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Biomedical subjects

P Franklin

Publications and source records attributed to P Franklin.

10 recordsLinked to original sources

Magnetic resonance imaging evaluation of calcaneal fat pads in patients with os calcis fractures.

Destruction of the calcaneal fat pad has been implicated as a source of chronic pain following fractures of the os calcis. Several investigators postulate that the initial trauma that produces a calcaneal fracture also results in destruction of the U-shaped fibrous septa that maintain the piston-like organization of the fat columns. Fibrosis and loss of the protective cushioning provided by the fat pad may eventually occur. The authors report on the largest series of magnetic resonance images of the calcaneal fat pad in the heels of patients with calcaneal fractures. A prospective consecutive study utilizing magnetic resonance imaging was performed on 22 heels with calcaneal fractures. Ten contralateral heels without calcaneal fracture and the heels of five normal subjects were scanned as controls. No signal changes suggestive of increased fat pad edema, fibrosis, or fatty release were detected. In addition, the vertical septa were well visualized and found to be intact in all cases. The height of the fat pad was measured, with no changes noted as compared with the contralateral heel. In those patients with acute fractures, signal changes suggestive of hematoma were well visualized in the soft tissue surrounding the calcaneus. In two of these cases, there was extension beneath the plantar fascia, but no penetration into the fat columns. Magnetic resonance imaging allows excellent detailed visualization of the calcaneal fat pad and surrounding structures. No evidence is found to support the hypothesis that marked damage to the gross structure of the fat pad occurs at the time of injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue

Mitomycin-C/5-FU and radiation therapy for locally advanced uterine cervical cancer.

To assess the feasibility and effectiveness of combined therapy on locally advanced cervical cancer, we entered 38 patients into a study. The patients were treated with mitomycin-C (10 mg/m2) on Days 1 and 30 and 5-FU (1000 mg/m2) on Days 1 to 4 and Days 30 to 33. In 5 weeks 4500-5000 cGy was given concurrently, followed by radioactive implants. Twenty-six patients had an early-stage disease (IB-IIB) and twelve had a late-stage disease (IIIB-IVA). Eighty-seven percent (33/38) of the patients had a tumor measuring 5 cm or more. The other 5 patients with a tumor size under 5 cm had biopsy-proven positive pelvic nodes; 2 of these 5 patients had a pretherapy hysterectomy. Tumor response, complete (CR) vs partial (PR), was assessed in 36 patients 3 months after completion of therapy. A CR was noted in 80% (29/36) of the patients. The PR status conferred a detrimental effect on the pelvic disease control (PDC), disease-free survival (DFS), and survival (S) while late stage correlated with the development of distant metastases (DM) and a poor DFS. PDC was obtained in 93% (27/29) of the patients who had a CR, as compared to only 43% (3/7) of those with a PR (P = 0.0228). The DFS and S rates were 59 and 77% for patients with a CR and 21 and 19% for those with a PR; respective P values were 0.0340 and 0.0002. Eleven percent (3/26) of the patients with an early stage developed DM, as compared to 50% (6/12) of those with late stage, (P = 0.0016). The DFS rates were 80 and 37% for patients with an early and late stage, respectively (P = 0.0141). Four patients developed transient neutropenia and one had transient thrombocytopenia. The second dose of mitomycin-C was omitted in 4 patients due to persistent neutropenia in 3 and to transfusion-related hepatitis in 1. Two percent (5/21) of the patients who had a staging laparotomy developed wound dehiscence. Three patients developed non-cancer-related small bowel obstruction requiring surgery. We concluded that this combined regimen was well tolerated. Although it was effective in controlling the cancer in the pelvis, this regimen failed to control DM in late-stage patients.

Adult

Malignant fibrous histiocytoma obstructing the thoracic aorta.

Neoplasms of the aorta are rare. In this report, we present a case of a malignant fibrous histiocytoma that nearly obliterated the lumen of the thoracic aorta. The neoplasm was resected and aortic continuity was reestablished with an interposition graft. This case is particularly unusual because the patient had an isolated lymph node excised 5 years previously that contained the same neoplasm.

Aorta, Thoracic

Thyroid uptake of gallium in Graves' disease.

A patient with hyperthyroid Graves' disease presented with ptosis, leading to a workup for myasthenia gravis. An enlarged thymus gland was noted on computed tomography. A scan with gallium-67 citrate showed prominent and diffuse thyroid gland activity as well as prominent lacrimal activity. This finding of thyroid uptake of gallium led to the correct diagnosis of Graves' disease. Such a finding has not been reported previously. The associated thymic, thyroid, and orbital findings in Graves' disease are discussed.

Adult

Functional oncocytoma of the kidney: evaluation by dual tracer scintigraphy.

We report a case of renal oncocytoma with a unique scintigraphic pattern. The tumor showed strong avidity for [123I]iodohippurate, but no affinity for [99mTc] glucoheptonate. We offer an explanation for such exceptional scintigraphic finding, which may potentially enable us to make a pre-operative diagnosis of renal oncocytoma in the future.

Adenoma

Can the rapid semiquantitative estimation of serum C reactive protein be adapted for the management of bacterial infection?

Serum C reactive protein concentrations measured by a laboratory based assay were compared with the semiquantitative results obtained with a visual agglutination method (Well-cotest, CRP kit). Using this agglutination kit, diluting serum 1/10 and 1/20 gave C reactive protein results which could be of more clinical value than those obtained using the 1/2, 1/4, 1/8, and 1/16 dilutions recommended by the manufacturers. The kit was also used on the ward by junior medical staff, who showed that after minimal training reproducible serum C reactive protein results could be obtained.

Bacterial Infections