Abstract：
BACKGROUND:The changing environment in academic medical centers has had a major effect on the recruitment and the demographic characteristics of leadership positions in academic surgery. Categorization of "cultures" from the business model has been extrapolated into the academic surgical model. METHODS:The types of cultures in organizations according to Cameron and Quinnn at a school of management can be classified into four: clan culture, adhocracy culture, hierarchy, and market-driven culture. In addition, academic surgical chairmen were surveyed in 1981 and also 20 years later, 2001, by the author. This was done in an effort to determine whether there is a difference in the type of person being attracted to such positions and if there is demographic difference in academic chairmen over the two decades. RESULTS:The organizational profile of academic departments in 1980 is perceived to be more clan and adhocracy in type and less hierarchical and market driven. That has reversed itself dramatically two decades later with much of the energy of a department and structure based on hierarchy and the market. Also, in terms of the chairman, the mean age at the time of appointment in 1981 was 44 years and the mean age at time of appointment in 2001 was 49 years. In 1981 the years in grade was 9.4 years and in 201 it is 7.1 years. The new chairman is now older and will not serve as long as his/her predecessor. CONCLUSIONS:There clearly has been a cultural evolution in academic surgery over the past two decades. The chairman has different priorities than chairmen 20 years ago. The success of an academic department will depend upon the adaptation to this cultural evolution and the understanding of the chairman as to what the job really is.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Shuck JMdoi
10.1016/s0002-9610(02)00814-0subject
Has Abstractpub_date
2002-04-01 00:00:00pages
345-8issue
4eissn
0002-9610issn
1879-1883pii
S0002961002008140journal_volume
183pub_type
历史文章,杂志文章abstract：:The experience with gastrointestinal cancer at a single large hospital has been utilized as a "micro-model" of the experience for the country at large, and the reasons why such a comparison might be possible have been presented. The incidence of various lesions has been discussed in terms of sex, age, and race. The ch...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90002-8
更新日期：1978-01-01 00:00:00
abstract：:Thrombosis and its major sequela, embolism, continue to contribute significantly to morbidity and mortality, both as primary disorders and as complications of other systemic systems. The understanding of the etiology of thromboembolism and the role of platelets, endothelium, and the plasma proteins in the development ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80743-3
更新日期：1990-12-01 00:00:00
abstract：BACKGROUND:Our aim was to determinate the prognostic value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in primary operable patients with non-small cell lung cancer (NSCLC). METHODS:Six hundred seventy-eight NSCLC patients were enrolled in this study. The prognostic significance of both mar...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.03.022
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND:blood loss during liver resection and the need for perioperative blood transfusions have negative impact on perioperative morbidity, mortality, and long-term outcomes. METHODS:a randomized controlled trial was performed on patients undergoing liver resection comparing hemihepatic vascular inflow occlusion, ...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2009.09.029
更新日期：2011-01-01 00:00:00
abstract：:False aneurysm formation in a twenty-nine year old black woman treated for renovascular hypertension secondary to fibromuscular hyperplasia by knitted Dacron prosthetic patch angioplasty is reported. Etiologic mechanisms are discussed. The most likely factors leading to false aneurysm formation in this patient are dis...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90366-4
更新日期：1976-11-01 00:00:00
abstract：BACKGROUND:Approximately 30% to 50% of appendicitis in children is already perforated at presentation. The optimal management of these children remains controversial. METHODS:Ninety-six children (aged 2 to 16 years) were treated for perforated appendicitis. Seventy-one underwent immediate appendectomy and drainage of ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.08.027
更新日期：2003-12-01 00:00:00
abstract：BACKGROUND:Hepatocellular carcinoma (HCC) occur in livers with injury-remodeling, accomplished by enzymes called matrix metalloproteinases (MMP). Metastasis involves basement membrane invasion also caused by MMP activity. Alterations in MMP expression and their endogenous inhibitor (TIMP) may factor in HCC metastasis. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)00833-4
