Abstract：
:Diabetic neuropathic ulcers are thought to arise from repetitive injury during normal walking in areas of high plantar pressures. It has been suggested that metatarsal head (MTH) resection alleviates elevated pressures at the site of the ulcer and, thus, expedites healing and prevents recurrence. We investigated the effect of MTH resection on plantar pressure distribution and ulcer healing. Sixteen diabetic patients with neuropathic plantar ulcers present for a mean of 36 +/- 28 weeks undergoing MTH resection were studied. Plantar pressure distribution was measured preoperatively and postoperatively using the EMED-SF pressure sensor platform (Novel, Munich, Germany). The data showed that 68.8% of the patients had mean peak plantar pressures (MPPs) elevated (greater than 500 kilopascal (kPA)) at sites of plantar ulceration. The MPPs following MTH resection were significantly reduced irrespective of the site (p = 0.002). There was maximal MPP reduction following the resection of the 1st MTH (70%) and a lower reduction with 2nd-3rd MTH (39.9%) and 4th-5th MTH (45.8%) resections. We found no significant transfer of pressure to adjacent metatarsal heads following resection of the 1st MTH (p = 0.87), 2nd-3rd MTH (p = 0.11), and 4th-5th MTH (p = 0.75). All patients achieved complete ulcer healing within 8 +/- 2 weeks after surgery. We concluded that reduction of plantar pressure is crucial for plantar ulcer healing, and we have demonstrated definitively that MTH resection leads to reduced peak plantar pressure, thus, expediting ulcer healing.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Patel VG,Wieman TJdoi
10.1016/0002-9610(94)90203-8subject
Has Abstractpub_date
1994-03-01 00:00:00pages
297-301issue
3eissn
0002-9610issn
1879-1883pii
0002-9610(94)90203-8journal_volume
167pub_type
杂志文章abstract：:Microvascular free tissue transfer has provided a variety of methods of restoring vascularized bone and soft tissue to difficult defects created by tumor resection and trauma. Over 7 years, 26 patients have undergone 28 free flaps for mandibular reconstruction, 15 for primary squamous cell carcinoma of the floor of th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80550-1
更新日期：1990-10-01 00:00:00
abstract：:Surgical patients are at high risk to develop nosocomial pneumonia, although an accurate diagnosis is difficult to make. Staphylococcus aureus and Pseudomonas aeruginosa are the most common pathogens, but Acinetobacteris emerging as an important pathogen. Because affected patients are often critically ill with multisy...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：
更新日期：2000-02-01 00:00:00
abstract：:Two courses of triple-agent chemotherapy were given to 47 patients with advanced head and neck cancer. All but one patient with a nasopharyngeal carcinoma had resectable stage III and IV squamous cell carcinoma. Eighty-eight percent of the patients responded to the chemotherapy with a 50 percent or greater decrease in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90417-2
更新日期：1982-10-01 00:00:00
abstract：BACKGROUND:Estrogen-receptor (ER)-, progesterone-receptor (PR)-, and androgen-receptor (AR)-negative breast cancer cells are unaffected by treatment with dehydroepiandrosterone-sulfate (DHEAS) and an aromatase inhibitor (AI). We hypothesized that cell growth would be inhibited with DHEAS/AI treatment after successful t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.02.004
更新日期：2006-05-01 00:00:00
abstract：BACKGROUND:A gender-neutral threshold aneurysm diameter (AD) of more than 5.5 cm for surgical intervention in abdominal aortic aneurysms (AAA) ignores the fact that women have a smaller baseline AD. We hypothesized that women have a greater AD relative to body surface area (BSA) at the time of surgery and that this wor...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.07.008
更新日期：2015-02-01 00:00:00
abstract：BACKGROUND:The unpredictability of prosthetic vascular access thrombosis precludes the scheduling of elective graft thrombectomy. This results in inconsistent dialysis for patients, as well as logistical challenges for dialysis clinics and surgeons, and increased cost. In an effort to solve this problem a community-wid...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00133-6
更新日期：1999-08-01 00:00:00
abstract：BACKGROUND:Hepatic resection is main approach to treatment of hepatolithiasis, but the long-term follow-up results of hepatic resection for hepatolithiasis are rarely reported. METHODS:A retrospective study was conducted of 87 patients with hepatolithiasis who underwent hepatic resection. RESULTS:The final stone clea...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.08.020
更新日期：2009-08-01 00:00:00
abstract：BACKGROUND:The term secondary abdominal compartment syndrome (ACS) has been applied to describe trauma patients who develop ACS but do not have abdominal injuries. The purpose of this study was to describe major trauma victims who developed secondary ACS during standardized shock resuscitation. METHODS:Our prospective...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01050-4
更新日期：2002-12-01 00:00:00
