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  • 1
    ISSN: 0942-0940
    Keywords: Keywords: Confounding effect; palmar hyperhidrosis; ROC analysis; temperature monitoring.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  To appraise the validity, intra-operative elevation of hand temperature ensuring a successful T2-sympathectomy, we conducted a randomized, self-compared, case-control study on 40 consecutive patients with palmar hyperhidrosis. All patients had a postoperative follow-up of at least 18 months without recurrence. During operation, dynamic temperature changes on their thenar eminence of both the surgically treated and non-surgically treated hands were simultaneously measured just before (baseline) and after completion of T2-sympathectomy, and again 5 and 10 minutes later. An elevation of the temperature by at least 0.5°C from the baseline temperature was recognized as an “elevated” temperature. The relationship between sensitivity and specificity of temperature changes was compared using receiver operator characteristic (ROC) analysis. Sensitivity was defined as the proportion of temperature-elevating procedures in the group of operated hands. As a whole, post-sympathectomy elevation of hand temperature is a useful, but not an ideal, indicator for assuring a successful T2-sympathectomy due to its low sensitivity. At the 5-minute point, if the hand temperature was elevated by 1°C, its sensitivity, specificity and positive predictive value were 40%, 80% and 66.7%. In comparison, a 2°C elevation at the 10-minute point had a sensitivity, specificity and positive predictive value of 30%, 90% and 75% (p〈0.05). We suggest that correct localization of the T2 ganglion followed by adequate ablation should be the prerequisite for use of this monitoring system.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0942-0940
    Keywords: Spinal tumour ; hemilaminectomy ; laminectomy ; spinal instability
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A series of 256 consecutive patients suffering from spinal tumours was studied with respect to the value of bilateral or unilateral surgical approaches. The case material included 152 extradural, 87 intradural, extramedullary and 17 intramedullary tumours. The cervical spinal cord was involved in 43, the thoracic in 152 and the lumbosacral region in 61 cases. Hemilaminectomy was chosen mainly for juxtamedullary tumours, while laminectomy was used for intramedullary tumours. No remarkable difference regarding the choice of approaches was found in extradural tumours. More than 60% of cervical or lumbosacral tumours were managed using unilateral procedures. A higher rate of surgical radicality but fewer complications, shorter stay in hospital and better early results were achieved using hemilaminectomy especially in patients with juxtamedullary tumours. From the observations it may be concluded that the results do not depend on the type of surgical approach but are closely related to the histology and location of tumours. Under the prerequisite of exact pre-operative definition of tumour location, unilateral approaches are advantageous for all kinds of spinal tumours especially for juxtamedullary benign tumours.
    Type of Medium: Electronic Resource
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