Angiogenesis and CD34 expression as a predictor of recurrence in oral squamous cell carcinoma.

Purpose: To assess immunohistologic features of angiogenesis of T1N0M0 oral squamous cell carcinoma (OSCC), and to identify predictors of regional recurrence. The identification of prognostic markers of early lymph node involvement in OSCC could allow for the use of more targeted biologic therapies for patients with early-stage tumors.

Patients And Methods: The study included patients treated for T1N0M0 OSCC at the Mayo Clinic from 1986 to 2001.

Surgical treatment of early wound complications following primary total knee arthroplasty.

Background: Wound-healing problems are a known complication after primary total knee arthroplasty. However, little is known about the clinical outcomes for patients who require surgical treatment of these early wound-healing problems. The purpose of the present study was to determine the incidence, risk factors, and long-term sequelae of early wound complications requiring surgical treatment.

Early return to surgery for evacuation of a postoperative hematoma after primary total knee arthroplasty.

Background: Development of a postoperative hematoma is a reported complication after primary total knee arthroplasty. However, little is known about the clinical outcomes in patients who require surgical evacuation of an acute hematoma. The purpose of this study was to determine the incidence, risk factors, and long-term sequelae of postoperative hematomas requiring surgical evacuation.

Patient-reported activity level after total knee arthroplasty.

We identified 1630 unrevised patients who underwent primary total knee arthroplasty (TKA) between 1995 and 2000. Patients were surveyed regarding clinical outcome and activity level, and were queried about actual participation in 40 different athletic activities. One thousand two hundred six patients (74%) responded at a mean of 5.

Patient reported activity after revision total knee arthroplasty.

A total of 335 patients underwent revision total knee arthroplasty (TKA) between 1995 and 2000 with a single implant design. These patients were surveyed regarding clinical outcome and activity level; 206 patients responded (62%). Average age at revision TKA was 69 years (range, 31-87 years).

Randomized prospective study of totally extraperitoneal inguinal hernia repair: fixation versus no fixation of mesh.

Background: Fixation of the mesh during laparoscopic totally extraperitoneal (TEP) inguinal hernia repair is thought to be necessary to prevent recurrence. However, mesh fixation may increase postoperative pain and lead to an increased risk of complications. We questioned whether elimination of fixation of the mesh during TEP inguinal hernia repair leads to decreased postoperative pain or complications, or both, without an increased rate of recurrence.

Effect of infliximab on short-term complications in patients undergoing operation for chronic ulcerative colitis.

Background: Total proctocolectomy and ileal pouch anal anastomosis (IPAA) is the preferred operation for patients with chronic ulcerative colitis (CUC) refractory to medical therapy. Infliximab (IFX), an antitumor necrosis factor-alpha antibody, has demonstrated efficacy in medical management of CUC. The aim of this study is to determine if IFX before IPAA impacts short-term outcomes.

Pulmonary embolism: prognostic CT findings.

Purpose: To retrospectively determine whether three computed tomographic (CT) findings-ventricular septal bowing (VSB), ratio between the diameters of right ventricle (RV) and left ventricle (LV), and embolic burden-are associated with short-term death, defined as in-hospital death or death within 30 days of CT, whichever was longer, due to acute pulmonary embolism (PE).

Materials And Methods: Institutional Review Board approval was obtained, and patient information was reviewed in compliance with HIPAA regulations. A total of 1193 patients with CT scans positive for PE from January 1, 1997, to December 31, 2002, who had given authorization for retrospective research were included.

Surgery versus conservative therapy in carpal tunnel syndrome in people aged 70 years and older.

Background: Carpal tunnel syndrome is common in the general population, with a prevalence that increases with age. Although good satisfaction has been described after carpal tunnel release, little is known about the long-term outcome of treatment in elderly individuals with carpal tunnel syndrome.

Methods: The authors reviewed data from a population-based sample of 102 patients aged 70 years and older with carpal tunnel syndrome.

Factors affecting outcomes of open surgical repair of pararenal aortic aneurysms: a 10-year experience.

