjacent_to",
"arg1_id": "DerChirurg.90701172.eng.abstr-s1-t6",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t2",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-r14-t5.1-t1.1",
"type": "location_of",
"arg1_id": "DerChirurg.90701172.eng.abstr-s1-t5",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-r15-t6.1-t2.1",
"type": "location_of",
"arg1_id": "DerChirurg.90701172.eng.abstr-s1-t6",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t2",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s1-r16-t1.1-t3.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90701172.eng.abstr-s3-t1",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t3",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s2-r1-t2.1-t3.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90701172.eng.abstr-s3-t2",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t3",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s2-r2-t1.1-t2.1",
"type": "result_of",
"arg1_id": "DerChirurg.90701172.eng.abstr-s3-t1",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t2",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s2-r3-t3.1-t2.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90701172.eng.abstr-s3-t3",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t2",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s2-r4-t3.1-t1.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90701172.eng.abstr-s3-t3",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s2-r5-t2.1-t1.1",
"type": "result_of",
"arg1_id": "DerChirurg.90701172.eng.abstr-s3-t2",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s2-r6-t1.1-t3.1",
"type": "associated_with",
"arg1_id": "DerChirurg.90701172.eng.abstr-s3-t1",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t3",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s3-r1-t4.2-t1.1",
"type": "isa",
"arg1_id": "DerChirurg.90701172.eng.abstr-s3-t4",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s3-r2-t2.1-t1.1",
"type": "isa",
"arg1_id": "DerChirurg.90701172.eng.abstr-s3-t2",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerChirurg.90701172.eng.abstr-s3-r3-t4.1-t1.1",
"type": "treats",
"arg1_id": "DerChirurg.90701172.eng.abstr-s3-t4",
"arg2_id": "DerChirurg.90701172.eng.abstr-s3-t1",
"normalized": []
}
] |
DerChirurg.90701193.eng.abstr
|
DerChirurg.90701193.eng.abstr
|
[
{
"id": "DerChirurg.90701193.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The grading of long-tubular-bone pseudarthrosis depends on the biological reaction or lack of reaction in pseudarthrosis or non-unions . Hypertrophic and oligotrophic pseudarthrosis belongs to biologically reacting non-unions , whereas non-reacting non-unions are necrotic pseudarthrosis and defective non-unions with partial decline or complete destruction of cortical substance . Pseudarthrosis is a serious disturbance or disorder within the regulation cycle in fracture healing , which consists of osteoregeneration , osteovascularization and stabilization . The causes and underlying reasons for disturbance of this regulation cycle are primarily massive destruction of the biological and functional very important unity of periost , cortical substance and medullary space . This can occur from trauma , but it happens more often from surgical procedures that do not take the biological principles of bone-healing into account . Surgical strategies and interventions that respect the importance of periosteal tissue , cortical tissue and medullary space do fill the biological principles of fracture-healing and fracture union ."
],
"offsets": [
[
0,
1133
]
]
}
] |
[
{
"id": "DerChirurg.90701193.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"long-tubular-bone"
],
"offsets": [
[
15,
32
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0262950"
}
]
},
{
"id": "DerChirurg.90701193.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"pseudarthrosis"
],
"offsets": [
[
33,
47
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0033785"
}
]
},
{
"id": "DerChirurg.90701193.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"pseudarthrosis"
],
"offsets": [
[
106,
120
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0033785"
}
]
},
{
"id": "DerChirurg.90701193.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"Hypertrophic"
],
"offsets": [
[
137,
149
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0020564"
}
]
},
{
"id": "DerChirurg.90701193.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"pseudarthrosis"
],
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[
167,
181
]
],
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{
"db_name": "UMLS",
"db_id": "C0033785"
}
]
},
{
"id": "DerChirurg.90701193.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"pseudarthrosis"
],
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[
273,
287
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0033785"
}
]
},
{
"id": "DerChirurg.90701193.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"Pseudarthrosis"
],
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[
382,
396
]
],
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"db_name": "UMLS",
"db_id": "C0033785"
}
]
},
{
"id": "DerChirurg.90701193.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"disorder"
],
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[
425,
433
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0012634"
}
]
},
{
"id": "DerChirurg.90701193.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"regulation"
],
"offsets": [
[
445,
455
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0034982"
},
{
"db_name": "UMLS",
"db_id": "C0220905"
}
]
},
{
"id": "DerChirurg.90701193.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"fracture"
],
"offsets": [
[
465,
473
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0016658"
}
]
},
{
"id": "DerChirurg.90701193.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"fracture healing"
],
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[
465,
481
]
],
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{
"db_name": "UMLS",
"db_id": "C0162542"
}
]
},
{
"id": "DerChirurg.90701193.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"causes"
],
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567,
573
]
],
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{
"db_name": "UMLS",
"db_id": "C0015127"
}
]
},
{
"id": "DerChirurg.90701193.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"regulation"
],
"offsets": [
[
621,
631
]
],
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[] |
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DerChirurg.90701202.eng.abstr
|
DerChirurg.90701202.eng.abstr
|
[
{
"id": "DerChirurg.90701202.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Operative treatment of acute humeral shaft fractures represents a major source of nonunions . The analysis of the biomechanical and biological causes of diaphyseal nonunions of the humerus is a prerequisite for the successful treatment of ununited humeral shaft fractures . Biologically active nonunions heal after debridement and correction of deformities with an improvement of mechanical stability , preferably by fixation with a compression plate . In atrophic nonunions , the restoration of the biologic capacity to restore osteogenesis by bone grafting is additionally necessary . The treatment of synovial pseudarthrosis and infected nonunion requires removal of bone and debridement of synovial and infected avascular tissues , respectively . Intramedullary nails to improve mechanical stability and nonoperative treatment with extracorporeal shock waves should only be used in a few special cases which do not have any severe deformities ."
