Surgery

Dallas Cowboys fullback Daryl Johnston will miss the rest of the season because of further neck problems related to 1997 surgery on a herniated disc. Johnston, 33, conceded the latest problem, discovered in tests Wednesday, could end his career. "It is going to be a tough decision," he said. "That will be considered at the end of the season. . .The strange thing is I thought after making it through last season, I'd be OK. " Johnston had surgery six weeks into the 1997 season to fuse two vertebrae in the neck.

In advanced emphysema, the lungs become progressively enlarged and overinflated. Sufferers are literally stuck holding more and more of their breath. Researchers have long tried to find ways to reduce lung volume and improve airflow without resorting to risky surgery. Now, three promising lung-shrinking techniques - coils, one-way valves, and an injectable sealant - are in or near clinical testing at Temple University and other U.S. medical centers. All three methods are already approved in Europe.

John Elway, one month removed from his first Super Bowl victory, had minor surgery on his right shoulder yesterday and should recover within six weeks. "It was routine, and it was successful," Broncos spokesman Paul Kirk said. Elway, who has not said whether he will return for his 16th NFL season, reportedly had said he would not have the surgery if he planned to retire. He will have better range of motion and less pain when he throws, Denver trainer Steve Antonopulos said.

MINNEAPOLIS - An MRI examination Monday revealed a medial meniscus tear in Erik Kratz's left knee, an injury that will require surgery and could endanger the remainder of his season. The Phillies offered no timetable for their backup catcher's return. Similar injuries have required months for recovery. It is unknown when Kratz will undergo the procedure. The Phillies said in a statement that they will establish a date for Kratz's return after the surgery. Kratz was hurt running to first base in the ninth inning of a loss to Milwaukee on Saturday.

Powerful state Sen. Vince Fumo will fly to Cleveland next week for heart surgery, sources have told the Daily News. The sources, who asked not to be identified, said the surgery was an elective procedure to correct a leaky valve, and is not considered to be high-risk. The Philadelphia Democrat chose to go to Cleveland, the sources said, because a surgeon there is a nationally known expert in the kind of surgery Fumo needs. The Cleveland Clinic is a highly regarded cardiac care hospital.

CLEARWATER, Fla. - After quickly recording the first two outs of the fourth inning, Mike Stutes turned and watched. And waited. The third batter of the inning, Atlanta Braves' third baseman Juan Francisco, squared up one of Stutes' pitches and launched the ball over the fence in leftfield. The home run was one of five hit Monday between the Phillies and Braves, even though it felt like there were a dozen. The homer was one of 36 hits between the two teams, even though it felt like 66. "The ball was carrying a little bit," Stutes said at his locker at the tail end of a wild, 17-10 loss to the Braves.

William J. Zintl, 99, of Haverford, who was a surgeon to Cardinal John Krol and one of two physicians delegated in 1965 to examine the exhumed body of St. John Neumann prior to his canonization, died Sunday, Jan. 27, of a heart attack at Bryn Mawr Hospital. Dr. Zintl wielded his scalpel for 60 years, first as a ship's surgeon in World War II and then as chief of surgery at three Delaware County hospitals. He settled in Haverford because he wanted to be near Misericordia, Fitzgerald Mercy, and Riddle Memorial Hospitals, where he was chief of surgery, said his daughter, Dolores "Choppy" Rouse.

At 14, Noah Kipfmiller has begun to think about what he'd like to be when he grows up. "Kind of like a video game designer," said the Bay City, Mich., eighth grader. He does not ponder his distinction as the world's first person to have had successful fetal surgery for a devastating spinal cord birth defect. "I have a scrapbook," his mother, Mellissa, said of the hoopla surrounding her son's 1998 birth. "I showed it to Noah. He's just not that into it yet. " Although Noah may not appreciate it, he is a measure of the success - and the implacable limits - of fetal surgery for severe spina bifida, which only recently ceased to be deemed experimental.

NEW YORK GIANTS defensive end Osi Umenyiora is having arthroscopic surgery on his right knee and likely will miss the season opener on Sept. 11. General manager Jerry Reese says yesterday that Umenyiora "let me know that he wanted to have the surgery now. " Umenyiora has been a headline all summer, as he did not report to training camp with the team following the lockout. Finally, on Monday, he unhappily reported under the terms of his current deal, and worked out for 3 days before his knee began to swell.

First, Flyers goalie Robert Esche had to bear being on the losing end of the NHL Eastern Conference finals. Now, Esche apparently has lost a chance to compete in the World Cup in September. Officials from Team USA said yesterday that Esche, a member of the 26-player roster set to defend Team USA's World Cup title, will have surgery on his left hip Tuesday in Pittsburgh. He is expected to be out of action for three to four months but available for Flyers training camp in mid-September if a collective-bargaining agreement is reached.