Purpose: Few large series document surgical outcomes for patients with pararenal abdominal aortic aneurysms (PAAAs), defined as aneurysms including the juxtarenal aorta or renal artery origins that require suprarenal aortic clamping. No standard endovascular alternatives presently exist; however, future endovascular branch graft repairs ultimately must be compared with the gold standard of open repair. To this end, we present a 10-year experience.

Quality-of-life after total pancreatectomy: is it really that bad on long-term follow-up?

While selected pancreatic diseases may be best treated by total pancreatectomy (TP), the anticipated sequelae of pancreatic insufficiency make TP an undesirable alternative. Our aim was to determine if patients undergoing TP have a worse quality of life (QoL) than age- and gender-matched controls and poor long-term glycemic control. Ninety-nine patients undergoing TP from 1985 through 2002 were identified.

Impact of primary resection on the outcome of patients with perforated diverticulitis.

Background: Primary resection has replaced the conventional drainage procedure in the management of patients with generalized peritonitis complicating diverticular disease of the colon. This study investigates the impact of primary resection on operative mortality, identifies predictors of mortality, and compares the results with those of our earlier experience.

Hypothesis: Primary resection of the perforated diseased segment of the colon is associated with lower mortality rates than the drainage procedure in patients with Hinchey stages 3 and 4 diverticulitis.

Double-blind, prospective, randomized study of warmed, humidified carbon dioxide insufflation vs standard carbon dioxide for patients undergoing laparoscopic cholecystectomy.

Hypothesis: Patients undergoing warmed, humidified carbon dioxide (CO2) insufflation for laparoscopic cholecystectomy will (1) maintain a warmer intraoperative core temperature, (2) have their surgeon experience less fogging of the camera lens, and (3) have less postoperative pain than patients undergoing laparoscopic cholecystectomy with standard CO2 insufflation.

Design: A double-blind, prospective, randomized study comparing patients undergoing laparoscopic cholecystectomy with standard CO2 insufflation vs those receiving warmed, humidified CO2 (Insuflow Filter Heater Hydrator; Lexion Medical, St Paul, Minn) was performed. Main variables included patient core temperature, postoperative pain, analgesic requirements, and camera lens fogging.

Quality-of-life assessment of surgical reconstruction after laparoscopic cholecystectomy-induced bile duct injuries: what happens at 5 years and beyond?

Hypothesis: Quality of life of patients after biliary reconstruction for laparoscopic injuries is comparable to that of patients after laparoscopic cholecystectomy.

Design: Outcomes study.

Setting: Tertiary referral center.

Characterization of lesions missed on interpretation of CT colonography using a 2D search method.

Objective: We examined potential factors that may cause false-negative results on CT colonography examinations.

Materials And Methods: In this prospective and retrospective study, 500 asymptomatic patients at high risk for colorectal cancer underwent CT colonography and colonoscopy. Each CT data set was interpreted by two independent observers, who were unaware of endoscopic findings, using a method of searching through enlarged axial images to detect intraluminal lesions.

Clinical spectrum and laboratory characteristics associated with detection of herpes simplex virus DNA in cerebrospinal fluid.

Objective: To determine the clinical, neurologic, and laboratory characteristics of patients with herpes simplex virus (HSV) type 1 (HSV-1) or HSV type 2 (HSV-2) DNA detected in cerebrospinal fluid (CSF) with use of polymerase chain reaction.

Patients And Methods: Clinical, laboratory, and demographic data were determined from 249 CSF specimens (collected from 247 patients >10 years of age) that tested positive for HSV-1 or HSV-2 DNA at the Mayo Clinic from January 1999 to August 2000.

Results: The median age of the 200 patients whose age was available was 70 years vs 40 years for those with HSV-1 or HSV-2 DNA in CSF, respectively.

Surface modification of extrasynovial tendon by chemically modified hyaluronic acid coating.

We investigated a method for chemically binding hyaluronic acid (HA) to extrasynovial tendon and the effect of chemically modified HA on the gliding resistance of tendon. Canine peroneus longus (PL) tendons were immersed into one of three different solutions (saline, 1% HA, or 1% chemically modified HA) for 2 h. The gliding resistance of treated PL tendons was measured at 1, 5, 10, 20, 50, and 100 cycles in a saline bath.