Abstract:
:Over the past three decades Canada has developed an exemplary system of universal health care. However, current financial constraints threaten to undermine the very foundation of the system that represents Canada's respect for social justice. The first of these two articles (Part 1) discusses the unique characteristics of the system, a comparative view of universal health care systems, the reaction of the medical profession to governmental control, and finally the funding and manpower shortages that are compelling a review of the values and organization that have sustained the system thus far. The second article (Part 2) reviews the organization and funding of medical education and the impact of some critical changes in the health care system on postgraduate medical education. Issues related to new licensure and certification requirements, changing population demographics and approaches to health care delivery, manpower needs, and the attitude and expectations of the public are discussed.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Cohen AH,Cohen R,Taylor BR,Reznick RKdoi
10.1007/BF00298897subject
Has Abstractpub_date
1994-09-01 00:00:00pages
672-5; discussion 671issue
5eissn
0364-2313issn
1432-2323journal_volume
18pub_type
杂志文章,评审abstract::The serum hyaluronate (HA) level reflects sinusoidal endothelial cell function correlated with liver function. We have reviewed multiple liver function indicators from 37 patients who underwent hepatectomy for various liver diseases. The serum HA level was well correlated with the indocyanine green retention rate at 1...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7389-1
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Linitis plastica-type gastric carcinoma remains a disease with poor prognosis despite an aggressive surgical approach. Although a prominent pattern of disease failure is peritoneal carcinomatosis, some patients experience rapid disease progression without signs of the peritoneal disease. METHODS:Clinicopath...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9672-z
更新日期:2008-09-01 00:00:00
abstract::A minority of patients with papillary thyroid carcinoma (PTC) is at high-risk of developing recurrent disease and death. Risk group stratification as defined by age, metastases to distant site, extrathyroidal invasion, and tumor size (AMES) criteria is frequently employed to identify high-risk patients for aggressive ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7420-6
更新日期:2004-11-01 00:00:00
abstract::Laparoscopic cholecystectomy is widely used and may be performed as an ambulatory procedure. We undertook a randomized comparison of the benefits of intraperitoneal pethidine compared with intramuscular pethidine for postoperative analgesia following laparoscopic cholecystectomy. A series of 100 consecutive American S...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00268-002-6339-z
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Strong evidence has confirmed the benefit of laparoscopy in colorectal cancer resection but remains a challenging procedure. It is not clear that such promising results in selected patients translate into a favorable risk-benefit balance in real practice. We conducted a multicenter national observational reg...
journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00268-015-3050-4
更新日期:2015-08-01 00:00:00
abstract::From January, 1975 to December, 1987, 241 patients with rectal cancer underwent pre-operative irradiation and surgical resection. The radiation was delivered with 25 MeV photons, 5 days per week by 2.4 grays fractions up to a total dose of 36 grays. Surgery was curative in 195 patients; 57% had abdomino-perineal resec...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02067122
更新日期:1992-01-01 00:00:00
abstract::Patients with obstructive jaundice (OJ) that requires surgery often have malnutrition associated with increased perioperative morbidity. This study investigated the factors influencing nutritional derangements in these patients. A series of 46 OJ patients were investigated prospectively (28 malignant tumors, 18 benign...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002680020043
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to assess the efficacy of the Nd:YAG laser for treating stage I squamous cell carcinoma (SCC) of the lip. The retrospective study was performed in a tertiary care referral hospital in northern India. METHODS:In January 2007 the records of patients treated by Nd:YAG laser ablation o...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9363-1
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to compare the influence of either general (GA) or local (LA) anesthesia on the postoperative neurocognitive outcome in patients undergoing carotid endarterectomy (CEA) in a randomized study. Therefore, we performed a subgroup analysis of the multicenter GALA study. METHODS:A total...
journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s00268-009-0047-x
更新日期:2009-07-01 00:00:00
abstract:INTRODUCTION:This study assesses the incidence of missed pelvic injuries in the pre-hospital setting. METHODS:All blunt trauma patients (ISS ≥ 9) with pre-hospital suspicion of and/or radiologically proven pelvic fracture documented in the TraumaRegister DGU® (TR-DGU) of the German Trauma Society DGU (2002-2011) were ...
journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00268-016-3647-2
更新日期:2016-12-01 00:00:00
abstract::Most neoplasms arising in the parotid gland are benign. Patients with cancer of the parotid gland usually present with normal facial nerve function. In these patients, findings at the time of surgery will guide the management of the facial nerve, with most surgeons preserving the nerve unless it is adherent to, or imb...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-003-7112-7
更新日期:2003-07-01 00:00:00
abstract::Surgical education in the United Kingdom has evolved to meet the need of the National Health Service (NHS) for a relatively small body of consultants practicing autonomously and carrying ultimate clinical responsibility for their patients. This form of specialist practice is markedly different from that found in most ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00298916
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:The clinical importance of papillary thyroid microcarcinoma (PTMC) remains controversial, with current guidelines suggesting that thyroid lobectomy alone is sufficient. The purpose of this study was to identify population-level treatment patterns in the USA for PTMC. METHODS:Patients with PTMC in SEER (1998...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2602-3
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Little is known about the changes in prognostic factors after adjuvant S-1 monotherapy has become widespread as a standard of care for patients with gastric cancer (GC) in East Asia. The present study compared prognostic factors of patients with stage II/III GC treated with or without S-1 adjuvant to formula...
journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00268-019-05198-2
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Assessment of preoperative physiological status is crucial for optimizing clinical outcomes in patients undergoing surgery for esophageal carcinoma (EC). We aimed to evaluate the prognostic impact of pulmonary dysfunctions and their relationships with other physiological factors, especially sarcopenia, in EC...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05450-0
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Although 18F-fluorodeoxyglucose (FDG) positron emission tomography combined with computed tomography (PET/CT) is a potentially powerful, non-invasive imaging tool in differentiating adrenal metastasis from benign disease, some adenomas also exhibit high FDG uptake, therefore mimicking metastasis (i.e., false...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3035-3
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Frequent use of computed tomography (CT) in trauma patients results in frequent detection of non-trauma-related incidental findings (IFs). Inpatient documentation and disclosure at discharge are infrequent, even when they are potentially serious. We aimed to not only identify the incidence of IFs but also to...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2092-8
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate the feasibility of digital defog technique in 3D laparoscopic surgery for right colon cancer. METHODS:Fifty patients with right colon cancer were divided into digital defogging group and control group. The intraoperative image clarity, the surgeon's anxiety, the time ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4402-z
更新日期:2018-06-01 00:00:00
abstract::The acid-base balance from the postoperative day (POD) 1 to POD 3 after cirrhotic liver resection was investigated in relation to operative outcome by conducting a retrospective study on the changes in arterial ketone body ratio (AKBR), which reflects the hepatic mitochondrial redox state, and arterial blood gas analy...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01655722
更新日期:1993-01-01 00:00:00
abstract::This paper investigates methodological limitations of the volume-outcome relationship. A brief overview of quality measurement is followed by a discussion of two important aspects of the relationship. ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-7993-8
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND AND AIMS:A variety of minimally invasive techniques have been proposed to replace open surgery for the treatment of infected pancreatic necrosis (IPN). In this study, we evaluate the feasibility and safety of the stent-assisted percutaneous endoscopic necrosectomy (SAPEN) procedure. METHODS:Data were collec...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-04878-9
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:We have developed a new technique for treatment of intramucosal carcinoma which exceeds the standard indication for endoscopic mucosal resection and carcinoma invading the submucosa without lymph node metastasis that are located in the posterior wall of the stomach, which we refer to as laparoscopic intragas...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9115-2
更新日期:2007-08-01 00:00:00
abstract::The aim of this study was to investigate the prognostic factors for hepatocellular carcinoma (HCC) in patients without cirrhosis who underwent hepatectomy. Between 1986 and 1998 a total of 197 men and 57 women with noncirrhotic HCC underwent hepatic resection in the Department of Surgery, Chang Gung Memorial Hospital,...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6708-7
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:The aims of this study were to investigate predictive factors for microscopic portal venous invasion (mPVI) in hepatocellular carcinoma (HCC) and whether anatomical liver resection (ALR) was useful in such cases. METHODS:We analyzed 852 patients with HCC without macroscopic portal venous invasion who were t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-3964-0
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Inguinal hernia repair is the most common elective procedure in general surgery. Therefore, the number of patients having complications related to inguinal hernia surgery is relatively large. The aim of this study was to compare complication profiles of inguinal open mesh (OM) hernioplasties with open non-me...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3028-2
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Abdominal compartment syndrome (ACS) is a difficult entity with two main problems during its course: (1) survival of the patient during the early period and (2) closure of the open wounds during the late period. In this study we evaluated the decision to decompress according to the level of intraabdominal pr...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9286-x
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Hepatic resection for hepatocellular carcinoma (HCC) patients with liver cirrhosis and severe hypersplenic thrombocytopenia is risky and controversial. METHODS:From 1989 to 2005, 341 patients underwent hepatic resection for HCC in our hospital. Of these, 15 patients were concomitant with severe thrombocytop...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9442-3
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Retroperitoneal soft tissue sarcomas (RSTS) are a rare and uncommon entity with a poor 5-year overall survival (OS) of approximately 50%, even though they rarely metastasize. The aim of the present study was to analyze the survival of patients with RSTS treated at our institution. PATIENTS AND METHODS:Patie...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0473-9
更新日期:2010-07-01 00:00:00
abstract::Variceal bleeding remains an important complication in extrahepatic portal vein thrombosis (EPVT). As for portal hypertension due to other etiologies, an elective treatment to decrease the risk of subsequent rebleeding is warranted. The results of the Sugiura-Futagawa procedure (SP) in 38 patients with variceal bleedi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00294409
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:Central venous catheters should be positioned at the cavoatrial junction or the right atrium. If catheters are inserted to a depth derived by adding the length between the needle insertion point and the clavicular notch and the length between the clavicular notch and the carina, the catheter tip can be place...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05449-7
更新日期:2020-07-01 00:00:00