Extended resection for thyroid disease has less operative morbidity than limited resection

BACKGROUND: Theodor Kocher, surgeon and Nobel laureate, has influenced thyroid surgery all over the world: his treatment for multinodular goiter-subtotal thyroidectomy-has been the "Gold Standard" for more than a century. However, based on a new understanding of molecular growth mechanisms in goitrogenesis, we set out to evaluate if a more extended resection yields better results. METHODS: Four thousand three hundred and ninety-four thyroid gland operations with 5,785 "nerves at risk" were prospectively analyzed between 1972 and 2002. From 1972 to 1990, the limited Kocher resections were performed, and from 1991 to 2002 a more radical resection involving at least a hemithyroidectomy was performed. RESULTS: The incidence of postoperative nerve palsy was 3.6%; in the first study period and 0.9%; in the second (P < 0.001, Fisher's exact). Postoperative hypoparathyroidism decreased from 3.2%; in the first period to 0.64%; in the second (P < 0.01). The rate of reoperation for recurrent disease was 11.1%; from 1972 to 1990 and 8.5%; from 1991 to 2002 (P < 0.01). CONCLUSIONS: Extended resection for multinodular goiter not only significantly reduced morbidity, but also decreased the incidence of operations for recurrent disease. Our findings in a large cohort corroborate the suggestions that Kocher's approach should be replaced by a more radical resection, which actually was his original intention more than 130 years ago.

Social Work, Social Politics and Justice

"The disaster does not primarily lie in people and in the way that they perceive the circumstances, rather in the circumstances that doom people to powerlessness and apathy - circumstances which they could, however, change" (Adorno, 1966, p. 189). When Karl Marx writes to Friedrich Sorge in his letter of the 19.10.1877, regarding his critique of the opinion of his opponents Dühring & Co., that one must deal with "a whole crowd of immature students and pompous doctors who claim to give socialism a 'higher, ideal' turn, that is to say, to replace the materialistic basis (that demands serious, objective study if one wants to operate on it)… with modern mythology by means of their goddesses of justice, freedom, equality and fraternité" (Marx, 1973, p. 303; cf. Schiller, 1993, p. 199 onwards), this thus refers to fundamental problems with the concept of "justice" up until today. As the debate shows, it concerns the contextualization of the term "justice", its meaning in historically concrete as well as socio-political circumstances, and therefore a social analysis that is both representation and critique. Essentially it also concerns the question of the relationship between ideas and reality and the development of standards of historical systematic 'nature' out of social frameworks (see Frey, 1978; Theunissen, 1989).

Little-known Swiss contributions to the description, diagnosis, and surgery of lumbar disc disease before the Mixter and Barr era

The understanding of lumbar spine pathologies made substantial progress at the turn of the twentieth century. The authors review the original publication of Otto Veraguth in 1929 reporting on the successful resection of a herniated lumbar disc, published exclusively in the German language. His early report is put into the historical context, and its impact on the understanding of pathologies of the intervertebral disc (IVD) is estimated. The Swiss surgeon and Nobel Prize laureate Emil Theodor Kocher was among the first physicians to describe the traumatic rupture of the IVD in 1896. As early as 1909 Oppenheim and Krause published 2 case reports on surgery for a herniated lumbar disc. Goldthwait was the first physician to delineate the etiopathogenes is between annulus rupture, symptoms of sciatica, and neurological signs in his publication of 1911. Further publications by Middleton and Teacher in 1911 and Schmorl in 1929 added to the understanding of lumbar spinal pathologies. In 1929, the Swiss neurologist Veraguth (surgery performed by Hans Brun) and the American neurosurgeon Walter Edward Dandy both published their early experiences with the surgical therapy of a herniated lumbar disc. Veraguth's contribution, however, has not been appreciated internationally to date. The causal relationship between lumbar disc pathology and sciatica remained uncertain for some years to come. The causal relationship was not confirmed until Mixter and Barr's landmark paper in 1934 describing the association of sciatica and lumbar disc herniation, after which the surgical treatment became increasingly popular. Veraguth was among the first physicians to report on the clinical course of a patient with successful resection of a herniated lumbar disc. His observations should be acknowledged in view of the limited experience and literature on this ailment at that time.

Ben-Lee, oder: ist eine Emancipation der Juden denkbar? : Biographische Skizze aus dem Tagebuche eines Poeten

von F. Th. Wangenheim

Handbuch der Judenfrage : eine Zusammenstellung des wichtigsten Materials zur Beurteilung des jüdischen Volkes

hrsg. von Theodor Fritsch

Antisemitismus : kleine Studien

von Theodor Haase

Handbuch der Judenfrage : eine Zusammenstellung des wichtigsten Materials zur Beurteilung des jüdischen Volkes

Auf der Grundlage der Erkenntnisse der Rassenforschung wird der Antisemitismus wissenschaftlich begründet; die bisher als Vorurteile angesehenen Anfeindungen und Verleumdungen gegen Juden erhalten damit den Anschein von Wahrheit. Der Autor kommt zum Schluß, dass sich die Nation gegen Juden wehren muss, wenn sie gesund bleiben will

Beziehungen auf Grundsätze des orthodoxen Judenthums : 2. Antwortschreiben an Salomon

von Ant. Theod. Harmann

Statistik des Judenthums

von Theodor Fritsch (Thomas Frey)