更新日期：2002-05-01 00:00:00
abstract：:Despite immediate operation, patients with abdominal aortic injuries and profound hypovolemic shock do not respond to the usual methods of resuscitation and die soon after celiotomy, prior to control and repair of the aortic injury. The rate of aortic hemorrhage exceeds the ability to restore blood volume. Shock becom...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90385-4
更新日期：1979-08-01 00:00:00
abstract：:Recent advances in molecular biology have greatly accelerated knowledge relating to the significance of the enterohepatic circulation of bile salts. This review highlights the role that both oxysterols and bile salts play as ligands which, when bound to nuclear hormone receptors, activate transcription factors that se...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(02)01212-6
更新日期：2003-02-01 00:00:00
abstract：BACKGROUND:Motility disturbances in the Roux loop can negatively influence the outcome of reflux gastritis; the uncut Roux loop does not have these disadvantages, but is less suitable for clinical application because of staple dehiscence. The reported "cut-closed-reconnected" Roux loop has the same physiological starti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00246-4
更新日期：2000-02-01 00:00:00
abstract：BACKGROUND:Increased anesthesia time may lead to respiratory complications in patients receiving tracheostomy, which contributes to patient morbidity. METHODS:The American College of Surgeon's National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for cases of planned tracheostomy (CPT 31600) f...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.07.059
更新日期：2018-10-01 00:00:00
abstract：BACKGROUND:Variable results regarding general surgery residency program (GSRP) impact on patient outcomes and charges are reported. The aim of this study was to determine any significant differences in patient outcomes and cost with a new GSRP. METHODS:We analyzed all laparoscopic appendectomies (lap-ap), cholecystect...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.11.016
更新日期：2017-07-01 00:00:00
abstract：BACKGROUND:Injury epidemiology fluctuates with economic activity in many countries. These relationships remain unclear in Canada. METHODS:The annual risk of admission for major injury (Injury Severity Score ≥12) to a high-volume, level-1 Canadian trauma center was compared with indicators of economic activity over a 1...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.011
更新日期：2014-05-01 00:00:00
abstract：BACKGROUND:Although the immunologic benefits of laparoscopic surgery have been established, effects from hand-assisted (HA) surgery have not been investigated thoroughly. We hypothesized that the HA approach maintains the immunologic advantage of laparoscopic surgery compared with the open (O) approach. METHODS:Six O,...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.09.026
更新日期：2011-07-01 00:00:00
abstract：:The records of patients treated for upper gastrointestinal bleeding from 1974 through 1978 were reviewed. Five percent of this group (69 patients) had bleeding due to the Mallory-Weiss syndrome. Only 36 percent of patients had a correct admitting diagnosis. Esophagogastroscopy proved the most reliable diagnostic tool,...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90425-6
更新日期：1981-11-01 00:00:00
abstract：:Acute recurrent pancreatitis in the absence of alcoholism and gallstones is a frustrating illness for both the patient and the physician. Over a 10 year period, 33 patients were operated on and found to have a duct of Wirsung entering the duodenum through the fibers of the sphincter of Oddi. Recurrent pancreatitis of ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90808-7
更新日期：1987-02-01 00:00:00
abstract：BACKGROUND:Alcohol use may alter mental status and vital signs in injured patients, leading to increased testing during emergency department (ED) evaluation. We hypothesized that alcohol use increases the hospital charges when caring for these injured patients. METHODS:The National Hospital Ambulatory Medical Care Sur...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.08.014
更新日期：2013-07-01 00:00:00
abstract：BACKGROUND:The aim of the current study was to identify predictors of pathologic complete response (pCR) following neoadjuvant therapy. METHODS:From 2000 to 2007, 518 breast cancer patients received neoadjuvant therapy. Data were compared using chi(2) and Fisher's exact tests and multivariate analysis of variance, as ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.06.004
更新日期：2009-10-01 00:00:00
