Search PubMed⌕ Search

Biomedical subjects

F J Frassica

Publications and source records attributed to F J Frassica.

At least 19 recordsLinked to original sources
PubMed1999

Pigmented villonodular synovitis of the hip and knee.

Pigmented villonodular synovitis is an uncommon disease that remains a diagnostic challenge. Presenting complaints commonly involve one joint, most often the knee or hip. Symptoms of pain and swelling characteristically have an insidious onset and are slowly progressive. The physical examination may be completely normal. Radiographs of the knee may appear normal or may show a periarticular soft tissue density, expansion of the suprapatellar pouch and local osseous changes confined to the patellofemoral articulation. Radiographs of the hip may show erosions in the head and neck of the femur and acetabulum. Magnetic resonance imaging usually demonstrates key diagnostic features, which include joint effusion, elevation of the joint capsule, hyperplastic synovium and low signal intensity resulting from hemosiderin deposition. The diagnosis of pigmented villonodular synovitis is confirmed by biopsy, and the treatment of choice is synovectomy.

Diagnosis, Differential↗
PubMed1999

Endovascular papillary angioendothelioma (Dabska tumor) of bone.

Endovascular papillary angioendothelioma, also known as Dabska tumor, is a rare vascular neoplasm that usually involves the skin or subcutaneous tissue of children. There have been no reported cases of this lesion occurring in bone. We report a Dabska tumor in the distal femur of a 45-year-old woman who, clinically and radiologically, was felt to have an osteoid osteoma. Histologic study of the lesion showed a hemangioma with budding fronds of endothelial cells, a feature characteristic of the Dabska tumor. We feel that the lesion arose in a pre-existing hemangioma, a hypothesis suggested in a few other case reports. Endovascular papillary angioendothelioma is a low-grade malignant neoplasm, although only one patient has died due to this lesion. Our patient is asymptomatic without evidence of recurrence 1 year post curettage.

Bone Neoplasms↗
PubMed1999

Osteosarcoma of the head and neck: a review of the Johns Hopkins experience.

OBJECTIVE: To determine factors including treatment modalities which influence survival in patients with osteosarcoma of the head and neck. STUDY DESIGN: Retrospective clinicopathologic study of 27 patients with osteosarcoma of the head and neck. METHODS: The clinical charts and pathology slides were reviewed on 27 patients who had osteosarcoma of the head and neck between 1946 and 1998. The following variables were examined for their effect on survival: age of diagnosis, site of tumor, presentation, race, sex, prior radiation exposure, retinoblastoma history, margin status, and method of treatment. RESULTS: The average age at the time of diagnosis of the patients was 37.6 years (range, 7-82 y). The sex distribution was similar with 14 male and 13 female patients. Eight of 27 patients had osteosarcoma of the mandible, 9 of 27 had osteosarcoma of the maxilla and paranasal sinuses, and in 10 of 27 patients osteosarcoma occurred elsewhere, including the temporal bones, occipital bones, and orbit. The overall 2-year survival was 66% with a 5-year survival rate of 55%. CONCLUSIONS: Positive surgical margins and a high tumor grade were found to have a statistically deleterious effect on overall survival. There was no detectable effect on survival of age, race, sex, prior radiation exposure, tumor site, and tumor cell type. It was not possible to differentiate between the different adjuvant treatment modalities because of the small numbers in the study.

Adolescent↗
PubMed1998

In vitro and in vivo study on the effect of autogenous cancellous bone and intramedullary polymethylmethacrylate on allograft construct strength.

An in vitro study was performed to compare the effects of augmenting interlocking nails of one of two diameters (5 or 6 mm) with intramedullary polymethylmethacrylate. Subsequently, an in vivo study was performed to compare the effects of augmenting the interlocking nail with five combinations of intramedullary polymethylmethacrylate and autogenous cancellous bone applied to the periosteal surface or within the medullary canal. Dogs were killed 6 months after the procedure for biomechanical evaluation of the femora in axial compression, mediolateral and craniocaudal bending, and torsion. Results from the in vitro study at the proximal osteotomy indicated the 6-mm interlocking nail with intramedullary polymethylmethacrylate had greater stiffness than the 5-mm interlocking nail without it (p < 0.05). At the distal osteotomy, regardless of the diameter of the interlocking nail, the addition of intramedullary polymethylmethacrylate increased stiffness (p < 0.05). Results from the in vivo study indicated greater global construct stiffness with an interlocking nail alone, an interlocking nail augmented with intramedullary polymethylmethacrylate and cancellous bone at the periosteal surface, and an interlocking nail augmented with cancellous bone within the medullary canal and at the periosteal surface (p < 0.05). At the osteotomy level, the interlocking nail augmented with intramedullary polymethylmethacrylate and cancellous bone at the periosteal surface had greater stiffness than did an interlocking nail alone or an interlocking nail augmented with either intramedullary polymethylmethacrylate, cancellous bone within the medullary canal, or cancellous bone at the periosteal surface (p < 0.05) but produced the same results as an interlocking nail augmented with cancellous bone within the medullary canal and at the periosteal surface. The results suggest that augmenting interlocking nail fixation with intramedullary polymethylmethacrylate by itself offers no advantage but that a combination of intramedullary polymethylmethacrylate and cancellous bone at the periosteal surface improves structural properties at 6 months.

