H Hassler — Page 2 | Search PubMed

PubMed1981

[On the cause of the anterolateral instability of the knee joint. A study on 20 cadaver knee joints with special regard to the tractus iliotibialis (author's transl)].

Experiments on 20 cadaver knee joints are reported on. A short medial incision was made to transect the anterior cruciate ligament. Through a long lateral incision the lateral structures (lateral capsule, lateral collateral ligament, and iliotibial tract) were transected in variable series to check their influence on the pivot shift-sign. The results are tabulated. The anterior cruciate ligament is shown to be the key structure for the pivot shift-sign. This sign is only markedly positive when the lateral structures are intact. Depending on the pattern of transection of the lateral structures the pivot shift-sign is less marked or totally absent. It is also shown why this sign is missing in the unhappy triad. Because the intact distal part of the iliotibial tract is responsible for the pivot shift-sign, a detailed description of its anatomy and physiology is given.

Fascia Lata↗

PubMed1981

Observations on rotatory instability of the lateral compartment of the knee. Experimental studies on the functional anatomy and the pathomechanism of the true and the reversed pivot shift sign.

Explore the source record for details and available documents.

Biomechanical Phenomena↗

PubMedDate not supplied

Pre-, intra- and postoperative staging of gastric carcinoma and clinical outcome.

BACKGROUND: We compared preoperative (combined clinical and radiological staging and endoscopical Borrmann classification), intraoperative (by the surgeon: curative/palliative; R0/R1/R2-resection; intraoperative stage I to IV) and postoperative staging including histological results (pTNM) in respect of resectability and prognosis. METHODS: All patients with adenocarcinoma of the stomach were prospectively and consecutively included in the study protocol and were staged during the hospitalisation by the different specialists. Out of 215 patients with malignant tumors of the stomach, 153 were finally evaluated for the study. We excluded 62 patients with other malignancies or with a follow up of less than 6 months. Preoperative endoscopic Borrmann classification was done by the gastroenterologist, preoperative TNM-classification by the radiologist and surgeon, intraoperative classification by the surgeon and postoperative classification by the pathologist. All results were immediately described in the protocol. Follow-up and survival curves were performed by the Regional Tumor Registry and statistics by the Statistical Department of the University using Kaplan-Meier survival curves and Log-Rank and Wilcoxon Test for significance. RESULTS: Preoperative staging was unreliable and there was no relationship between preoperative and postoperative staging nor survival. In opposite intra- and postoperative staging correlated significantly between the different groups and with survival (p < 0.001). CONCLUSIONS: As long as preoperative staging systems are not improved (which may be in the future the case with endosonography), all operable patients with gastric carcinoma should undergo a laparotomy or laparoscopy, because only intraoperative evaluation of the surgeon allows a decision on a possible curative resection. Patients with stages I-III should be resected radically with complete dissection of lymph node compartments 1 and 2. This policy is justified especially in view of a minimal hospital mortality (3%).

Adenocarcinoma↗