Search PubMed⌕ Search

Biomedical subjects

S S Spanier

Publications and source records attributed to S S Spanier.

At least 37 records · Page 2Linked to original sources
PubMed1988

Surgical treatment for osteosarcoma.

Fifty-three patients who had a high-grade osteosarcoma had either a limb-salvage resection or an amputation. They all received adjuvant therapy that consisted of administration of Adriamycin (doxorubicin) and whole-lung irradiation. At the time of follow-up, the surgical margin was assessed by examination of the surgical specimen. Each patient was followed for at least three years or until death. The data suggested that a wide surgical margin is adequate to control a primary osteosarcoma. When a wide surgical margin can be used and a functional limb can be salvaged, an amputation probably is not required.

Adolescent↗
PubMed1987

Flow cytometric analysis of DNA in bone and soft-tissue tumors using nuclear suspensions.

Ninety-four bone and soft tissue tumors were analyzed for their DNA content using flow cytometry (FCM). A simple, rapid method for preparing isolated nuclear suspensions was used. Tissues, minced in a hypotonic solution containing detergent and propidium iodide as a fluorescent probe for DNA, provided in most instances high nuclear yields from only 0.02 to 0.03 g of solid tumor. Whereas all nonneoplastic samples had a diploid DNA content, various degrees of abnormal DNA distributions were detected in 90% of the neoplastic samples and were present in benign as well as malignant tumors. Our findings demonstrate that FCM DNA analysis is practical in most musculoskeletal tumors and support the observations of others that abnormal DNA content may serve as a general neoplastic marker in these tumors.

Bone Neoplasms↗
PubMed1984

Radiology of giant cell tumors of bone: computed tomography, arthro-tomography, and scintigraphy.

Radiologic studies of 50 giant cell tumors of bone in 48 patients were useful in assessing the anatomic extent for planning surgical treatment. Contrast-enhanced computed tomography (CT) provided the most useful and complete evaluation, including soft tissue extent and relationship to major vessels. Angiography was useful when the extraosseous extent and vascular relationships were not entirely clear on CT. Arthro-tomography was the best way to evaluate tumor invasion through subchondral cortex and articular cartilage. Reactive soft tissues, with edema and hyperemia, were difficult to distinguish from tumor tissue on CT and angiograms. Bone scintigrams often showed intense uptake beyond the true tumor limits.

Adolescent↗
PubMed1984

Aggressive fibromatosis: evaluation by computed tomography and angiography.

Fifteen CT scans of 13 patients who had aggressive fibromatosis were generally accurate in showing the extent of disease, although the CT definition of half or more of the margins of nine lesions was poor. Fibromatosis tumors were typically isodense or slightly hypodense with muscle when no contrast medium was used, and they enhanced to hyperdense with better delineation during infusion of contrast medium. Obliterated intermuscular planes did not always signify disease extension; the relationship to bone was often obscured by beam-hardening artifact; and small blood vessels were often invisible. Arteriograms of seven of eight patients showed some hypervascularity and helped to delineate lesions and vessels that were poorly seen on CT scans. In four instances CT findings were clearer, in two instances arteriographic findings were clearer, and twice the findings were equally clear. Three of six bone scintigrams added accurate information about involvement of adjacent bones. Since fibromatosis can microscopically infiltrate beyond the margins indicated by radiographic studies and even by direct palpation at operation, the surgeon should obtain a wide margin beyond the defined tumor limits.

Adolescent↗
PubMed1984

Benign exostoses and exostotic chondrosarcomas: evaluation of cartilage thickness by CT.

Computed tomograms of 16 benign exostoses and 15 exostotic chondrosarcomas were generally accurate in delineating anatomy for purposes of planning surgery, but they were inaccurate in the detection and measurement of the cartilage caps of the lesions. CT studies of 14 of the benign exostoses failed to show any cartilage cap, although the maximum cartilage thickness of these 14 lesions ranged from 0.1 to 2.5 cm pathologically. CT did demonstrate thick cartilage in 14 of the 15 chondrosarcomas, but the CT measurements of maximum thickness often were imprecise. Altogether, 15 CT studies failed to show any cartilage cap; 14 of these lesions were benign. CT did not reliably detect cartilage caps less than 2.5 cm in maximum thickness, and CT measurement of cartilage thickness was imprecise when the cartilage was 1.5 to 2.5 cm thick. For this reason, CT did not solve the difficult problem of distinguishing between benign exostoses with relatively thick cartilage caps and exostotic chondrosarcomas with relatively thin cartilage.

