Biomedical subjects

J Thunold

Publications and source records attributed to J Thunold.

5 recordsLinked to original sources

PubMed1990

Low-dose preoperative radiation postpones recurrences in operable rectal cancer. Results of a randomized multicenter trial in western Norway.

A randomized, multicenter clinical trial was conducted in Western Norway to study the effectiveness of preoperative radiation therapy in operable rectal cancer, given at a dosage of 3150 cGy in 18 fractions, 2 to 3 weeks before radical surgery. Three hundred nine patients were entered into the trial between May 1976 and December 1985. After radiation no tumor was seen in 4.5% of the patients. There was no increased morbidity or mortality at surgery. The 5-year survival for evaluable patients was 57.5% in the control group and 56.7% in the radiotherapy group. For patients operated on for cure the 5-year survival was 60.9% and 64.2% in the control group and radiotherapy group, respectively. Radiation significantly delayed both local and distant recurrences in patients in the radiation group who had curative resection from 13.3 months in controls to 27.1 months. The local recurrence rate in the corresponding groups was 21.1% and 13.7%, respectively. We conclude that higher preoperative radiation doses should be used in new trials as a higher dosage may transform the observed positive effects into a survival benefit.

Adult↗

PubMed1986

Risk of carcinoma following gastric operations for benign disease. A historical cohort study of 3470 patients.

The risk of stomach cancer was analysed in a cohort of 3470 patients who had had gastric surgery for benign disease between 1900 and 1969. In 87 patients (2.2%) stomach-stump cancer was diagnosed in the follow-up period 1970-84. By comparison with the total incidence of stomach cancer in the same region during the same time period, the observed versus expected ratio in the post-surgery group was 2.1 (p less than 0.001) and did not differ between men and women. At 5-10 years postoperative the risk of cancer was no different from that in the total population, whereas after 40-45 years it was 7.3-fold higher. The risk was unrelated to primary diagnosis or type of operation.

Adult↗

PubMed1976

Synovial sarcoma: a case report.

The case described, of a 40-year-old woman with a 26-year history of a chronic, non-specific knee disorder, is a rather typical example of synovial sarcoma, according to the information given by other authors over the past three to four decades. The diagnostic difficulties and failures are clearly illustrated. It must be emphasized that severe, obscure joint symptoms such as our patient presented over the many years before death should have led to a proper surgical exploration of the knee. Furthermore, it should be unnecessary to stress the importance of performing a histological examination whenever excising abnormal tissue.

Adult↗

PubMed1975

Tibial shaft fractures treated by rigid internal fixation: the early results in a 4-year series.

Ninety-nine fractures of the shaft of the tibia in 98 patients were treated by rigid internal fixation over 4 years. One patient died after operation from myocardial infarction; and one patient went abroad. The healing course of the remaining 97 fractures is described, classified according to the type of fracture and the accuracy of operative reduction. Seventy-five fractures had a normal time to union, defined as the lasting achievement of full weight-bearing within 4 months. In 7 fractures the healing period was moderately delayed (full weight-bearing being achieved in 4-6 months) and in 5 it was seriously delayed, requiring 6-11 months after injury. Nonunion occurred in 4 cases and refracture in 6 cases. Osteitis developed in 2 cases and was successfully treated with antibiotics within 6 weeks. A second internal fixation was necessary in 12 patients. In 5 patients a plaster cast was applied to treat delayed union. Amputation was necessary in a 75-year-old man with senile dementia who developed infection after a second operation for refracture. One patient still has a pseudarthrosis after 2 years and 2 further operations. In the other 95 fractures union was the end-result. Of the 21 comminuted and open fractures only 13 healed within 4 months. We recommend a different approach in the treatment of badly comminuted and open 'high-energy' fractures. With this reservation, we find that the method of rigid internal fixation which we employ has given satisfactory early results. The frequency of both delayed healing and infection is reasonably low compared to the results in similar series.

Adolescent↗

PubMed1975

Primary prosthetic replacement in acute femoral neck fractures.

This paper reports a retrospective study of acute femoral neck fractures in 123 patients treated by primary prosthetic replacement. The average age in our patient population was 80-5 years. A Christiansen trunnion-bearing hip prosthesis (Christiansen, 1969 and 1974) was used in all patients except one. The prosthesis was cemented to the femoral shaft. The postoperative mortality rate was low, and the mortality rate was 8-7 per cent. The patients were examined between 6 months and 3 1/2 years after operation. Excellent or good results according to Stinchfield's hip assessment system (Stinchfield et al., 1957) were obtained in 82 per cent of the patients. We suggest that primary prosthetic replacement in acute femoral neck fractures in elderly patients is a safe and valuable procedure. However, a definite conclusion concerning this therapy cannot be drawn before a prospective study comparing the results of internal fixation and primary prosthetic replacement is made.

Acute Disease↗