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J Gray

Publications and source records attributed to J Gray.

513 records · Page 29Linked to original sources
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Solitary osteochondroma of the foot: an in-depth study with case reports.

Osteochondroma represents the most common benign bone tumor and occurs most frequently in the proximal humerus, tibia, and distal femur. The bones of the foot, by comparison, are less commonly involved. The tumor appears to be a developmental defect of bone preformed in cartilage rather than a true neoplasm. However, on rare occasions it may undergo chondrosarcomatous degeneration, thus demonstrating neoplastic behavior. A review of the literature, including clinical features of osteochondroma, radiologic and histologic characteristics, and theories on pathogenesis, is presented. Information concerning principles of surgical treatment, techniques of diagnosis, and facts to aid in the differential diagnosis of osteochondroma is presented also. Finally, a series of case reports is presented to demonstrate the surgical treatment of osteochondroma of the foot. Included are three cases of phalangeal osteochondroma, one of metatarsal osteochondroma, and an unusual report of osteochondroma of the talus. A case report and discussion of a patient with juxtacortical circumscripta myositis ossificans of the foot is also presented to demonstrate how information on lesions included in the differential of osteochondroma can be utilized clinically to make the diagnosis.

Adult↗
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Epstein-Barr virus infection in heart and heart-lung transplant recipients: incidence and clinical impact.

BACKGROUND: A retrospective serologic study was made of 67 heart-lung and 295 heart transplant recipients (with transplantations at Papworth Hospital, Cambridge, England) to determine the incidence and clinical impact of Epstein-Barr virus infection. METHODS: Epstein-Barr virus capsid antigen immunofluorescence tests were performed, and the antibody avidity was determined by modifying the washing procedure to include a mild reducing agent (8M urea). RESULTS: This testing showed that 6.0% of the patients had primary Epstein-Barr virus infections, whereas 17.4% had the reactivation of a past infection. Primary infections were only detected in patients who were Epstein-Barr virus antibody-negative before transplantation, who had received an organ from an Epstein-Barr virus antibody-positive donor. Of the patients with serologically proven Epstein-Barr virus infections, 52.9% had symptoms. Although these were generally mild, five heart and two heart-lung transplant recipients had malignant lymphoma and one heart and one heart-lung transplant recipient had lymphoproliferative disease after Epstein-Barr virus infection. Additional four heart transplant recipients had lymphoma after transplantation. None of these four patients had evidence of active Epstein-Barr virus infection; one was Epstein-Barr virus antibody-negative during the study period and three had stable Epstein-Barr virus virus capsid antigen immunoglobulin G titers throughout. CONCLUSIONS: Epstein-Barr virus infection in organ transplant recipients may lead on to life-threatening lymphoproliferative disease or lymphoma. For this reason it may be beneficial to monitor patients after transplantation for evidence of Epstein-Barr virus infection and to follow the progress of those affected.

Adolescent↗
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