Adolescent↗
PubMed1984

The comparative value of bone scintigraphy and computed tomography in determining bone involvement by soft-tissue sarcomas.

In seventeen patients with a soft-tissue sarcoma, bone scintigrams were found to be more useful than computed tomograms for evaluating bone involvement. The scintigrams had higher predictive value and higher sensitivity, as there were no false-negative or false-positive scintigrams, while there were three false-positive computed tomograms. Accurate scintigraphy requires the use of high-resolution static gamma-camera images that show the tangential relationship between tumor and bone. The images that are usually made in surveying the skeleton for metastatic disease--routine whole-body bone scans, or even gamma-camera images that provide only anterior and posterior views--are inadequate. They did not demonstrate the true relationship of the tumor to bone in the patients in this study when activity within the tumor itself was superimposed over bone. In such patients, properly selected oblique views sometimes showed that the tumor was clearly separate from normal bone activity. Determination of the relationship of the soft-tissue tumor to bone is an important part of the accurate anatomical staging that is required to select appropriate surgical management.

Adolescent↗
PubMed1983

Radiologic imaging of osteosarcoma: role in planning surgical treatment.

We reviewed radiographic studies of 50 central osteosarcomas to assess their accuracy and contributions to surgical treatment planning. Accurate anatomic delineation was especially important when limb-sparing tumor resection was considered. The plain roentgenograms yielded most of the diagnostic information, and often showed large masses located so that major neurovascular involvement was inevitable. Conventional tomography added little. Computed tomography (CT) usually was accurate in showing tumor extent and relationships to major nerves and vessels. However, CT was less useful when vessels were not seen, when edema and hemorrhage (especially after biopsy) blurred tumor margins, or when tumor margin and soft tissue planes blended together without clear definition. Angiography was essential when vascular relationships were unclear on CT. Scintigraphy occasionally revealed subtle intra-marrow tumor extension, but nonspecific increased uptake beyond the true tumor limits was more common than occult tumor spread.

Adolescent↗
PubMed1983

Radiology of medullary chondrosarcoma: preoperative treatment planning.

We evaluated the radiologic studies of 30 medullary chondrosarcomas with respect to their accuracy in diagnosis and surgical staging. There were 30 sets of plain radiographs, 14 conventional tomograms, 26 radionuclide bone scans, 19 arteriograms, and 15 computed tomograms (CT). Plain radiographs provided most of the diagnostic information although many tumours looked benign. CT provided the most complete anatomic staging, including intra- and extraosseous tumor, and neurovascular involvement. However, it was difficult to be sure about subtle soft tissue invasion. Arteriography remained useful for evaluating major vessel involvement or cortical penetration when CT and conventional tomography were equivocal. Scintigrams disclosed increased uptake, usually corresponding to the true tumor extent; "extended uptake" beyond the tumor was uncommon. Conventional tomography has been largely replaced by CT, but was occasionally useful when the tumor was near the end of a bone.

Adult↗
PubMed1981

The effect of the Anatomic setting on the results of surgical procedures for soft parts sarcoma of the thigh.

