Pub Date : 2003-12-02DOI: 10.1080/11024159850191157
Christer Drott
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To find out whether subtotal thyroidectomy results in long term stable functional and immunological remission in patients with Graves' disease.
Design:
Retrospective study.
Setting:
Teaching hospital, Japan
Subjects:
176 patients who underwent subtotal thyroidectomy for Graves' disease, 1970–79.
Intervention:
Follow up surveys in 1984 and 1992.
Main outcome measures:
- Changes in thyroid function, antibody titres, and lymphocyte subsets.
Results:
29/79 patients (39%) who were euthyroid in 1984 had evidence of thyroid dysfunction in 1992. Of the 8 patients with latent hypothyroidism in 1984, 3 (38%) had become euthyroid by 1992, and none required treatment. Of the 29 patients who were hypothyroid in 1984, 5 had latent hypothyroidism and 1 was euthyroid in 1992, and of the 18 patients with recurrent hyperthyroidism in 1984, 1 had become euthyroid by 1992. The number of positive titres to TSH-binding inhibitory immunoglobulin was significantly higher in the recurrence group (31/36, 86%) compared with the hypothyroid (7/26, 27%), latent hypothyroidism (8/37, 22%), and euthyroid (22/77, 29%) groups (p < 0.01). There were also significant differences in the mean (SD) number of Leu HLA DR subsets between the control (17 (3), n = 18) and recurrence (21 (6), n = 38), hypothyroid (22 (6), n = 35), latent hypothyroidism (22 (6), n = 22), and euthyroid (22 (9), n = 64) groups (p < 0.002). There were no differences in the number of T cell subsets among the groups.
{"title":"Pancreatoblastoma in an adolescent girl: case report and review of 26 Japanese cases","authors":"Atsushi Imamura, Akihiko Nakagawa, Masashi Okuno, Souichirou Takai, Hisanao Komada, A-Hon Kwon, Shouji Uetsuji, Yasuo Kamiyama, Noriko Sakaida, Akiharu Okamura","doi":"10.1080/110241598750004553","DOIUrl":"10.1080/110241598750004553","url":null,"abstract":"","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 4","pages":"309-312"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004553","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20559654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2003-12-02DOI: 10.1080/11024159850191094
Lars Olsson Rex, Christer Drott, Göran Claes, Gunnar Göthberg, Peter Dalman
Objective:
To study the outcome of endoscopic thoracic sympaticotomy (ETS) for palmar, axillary, facial hyperhidrosis and facial blushing.
Subjects:
1152 patients, 59% women and 41% men.
Intervention:
ETS was performed by transection of the sympathetic chain where it overlies the second and third rib. The nerve was divided also over the fourth rib in patients with axillary hyperhidrosis. Questionnaires were sent to all patients.
Main outcome measures:
The effect of surgery was assessed by a 10 grad visual analogue scale (VAS) by the patients. The results were divided into effect rate (the effect on the symptom) and overall satisfaction rate, taking into account any side effects and complications apart from the effect.
Results:
The response rate was 90%. The mean follow up time, effect rate and overall satisfaction rate were: 38 months for palmar hyperhidrosis, 99,4% and 87%; 26 months for axillary hyperhidrosis, 94,5% and 68%; 31 months for facial hyperhidrosis, 97% and 76%; 8 months for facial blushing, 96% and 85%.
Pub Date : 2003-12-02DOI: 10.1080/110241598750005886
François Mosimann, Patrick Cornu
Objective:
To assess the effect of preoperative enemas on the recovery of peristalsis after non-colonic abdominal operations.
Design:
Prospective randomised trial.
Setting:
University hospital, Switzerland.
Subjects:
116 adult patients (>16 year old) about to undergo elective non-colonic abdominal operations under general anaesthaesia were considered.
Intervention:
Two groups were randomised to receive a one litre water and glycerine enema the day before operation (n = 53) or no preoperative intestinal preparation (n = 53).
Main outcome measures:
Return of peristalsis after operation, assessed by auscultation of bowel sounds and time of the first spontaneous faeces. All participants were followed daily for 10 days or until discharge by the same observer.
Results:
110 patients gave informed consent, 6 refused to participate, and 4 had to be withdrawn after randomisation, leaving 106 for analysis. The patients without an enema recovered bowel sounds activity sooner (p = 0.02) and passed their first spontaneous faeces significantly earlier (p = 0.01). No subgroup of patients benefited from an enema.
Pub Date : 2003-12-02DOI: 10.1080/110241598750005840
Giuseppe Pappalardo, Antonio Guadalaxara, Fabrizio Maria Frattaroli, Giovanni Illomei, Paolo Falaschi
Objective:
To evaluate the outcome after total and subtotal thyroidectomy for the treatment of single and multinodular goitres in two comparable groups of patients.
Design:
Prospective randomised study.
Setting:
University hospital, Italy.
Subjects:
141 Patients operated on for benign goitre from 1975–85.
Interventions:
69 Patients were randomised to have total thyroidectomy and 72 subtotal thyroidectomy by standard techniques.
Main outcome measures:
Temporary or permanent palsy of the recurrent laryngeal nerve, temporary or permanent hypoparathyroidism, recurrence of the goitre, and the incidence of iatrogenic injuries after completion thyroidectomy.
Results:
Patients were followed up for a median of 14.5 years (range 10–21). After total thyroidectomy 2 patients (3%) developed temporary palsy of the recurrent laryngeal nerve but there were no permanent lesions; and 24 (35%) developed temporary and 2 (3%) permanent hypoparathyroidism. After subtotal thyroidectomy 2 (3%) developed temporary and 1 (1%) permanent palsy of the recurrent laryngeal nerve; and 13 (18%) developed temporary and 1 (1%) permanent hypoparathyroidism. In addition, there were 10 recurrent goitres (14%). After completion thyroidectomy (n = 9) there were 2 cases of temporary and 1 of permanent palsy of the recurrent laryngeal nerve, and 2 cases of temporary and 2 of permanent hypoparathyroidism.
Pub Date : 2003-12-02DOI: 10.1080/110241598750004210
Maaike M. S. Ibelings, Hajo A. Bruining
OBJECTIVE To evaluate the risk of patients in intensive care units (ICU) of becoming infected with methicillin-resistant Staphylococcus aureus (MRSA) and to assess the mortality during a six week follow-up period, compared with patients who developed methicillin-sensitive S. aureus (MSSA) infection. DESIGN Point prevalence survey. SETTING 1417 ICU in 17 Western European countries. SUBJECTS 10038 patients in ICU who were part in the EPIC (European Prevalence of Infection in Intensive Care) Study. MAIN OUTCOME MEASURES Prevalence of MRSA and MSSA ICU-acquired infections, risk factors, and mortality. RESULTS On the study day 21% of patients had ICU-acquired infections. The most commonly reported pathogen was Staphylococcus aureus (30%). Overall, 60% of strains of S. aureus were resistant to methicillin (with a wide intercountry variation). The most commonly reported MRSA infections were pneumonia and lower respiratory tract infections. The most important risk factor for MRSA was the length of stay in the ICU. MRSA infection reduced the chance of survival, particularly when it was found in lower respiratory tract infections: the risk of mortality was three times higher in patients with MRSA than in those with MSSA. CONCLUSION Patients in ICU are at high risk of becoming infected with MRSA. The longer they stay, the higher the risk. Patients with MRSA infections are less likely to survive than those with MSSA.
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