No abstract

Cryotherapy is a modality commonly used after arthroscopic procedures. We divided 17 patients into two groups after routine knee arthroscopy: 12 patients were immediately treated with ice and 5 control patients were treated without ice for the first hour. In all patients, thermocouple probes were placed intraarticularly into the lateral gutter of the knee. Ice was placed on the operative knees of the treatment group for 2 hours. The control group had no intervention for the 1st hour and then had ice applied for the 2nd hour. Temperatures were continually recorded every minute for 2 hours. The temperature in the treatment group declined significantly, by 2.2 degrees C (95% confidence interval [-3.6 degrees C, -0.72 degrees C]) over the 1st hour and by 0.79 degrees C (95% CI [-1.8 degrees C, 0.18 degrees C]) over the 2nd hour (P = 0.008). The temperature in the control group increased significantly, by 5.0 degrees C (95% CI [2.4 degrees C, 7.5 degrees C]) over the 1st hour (P = 0.006). After ice was applied, the temperature fell significantly, by 4.0 degrees C (95% CI [-8.3 degrees C, 0.26 degrees C]) (P = 0.06). The difference between the temperature decrease in the treatment group and the increase in the control group at 60 minutes was 7.1 degrees C. This is the first rigorously conducted study in human patients that documents a statistically significant decline in intraarticular knee temperature with the application of ice and compression to the skin. The mechanism by which cryotherapy acts must therefore include the cooling effect on the intraarticular environment and synovium.

No abstract

We evaluated the treatment experiences with thyroid carcinoma at a private, a Veterans Administration, and a University hospital to determine the frequency, treatment, and outcome of patients with this uncommon malignant tumor. All 120 patients with thyroid carcinoma were identified through hospital tumor registries between 1953 and 1988, representing 0.3% of the total cancer registry cases during this period. Well-differentiated carcinoma of the thyroid represented 73%, medullary carcinoma 7%, poorly differentiated carcinoma 18%, and Hürthle cell carcinoma 2% of histologic varieties. Seventy-eight percent of patients were treated initially by surgery or by surgery plus postoperative irradiation. The remaining patients received other treatment. At 10 years after treatment, 90% of patients with well-differentiated carcinoma survived, while only 20% of patients with medullary and poorly differentiated carcinoma survived. Sixty percent of recurrences for all histologic types appeared within the first 12 months after treatment. Patients with well-differentiated carcinoma had sporadic recurrences over a 21-year-period. Recognition of these time intervals allows for better follow-up management.