Animals↗
PubMed1998

Effect of intramedullary polymethylmethacrylate and autogenous cancellous bone on healing of frozen segmental allografts.

This study was designed to compare bone mineral density, periosteal callus production, new bone formation, bone porosity, histologic appearance, and union of mid-diaphyseal segmental allografts of the femur stabilized with an interlocking nail technique in a canine model 6 months after the procedure. An in vivo study was performed to compare the effects of augmenting interlocking nail fixation with an interlocking nail alone, intramedullary polymethylmethacrylate, intramedullary polymethylmethacrylate and autogenous cancellous bone applied to the periosteal surface of the host-allograft junction, autogenous cancellous bone applied to the endosteal surface of the allograft, autogenous cancellous bone applied to the periosteal surface of the host-allograft junction, and autogenous cancellous bone applied to the periosteal surface of the host-allograft junction and to the endosteal surface of the allograft. There were no differences among treatments for bone mineral density at any time interval. Callus area 4 weeks after the procedure was greater along the lateral and cranial surfaces for treatments with periosteal cancellous bone (p < 0.05). New bone within the allograft segment did not differ among treatments and was reduced compared with the host-allograft junctions (p < 0.05). The amount and quality of bone tissue at the host-allograft junctions were greatest with treatments of intramedullary polymethylmethacrylate and autogenous cancellous bone applied to the periosteal surface of the host-allograft junction and of autogenous cancellous bone applied to the periosteal surface of the host-allograft junction and to the endosteal surface of the allograft (p < 0.05). The rate of bone union was lower, and there was a greater gap (non-bone tissue) remaining between host and allograft bone with treatment involving just intramedullary polymethylmethacrylate than with other treatments (p < 0.05). The results suggest that augmenting interlocking nail fixation with intramedullary polymethylmethacrylate by itself offers no advantage but that a combination of intramedullary polymethylmethacrylate and cancellous bone at the periosteal surface or of cancellous bone within the medullary canal and at the periosteal surface improves the quality of healing at 6 months.

Animals↗
PubMed1997

Effect of cisplatin chemotherapy on extracortical tissue formation in canine diaphyseal segmental replacement.

The reconstruction of large bone and joint defects after the resection of malignant tumors remains a major challenge. Chemotherapy has significantly lowered the risk of metastasic disease, but complications associated with reconstructive techniques continue to result in late morbidity. In the present study, biomechanical torsion testing, gait analysis, and histomorphometric and scanning electron microscopic evaluations of 24 dogs were used to examine the effects of preoperative and postoperative administration of cisplatin on the biologic fixation of a porous-coated segmental replacement prosthesis. The chemotherapy consisted of four cycles of cisplatin administered at a dosage of 75 mg/m2 preoperatively or postoperatively. The healing was enhanced by use of an autogenous corticocancellous bone graft. The graft was placed evenly around the prosthesis and the adjacent femoral cortex. Mechanical analyses of torsional stiffness, yield strength, and maximum strength revealed no statistically significant differences between the groups at 12 weeks. Such lack of difference was mainly due to the penetration of highly organized fibrous tissue into the porous surface; this provided strong fixation of the implant to bone even in the absence of bone ingrowth. Although bone ingrowth into the prostheses was not affected, electron microscopic, histomorphometric, and radiologic analyses showed a clear difference in the formation of new bone around the prosthesis. Preoperative chemotherapy did not alter the formation of new bone, but specimens from animals treated postoperatively with cisplatin showed significantly less bone graft resorption and less new bone formation. Hence, the effect of cisplatin administration caused only a temporary delay, not a permanent effect, on extracortical capsule formation. The formation of extracortical bone and soft tissue might prevent debris-incised osteolysis and, therefore, prevent late complications by forming a tight capsule around the bone-prosthetic interface.

Animals↗
PubMed1997

Skeletal system: biomechanical concepts and relationships to normal and abnormal conditions.