],
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0,
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]
]
}
] |
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DerChirurg.90701209.eng.abstr
|
DerChirurg.90701209.eng.abstr
|
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],
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}
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[] |
[] |
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DerChirurg.90701216.eng.abstr
|
DerChirurg.90701216.eng.abstr
|
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"id": "DerChirurg.90701216.eng.abstr-passage-0",
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"text": [
"Failures after ankle arthrodesis are , according to the literature and our own experience , more frequently seen with external fixation than with internal fixation methods . Favourable results can be obtained with the standard four-screw technique , preservation of the ankle and the biomechanical axes seeing only one non-union in 44 own cases with this technique ."
],
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0,
366
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}
] |
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[] |
[] |
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DerChirurg.90701225.eng.abstr
|
DerChirurg.90701225.eng.abstr
|
[
{
"id": "DerChirurg.90701225.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Introduction : Injuries precede the vast majority of all odontoid pseudarthroses . Because of specific anatomic conditions type II injuries lead more often than other types to non unions . For its development insufficient internal or external fixation and a persisting fracture gap are crucial . Methods and results : In 71 patients after operative stabilization of odontoid fractures with two anterior lag-screws we detected 8 non unions . In 3 patients the interval between accident and operation amounted to more than 5 weeks , seven times we did not succeed in closing the fracture gap . Technical mistakes like insufficient reduction ( n = 1 ) or screw misplacement ( n = 3 ) were additional reasons . According to the literature and own observations an os odontoideum must be considered in most instances as a pseudarthrosis after a lesion of the subdental synchondrosis in childhood . The most important diagnostic tool in odontoid non unions is a dynamic examination of the upper cervical spine under fluoroscopic control in maximum flexion and extension . We propose a classification of posttraumatic dens non unions into 4 types . Type I corresponds to a stable \" non union \" in approximate anatomical position of the dens and without signs of instability in the former fracture zone . Typ II describes a relatively stable grossly displaced non union that is not to be reduced by simple , closed means . Typ III means an unstable non union and Typ IV a posttraumatic os odontoideum . Conclusions : Therapeutical recommendations need to be differentiated . Unstable non unions are most often responsible for persistent pain , may result in acute or chronic myelopathie and therefore - as well as ossa odontoidea - need operative fixation . In considerably displaced non unions a closed reduction manoeuver with long term traction should be tried . The operative treatment of choice is the posterior transarticular screw fixation C1/C2 desirably in a percutaneous technique . Tight , \" stable \" pseudarthroses in the sense of a persisting fracture gap in painfree patients should first be controlled radiologically . If the odontoid position remains unchanged , non operative treatment may be continued ."
],
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[] |
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DerChirurg.90701239.eng.abstr
|
DerChirurg.90701239.eng.abstr
|
[
{
"id": "DerChirurg.90701239.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Understanding the pathophysiology of non-union is a prerequisite for successful treatment of this disorder . Fracture healing may be impeded by mechanical or biological factors as well as a combination of these . A thorough evaluation of each individual case before surgery is necessary to prevent either undertreatment or overtreatment . The whole spectrum of methods of internal fixation may be utilized for stabilization . To optimize the biological component , classic methods such as decortication and cancellous autograft may be employed . It is too early yet to determine if alternative techniques ( e.g. ultrasound ) will successfully replace these long-standing options . In any case , these newer modalities cannot supplant the need for skeletal stabilization . For infected pseudarthroses the first step is eradication of infection , after which meaures can be taken to unite the fracture . Callus distraction has opened new and safe ways to treat large bone defects ."
],
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0,
979
]
]
}
] |
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] |
[] |
[] |
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DerChirurg.90701246.eng.abstr
|
DerChirurg.90701246.eng.abstr
|
[
{
"id": "DerChirurg.90701246.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Lethality and morbidity of blunt abdominal trauma are directly dependent on the immediately valid diagnostic work-up . Since blunt abdominal trauma usually occurs in the setting of multisystem injury and patients are no longer cooperative , clinical methods of diagnosis are unreliable . In regard to the imaging procedures , the practical approach has been simplified and standardized in the last few years . Initially , ultrasonography of the abdomen is performed . If the patient is hemodynamically unstable because of intra-abdominal loss of blood , this can be reliably detected by ultrasound and emergency laparotomy is indicated . If patients are hemodynamically stable , more sophisticated assesment of the abdomen can be achieved by computed tomography . The next step depends on direct or indirect signs of an intra-abdominal lesion . Angiography may be indicated in injuries to the liver , spleen , kidney , mesenteric root or caval vein . If lesions to the liver , biliary or pancreas are detected , ERCP may be required . Lacerations of hollow organs are identified by fine-needle aspiration of free intra-abdominal fluid . Findings on computed tomography are usually reliable enough to support a more conservative approach in the treatment of parenchymal lesions in blunt abdominal trauma . Since the facilities to perform ultrasound are provided in all emergency units and knowledge of ultrasonography is an essential part of surgical training , competitive diagnostic procedures like peritoneal lavage have completely lost their former important clinical role . Similarly , diagnostic laparoscopy is - in contrast to abdominal perforations - no longer of importance ."
],
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] |
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