abstract：BACKGROUND:Malignant melanoma is an aggressive form of skin cancer with limited effective therapeutic options. Melanoma research concentrates on maximizing the effect on cancer cells with minimal toxicity to normal cells. AMP-activated protein kinase (AMPK) is an important regulator of cellular energy homeostasis and h...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.09.014
更新日期：2014-12-01 00:00:00
abstract：BACKGROUND:No studies to date exist regarding the attire of physicians on a surgical service. The objective of this study was to determine patient, surgeon, and nonhospitalized public (NHP) attitudes and preferences regarding surgeons' attire and mannerisms. METHODS:A questionnaire was developed to survey each group. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.04.003
更新日期：2005-07-01 00:00:00
abstract：:The results of aggressive surgical treatment of primary lip cancer and advanced and recurrent carcinoma of the lip are illustrated and discussed. Early detection of involved lymph nodes before capsular penetration occurs and careful and complete dissection of the submental and submandibular regions are advocated as po...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90326-3
更新日期：1976-10-01 00:00:00
abstract：:From 1980 to 1984, 500 asymptomatic patients with anterior abdominal stab wounds found to have penetrated the anterior peritoneal cavity on local wound exploration in the emergency center were evaluated by the technique of open peritoneal tap, quantitative diagnostic peritoneal lavage, or both. The technique was found...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90435-5
更新日期：1984-12-01 00:00:00
abstract：BACKGROUND:Despite significant evolutions in health care, outcome discrepancies exist among demographic cohorts. We sought to determine the impact of race on emergency surgery outcomes. METHODS:This is a retrospective review of the American College of Surgeons National Surgical Quality Improvement Program database (20...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.11.022
更新日期：2013-08-01 00:00:00
abstract：BACKGROUND:Incisional hernias are common. Optimal repair is one of the most analyzed and debated topics; however, there is no consensus as to the appropriate surgical technique. METHODS:An Institutional Review Board-approved protocol was designed using an Internet-based survey site (www.surveymonkey.com) to assess pra...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.08.002
更新日期：2007-11-01 00:00:00
abstract：:A new S-shaped cystic duct metal cannula was developed and used successfully in 200 cystic duct cholangiograms. It has the advantage of being easy to manipulate because the configuration does not obscure the vision and the resistance is less than that of plastic tubes, facilitating injection with lower pressure. It is...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90106-5
更新日期：1979-06-01 00:00:00
abstract：BACKGROUND:Antiphospholipid (APL) antibodies are a heterogenous group of antibodies that have been associated with an increase in bleeding complications and a marked increase in thrombotic events, both of which result in significant patient morbidity and mortality. PATIENTS AND METHODS:A retrospective analysis of pati...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80285-2
更新日期：1995-08-01 00:00:00
abstract：:The therapeutic significance of noncurative gastrectomy for gastric cancer with liver metastasis was evaluated and the histologic characteristics of such cancer examined. The mean postoperative survival time of patients with liver metastasis limited to one lobe or a few scattered metastases to both lobes without perit...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90167-1
更新日期：1980-09-01 00:00:00
abstract：BACKGROUND:Patients with recurrent pelvic malignancy have few treatment options, and surgery is fraught with complications. We sought to characterize the relationship between radiographic pelvic volume and postoperative complications after pelvic salvage surgery. METHODS:A retrospective chart review of all patients un...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.08.015
更新日期：2014-12-01 00:00:00
abstract：BACKGROUND:Michigan repealed a 35-year mandatory helmet law on April 13, 2012. We examined the early clinical impacts at a level 1 trauma center in West Michigan. METHODS:Retrospective cohort study comparing outcomes among motorcycle crash victims in a 7-month period before and after the helmet law repeal. RESULTS:On...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.001
更新日期：2014-03-01 00:00:00
abstract：:The records of 46 immunocompromised patients who presented with diffuse pulmonary infiltrates were reviewed to determine the role of open lung biopsy in their management. Fifty-two percent of these patients had underlying hematologic malignancies and 54 percent had received chemotherapy within 3 months prior to biopsy...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90246-7
更新日期：1987-12-01 00:00:00
abstract：:The management of the failing myocardium was primarily empirical for centuries, until Withering introduced foxglove (digitalis) in 1785 as an effective medication. Gradually, the medical treatment included, besides digitalis preparations, the use of diuretics to reduce excessive sodium and water retention; limiting sa...