The human skeleton is a remarkable organ that is uniquely designed to provide structural support and to house the body's hematopoietic system and mineral reservoirs. Seven concepts that will assist the clinician in understanding skeletal function are (1) material properties of bone, (2) stress and strain, (3) bending moments and torsional loads, (4) area moments of inertia, (5) fatigue and catastrophic failure, (6) Wolff's law, and (7) stress risers and open section effect. For example, as the modulus of a bone, a measure of stiffness decreases as in Padget's disease or fibrous dysplasia and the same levels of stress will cause greater deformations. The sum of these principles also explains the torus fracture (ductility), fracture of the olecranon by contracting tricep muscle (tensile loading), osteoporotic compression fracture of the spine, and the other biomechanical lesions that are encountered. Understanding these basic biomechanical principles can help physicians comprehend neoplastic processes and fractures that are the metabolic responses of the skeleton to stress and that appear on the radionuclide bone scan.

Biomechanical Phenomena↗
PubMed1997

Benign and malignant musculoskeletal masses: MR imaging differentiation with rim-to-center differential enhancement ratios.

PURPOSE: To assess the diagnostic potential of the rim-to-center differential enhancement ratio in the magnetic resonance (MR) imaging differentiation of benign from malignant musculoskeletal masses. MATERIALS AND METHODS: Dynamic gadolinium-enhanced fast multiplanar spoiled gradient-recalled acquisition in the steady state imaging was performed to evaluate 17 one and soft-tissue masses (10 malignant, seven benign) in 14 patients. The rim-to-center differential enhancement ratio was determined from images at the maximal enhancement rate. The difference in differential enhancement ratios between benign and malignant masses was evaluated and compared with the maximum rate of enhancement for each mass. RESULTS: Nine of 10 malignant masses showed rapid rim enhancement with delayed central fill-in. This enhancement pattern was absent in benign masses. The average rim-to-center differential enhancement ratio was 0.64 +/- 0.26 for malignant masses and -0.16 +/- 0.33 for benign masses (P < .001). This difference was statistically significant. The average maximum rate of enhancement was 3.41%/sec +/- 2.20 for malignant masses and 2.74%/sec +/- 2.46 for benign masses (P > .05). CONCLUSION: Intratumoral enhancement patterns of malignant and benign masses differ because of differences in vascular architecture. These preliminary results suggest that the rim-to-center differential enhancement ratio has potential as an additional parameter for the MR imaging differentiation of indeterminate musculoskeletal masses.

Adolescent↗
PubMed1997

The short-term effects of cisplatin chemotherapy on bone turnover.

Cisplatin is an effective agent in the treatment of osteosarcoma of bone but little is known of its effects on normal bone turnover. Twenty-four dogs divided into three study groups were used to study the effect of cisplatin on normal bone turnover at the distant site of surgery. Group 1 served as the control group, group 2 received four cycles of cisplatin every 3 weeks before the surgery, and group 3 received four cycles postoperatively. The bone turnover rate was evaluated by measuring levels of systemic bone markers, osteocalcin, alkaline phospohatase, urine pyridinoline cross-links, and by determination histomorphometric indices. Histomorphological analysis showed poor correlation on bone formation with systemic bone markers at distant sites of surgery. Histomorphometrically normal bone turnover was affected by administration of cisplatin, but the effect was temporary, late, and less significant than what occurred at the surgical site. Our data showed that significant effects of cisplatin are observed at the site of active cellular induction and proliferation, such as implant-host interface, and less effects are seen at the sites of normal bone turnover.

Alanine Transaminase↗
PubMed1997

CT and MRI evaluation of musculoskeletal infection.

While the plain film and nuclear medicine bone scan are still the traditional imaging modalities used in the evaluation of musculoskeletal infection, the cross-sectional imaging modalities, computed tomography (CT) and magnetic resonance imaging (MRI), have become critical in the delineation of many types of musculoskeletal infection. In particular, the evaluation of soft tissue infections, including cellulitus, myositis, fasciitis, abscess, and septic arthritis are often best evaluated by MRI or CT due to their excellent anatomic resolution and soft tissue contrast. Even in osseous infection, CT and MRI can give better anatomic delineation of the extent of infection. In cases where the plain film and nuclear medicine bone scan findings are complicated due to previous surgery, trauma, or underlying illness, the anatomic resolution and soft tissue contrast provided by MRI and CT are often necessary to determine if underlying infection exists. MRI's visualization of the bone marrow allows for the sensitive detection of osteomyelitis, although specificity for the diagnosis of osteomyelitis is aided by other findings, including cortical destruction. The CT and MRI findings in the spectrum of musculoskeletal infections are discussed and contrasted, and pitfalls in their evaluation of musculoskeletal infection are described.

Abscess↗