In medicine, it's one thing to know that a treatment works, but quite another to know whether it's better than alternatives. How do doctors decide what's best? If the treatment in question involves a device, it could be relatively easy. The company that makes the device is happy to fund a study to test its device against other options. But what if the question is how quickly surgery should be done to get the best result after certain spinal injuries? No one benefits but the patient.

MINNEAPOLIS - An MRI examination Monday revealed a medial meniscus tear in Erik Kratz's left knee, an injury that will require surgery and could endanger the remainder of his season. The Phillies offered no timetable for their backup catcher's return. Similar injuries have required months for recovery. It is unknown when Kratz will undergo the procedure. The Phillies said in a statement that they will establish a date for Kratz's return after the surgery. Kratz was hurt running to first base in the ninth inning of a loss to Milwaukee on Saturday.

MILWAUKEE - Mike Adams grabbed a seat in front of a laptop in the visitors clubhouse and searched for answers in the form of video. Bullpen coach Rod Nichols stopped and chatted. While seated, Adams mimicked his pitching motion. Later, pitching coach Rich Dubee acted as his sounding board. The Phillies agreed to pay Adams $12 million over two seasons so he could bring stability to the eighth inning. The pitcher has a history of injuries and his latest, described as "biceps irritation," complicates the relief situation.

Doctors anticipate Jim Kelly will have a "successful outcome" after the Buffalo Bills Hall of Fame quarterback had surgery to remove cancer from his upper jaw on Friday. "The surgery went very well," according to a news release issued by Buffalo's Erie County Medical Center. "We are hopeful for and anticipate a speedy recovery and successful outcome. " A person with knowledge of the situation said free-agent running back Ahmad Bradshaw is trying to work out a contract with the Indianapolis Colts.

NEW ENGLAND Patriots tight end Rob Gronkowski will have back surgery in June, ESPN reported, citing a source. Gronkowski recently had a fourth surgery on his broken forearm. He is not expected to be ready for the start of training camp. Gronkowski recently had an MRI for a back disk problem from last season, various media outlets reported. In other NFL news: * Two employees of the truck- stop chain owned by the family of Tennessee Gov. Bill Haslam and Cleveland Browns owner Jimmy Haslam pleaded guilty in a federal probe of the company's business practices.

Debbi Cook decided to have weight-loss surgery when her doctor told her she needed five shots a day for her diabetes instead of four. She was 5-foot-8 and 349 pounds, and she'd already had diabetes for 37 years. She just couldn't face one more shot. "I really honestly would have rather died," the Norristown woman said. Cook, 57, chose to have gastric bypass surgery at Mercy Suburban Hospital 11 months ago. The most complex of the three common weight-loss procedures, it also has the best record of alleviating or even reversing diabetes.

Tonsil and adenoid removal improves a variety of symptoms in children with moderate sleep apnea, but "watchful waiting" also helped in some ways, a new study found. Overall, the surgery resulted in better sleep, less restlessness and impulsivity, and improved quality of life for most patients. But nearly half of children in the "watchful waiting" group also saw sleep improvements. No correlation was found between the surgery and improving attention and brain function. "If you ask me what, as a pediatrician, I would recommend to my patients . . . with sleep apnea, I would recommend surgery, because we saw many improvements," said Carole Marcus, a physician and director of the Sleep Center at Children's Hospital of Philadelphia and the study's first author.

Eagles tight end James Casey underwent arthroscopic surgery on his right knee earlier this week and will miss the remainder of organized team activities. The recovery usually takes only a few weeks, so Casey should be back in time for training camp this summer. "I had a minor scope done on my right knee," Casey, 28, wrote on his Twitter account. "I'll be back to full speed in two weeks. Better to get it taken care of now. " A four-year veteran, Casey signed a three-year, $14.6 million contract in March.

San Francisco may have a one-game-to-none lead over Washington in the teams' current series, but the Giants and Nationals are even-steven when it comes to broken right hands on righthanders. (The Nats, however, have an overwhelming edge in margin of stupidity, as we'll explain.) Giants starter Ryan Vogelsong, the pride of Octorara Area High, suffered two broken bones in his pitching hand fouling one off in the fifth inning of Monday's 8-0 win over the Nationals. He had surgery on Tuesday morning and is likely out for two months or more.

New England Patriots tight end Rob Gronkowski underwent a fourth surgery on his forearm Monday and doctors believe his previous infection is gone, a league source told ESPN.com. Doctors put new plates in to repair the previously broken left forearm. The estimated timetable for recovery is around 10 weeks, assuming there are no setbacks. Gronkowski originally broke the arm Nov. 18 in a game against the Indianapolis Colts. He returned to action on Dec. 30 in the regular-season finale, then broke the forearm again in the AFC divisional round of the playoffs on Jan. 13 against the Houston Texans.