abstract：BACKGROUND:Burnout affects surgical residents' well-being. OBJECTIVE:We sought to identify factors associated with burnout among surgery residents. METHODS:An electronic/anonymous survey was sent to surgical residents at 18 programs, consisting of demographic/programmatic questions and validated scales for burnout, d...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.07.004
更新日期：2020-06-01 00:00:00
abstract：:Immunologic changes after blood transfusions cannot be studied ethically in normal individuals. We therefore studied two comparable groups of patients with atherosclerotic cardiovascular disease who received similar drug treatment and experienced a similar degree of surgical trauma, except that one group received an a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(92)90114-7
更新日期：1992-02-01 00:00:00
abstract：BACKGROUND:Obturator hernia is a relatively rare pelvic hernia and usually occurs in elderly, thin, multiparous women. Because symptoms are nonspecific, the diagnosis is often delayed until laparotomy is performed form to treat bowel obstruction. METHODS:Forty-three patients with obturator hernia undergoing surgery at...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.12.041
更新日期：2004-04-01 00:00:00
abstract：BACKGROUND:The appropriate management of gallstones in patients undergoing renal transplantation is controversial. Screening for gallstones and subsequent prophylactic cholecystectomy has been recommended by some authors for kidney transplant candidates. Our program does not practice routine pretransplant screening for...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00009-9
更新日期：1998-04-01 00:00:00
abstract：:The reported incidence of hypotension after carotid reconstruction ranges from 21 to 50 percent. To evaluate baroreceptor dysfunction, 283 carotid reconstructions were studied. During 181 consecutive reconstructions, a transcutaneous Teflon catheter was positioned intraoperatively at the carotid bifurcation for postop...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90196-x
更新日期：1984-06-01 00:00:00
abstract：:Initial manifestations of AIDS in the head and neck area occur frequently. In fact, up to 40 percent of patients may have involvement of the head and neck. The most common malignancies are Kaposi's sarcoma and non-Hodgkin's lymphoma. Since AIDS-related malignancies are a relatively new problem for radiation oncologist...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90021-4
更新日期：1987-10-01 00:00:00
abstract：BACKGROUND:Because the abdominal insufflation and desufflation associated with laparoscopic procedures may adversely effect a compromised myocardium, patients with significant cardiopulmonary disease should be closely monitored during these procedures. The utility of intraoperative pulmonary artery catheter (PAC) and t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80137-8
更新日期：1995-02-01 00:00:00
abstract：:Recurrent, nodular necrotizing granulomatous mastitis in two patients is reported in detail. Pathologic, immunologic, and bacteriologic studies in one patient indicate that this entity is different from plasmas cell mastitis, fat necrosis, mammary ductal ectasia, and the usual infectious and puerperal mastitis. System...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90397-0
更新日期：1979-08-01 00:00:00
abstract：BACKGROUND:Minimally invasive techniques are now often used to treat primary hyperparathyroidism but with uncertain conformity and some controversy. Endocrine surgery fellowships (ESFPs) have recently proliferated. METHODS:The directors of the 19 ESFPs recognized by the American Association of Endocrine Surgeons were ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.05.012
更新日期：2014-04-01 00:00:00
abstract：BACKGROUND:Peritoneal macrophages play an important role in the immune response after abdominal operations. The stress response after these operations has been associated with impaired phagocytosis by peritoneal macrophages. This study examined the influence of minimally invasive techniques and preoperative corticoster...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.07.023
更新日期：2008-12-01 00:00:00
abstract：:The restitution of blood volume and plasma protein after 10 per cent hemorrhage was studied in intact dogs and in dogs subjected to adrenalectomy and infused with cortisol at basal or physiologically increased rates. The results suggest that increased extracellular osmolality, mediated by an increased secretion of cor...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90513-9
更新日期：1975-11-01 00:00:00
abstract：BACKGROUND:Merkel cell carcinoma (MCC) is a cutaneous neuroendocrine tumor that may spread via lymphatics and can therefore be staged with sentinel lymph node biopsy (SLNB). MCC is radiosensitive and chemosensitive, although the role of adjuvant therapy is still unclear. We examined the impact of different treatments o...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.06.013
更新日期：2015-02-01 00:00:00