The results of surgical treatment in 40 patients with a soft tissue sarcoma of the thigh were analyzed to determine the influence of the anatomic setting on the effectiveness of the procedure. The anatomic setting, based on functional anatomic compartments, was defined as either intra- or extracompartmental. The lesions were graded for aggressiveness as either high or low. The lesions were staged by biologic aggressiveness, anatomic setting, and metastases. The procedures, whether amputations or local resections, were classified by the relationship of the surgical margin to the pseudocapsule and reactive zone about the lesion as marginal, wide, or radical. Marginal procedures were done four times with two recurrences. Wide margins were achieved 12 times. When done for low grade lesions, there were no recurrences (0/2), but when done for high grade lesions, the recurrence rate was 30% (3/10). Radical margins were obtained 24 times. There was one recurrence after a radical procedure. Recurrence rates did not depend upon whether the procedure was a resection or amputation but upon the margin achieved. The anatomic setting of the lesion was intracompartmental in 13 cases and extracompartmental in 27. Not only were surgically adequate margins achieved more often for intracompartmental lesions (10/13) than for extracompartmental lesions (17/27), but there was a significant difference in the manner required to achieve an adequate margin. Although 9 of the 13 intracompartmental lesions were amenable to nonablative resection, only 3 of 27 extracompartmental lesions were resectable. The margin required for local control (wide vs. radical) was dictated by the biologic aggressiveness (grade) of the lesion. How the necessary margin was most satisfactorily achieved (resection vs. amputation) was determined by the anatomic setting (intra- vs. extracompartmental).

Adolescent↗
PubMed1981

The role of radionuclide bone-scanning in determining the resectability of soft-tissue sarcomas.

In sixty patients with soft-tissue sarcoma, radionuclide bone scans were 92 per cent accurate in evaluating the presence or absence of involvement of contiguous bone by the tumor itself, by the tumor's reactive pseudocapsule, or by tissue contaminated during inadequate excision. The scans were most helpful when the relationship of the tumor to the bone was crucial in determining the resectability of the tumor. Meticulous imaging technique is essential to a complete and accurate radionuclide study. High-resolution, high-count gamma-camera scans in multiple projections are required for precise localization of tumor.

Biopsy↗
PubMed1979

Angiography of malignant fibrous histiocytoma of bone.

Angiograms of 10 cases of malignant fibrous histiocytoma of bone were reviewed and correlated with surgical and pathological findings. Nine tumors were hypervascular. Seven demonstrated malignant characteristics (laking in one and coarse tumor vessels in 6). Seven tumors displaced adjacent normal vessels. All angiograms accurately delineated soft-tissue masses and cortical breakthrough but intraosseous extent was less clearly defined. Tumor thrombi within draining veins were evident retrospectively in one instance. Angiography in these cases contributed substantially to surgical management.

Angiography↗
PubMed1975

Aural abnormalities in partial DiGeorge syndrome.

DiGeorge syndrome patients frequently have multiple anomalies of the craniofacial, cardiovascular, and visceral structures in addition to thymic and parathyroid hypoplasia. Gross and microscopic aural abnormalities occurring in a patient with partial DiGeorge syndrome are presented and compared with findings from the only other known temporal bone report.

Abnormalities, Multiple↗
PubMed1975

Primary malignant fibrous histiocytoma of bone.

A review of over 400 primary bone tumors yielded 11 lesions with features allowing classification as malignant fibrous histiocytoma on a purely histological basis. Correlation with roentgenograms and clinical data indicated that these tumors occurred as osteolytic lesions associated with a high incidence of pathologic fractures in the metaphyses of skeletally mature long bones. Nine patients developed pulmonary metastases and 3 developed lymph node metastases within 21 months following diagnosis. The average survival was 12 months in 6 of the 9 patients who had no secondary treatment in their metastases. Treatment of 3 patients with metastatic lesions with chemotherapy or radiotherapy has been clinically encouraging. Some evidence was obtained that either or both the histiocytic and fibroblastic component may metastasize. There is a need for biopsy of metastatic lesions and autopsy followup to more accurately assess the mode of spread and histologic type of the metastases.

Adolescent↗
PubMedDate not supplied

Laryngeal clefts: a histopathologic study and review.

The histopathologic findings in a case of laryngeal cleft studied by serial sectioning, and a literature review of this clinical entity are presented. The primary micropathologic findings include a cleft deformity of the posterior cricoid lamina, and alterations in muscle differentiation involving the interarytenoid and posterior cricoarytenoid muscles. Possible embryogenic mechanisms are discussed. The clinical picture is characterized by signs and symtpoms of aspiration with airway obstruction, and definitive diagnosis is achieved by endoscopic examination. Treatment consists of surgical repair, although some patients with type 1 laryngeal clefts may be managed on a conservative trial. The need for uniform classification of laryngeal clefts in future reporting is emphasized.

Congenital Abnormalities↗