journal_title：American journal of surgery
pub_type： 历史文章,杂志文章
doi：10.1016/0002-9610(84)90186-7
更新日期：1984-06-01 00:00:00
abstract：BACKGROUND:One of the issues in the debate surrounding the extent of thyroid excision for localized, well-differentiated thyroid cancer is the low morbidity rate reported after all degrees of thyroid resection. This study was conducted to determine morbidity and mortality after surgical resection for thyroid cancer. M...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80085-6
更新日期：1994-11-01 00:00:00
abstract：:A procedure of tape-guided living donor left hepatectomy is described. A tape was placed along the anterior wall of the inferior vena cava for left liver with caudate lobe, and along Arantius' ligament for left liver without caudate lobe. The final step of liver transection was applied by dividing the liver parenchyma...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.09.044
更新日期：2007-07-01 00:00:00
abstract：:Recently, carotid plaque factors, specifically intraplaque hemorrhage, have been studied with respect to the production of cerebrovascular symptoms. Ninety-five carotid endarterectomies were performed and the plaques that were removed were examined for intraplaque hemorrhage. Patients were separated into three groups:...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90450-1
更新日期：1984-12-01 00:00:00
abstract：BACKGROUND:As medicinal and recreational marijuana use broadens across the United States, knowledge of its effects on the body will become increasingly important to all health care providers, including surgeons. DATA SOURCES:We performed a literature review of Pubmed for articles discussing the basic science related t...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2018.10.053
更新日期：2019-04-01 00:00:00
abstract：BACKGROUND:Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening disorder of unknown pathophysiology. The role of splenectomy in the multimodality therapy of TTP is controversial. MATERIALS AND METHODS:All charts of patients with TTP at the University of Utah between 1984 and 1994 were reviewed to eval...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80015-4
更新日期：1995-12-01 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：BACKGROUND:The insertion and subsequent removal of chest tubes are frequently performed procedures. We hypothesize that routine chest radiographs obtained after chest tube removal to confirm the absence of any post-procedure complications have little impact on clinical management. MATERIALS AND METHODS:A 5-year retros...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00260-3
更新日期：2000-01-01 00:00:00
abstract：:We tested the effectiveness of a single dose of prophylactic antibiotic (gentamicin) in elective cholecystectomy in a double-blind, controlled randomized study. All patients recognized preoperatively as being at risk were excluded. The treatment group comprised of 102 patients received a single dose of gentamicin and ...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0002-9610(86)90218-7
更新日期：1986-11-01 00:00:00
abstract：BACKGROUND:The efficacy of antibiotics in appendicitis remains controversial, and physicians are not confident in prescribing antibiotics as the first line treatment. This network meta-analysis was conducted to assess the efficacy and safety of individual antibiotics in uncomplicated appendicitis. METHODS:Randomized c...
journal_title：American journal of surgery
pub_type： 杂志文章,meta分析
doi：10.1016/j.amjsurg.2018.10.009
更新日期：2019-07-01 00:00:00
