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At least 685 records · Page 38Linked to original sources
PubMed2000

[Long-term results of combined therapy for primary osteosarcoma in extremities].

OBJECTIVE: To evaluate the survival rates, functional outcome, and complications between the combined and non-combined treatment of primary osteosarcoma of the extremities. METHOD: From 1977 through 1992, 170 patients with high-graded, nonmetastatic osteosarcoma were treated. Their average age at diagnosis was 21 years old (ranging from 6 to 52). Tumors were observed at distal femurs in 80 patients (47%), proximal tibia in 51 (30%), proximal humors in 10 and other locations in 22. Combined therapy (en bloc resection of tumor with preoperative and postoperative neoadjuvant chemotherapy) was given 104 patients and non-combined therapy (tumor resection only) to 66. Ninety-four patients underwent limb salvage surgery. In 76 patients who received amputations or disarticulations 33 received chemotherapy. RESULTS: The 5-and 10-year-survival rates were 61% and 53% in the combined therapy group and 28% and 26% in the non-combined therapy group. Local recurrence rate was 23% in limb salvage surgery group and 5.2% in amputation group. Functional evaluation of 80 patients showed that the patients who underwent salvage surgery had higher functional scores than those who had an amputation according to MSTS scoring system (1993). The average scores reached 71% in the salvage surgery group and 53% in the amputation group. CONCLUSIONS: In this study, long-term that combined therapy raised the survival rate of the patients with osteosarcoma. The ase of en bloc resection of bone tumor and reconstructive technique, has enable limb salvage procedures possible to produce excellent functional outcomes. The patients who well have responses to preoperative chemotherapy may have a higher survival rate.

Adolescent↗
PubMed2002

Effect of prenatal doxycycline administration on skeletal differentiation in long bones of Albino rat.

OBJECTIVE: To study the teratogenic risk of Doxycycline administration during gestation on skeletal differentiation. DESIGN: An animal study carried out on experimental Albino rat. SETTING: The study was carried out in the Department of Anatomy Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre (JPMC), Karachi from June 1999 to May 2000. METHODS: Doxycycline was given to pregnant female Albino rats in a dose of 8 mg/kg intraperitoneally from day 8th to 19th of gestation. The intact rat fetuses were isolated on days 15th to 19th of gestation and pups on 1st postnatal day. These animals were then killed by deep ether anesthesia and fixed in 80% alcohol. They were then bulk stained with alizarin red S and alcian blue. Finally they were cleared in 4% KOH and stored in glycerin. The fore and hind limbs were disarticulated from the axial skeleton and observed under stereomicroscope for evidence of skeletal differentiation in the form of presence of primary ossification centers in long bones. The time of appearance of these centers were noted and compared statistically with those in the control animals. RESULTS: The study revealed that the skeletal differentiation in long bones was delayed in experimental animals as compared with controls. CONCLUSION: Doxycycline administration during pregnancy presents a risk to skeletal differentiation and therefore to its growth.

Animals↗
PubMed1975

Combined limb deficiencies and cranial nerve dysfunction: report of six cases.

Six cases have been presented with combined limb deficiencies and cranial nerve dysfunctions. The major features are congenital disarticulation and congenital amputation associated with various orofacial deficits. Anatomic variations in limb and facial anomalies in these cases, as well as in other cases previously reported; seem to indicate that they are part of a single dysmorphic syndrome rather than a group of distinct clinical syndromes as reported in the past.

Abnormalities, Multiple↗
PubMedDate not supplied

Transclavicular access as an adjunct to standard cervical incision in the treatment of mediastinal goitre.

There are cases in which resection of cervico-mediastinal goitres requires additional thoracic access as an adjunct to standard transverse cervicotomy, and typically this takes the form of sternotomy or thoracotomy. The authors propose transclavicular access as an alternative to thoracotomy or sternotomy access for the removal of such goitres. This technical variant is performed by means of resection of the middle third of the clavicle and extraperiosteal disarticulation. They report a case of cervicomediastinal or "plunged" goitre associated with mediastinal metastasis from a follicular thyroid carcinoma in a 77-year-old woman, in whom this technical variant was used. They conclude by stressing the greater effectiveness, ease of execution and relatively limited "aggressiveness" of the technique in comparison with other ways of reaching the mediastinum. The variant proves effective in solving a number of technical, functional and aesthetic problems.

Adenocarcinoma, Follicular↗
PubMedDate not supplied

Ex vivo biomechanical comparison of hydroxyapatite and polymethylmethacrylate cements for use with vertebroplasty.

BACKGROUND AND PURPOSE: Little is known about the mechanical stabilization afforded by new materials proposed for use with vertebroplasty. This comparative ex vivo biomechanical study was designed to determine the strength and stiffness of osteoporotic vertebral bodies (VBs) subjected to compression fractures and stabilized with bipedicular injections of Cranioplastic altered in a manner consistent with the practice of vertebroplasty or BoneSource cement. METHODS: VBs T8-T10 and L2-L4 from 10 fresh spines were harvested from female cadavers (aged 91.5 years +/- 3.9 at death). These were screened for bone density (t score, -4.9 +/- 1.4; bone mineral density, 0.61 g/cm(2) +/- 0.19), disarticulated, and compressed to determine initial strength and stiffness. The fractured VBs were stabilized with bipedicular injections of a predetermined quantity and type of cement and then re-crushed. RESULTS: At both the thoracic and lumbar levels, VBs repaired with altered Cranioplastic resulted in significantly greater strength (P <.05) than that in their prefracture states, whereas those repaired with BoneSource were restored to their initial strength. Cranioplastic resulted in significantly stronger repairs than BoneSource in the thoracic region; however, repair strengths in the lumbar region were not significantly different. The repaired stiffness was significantly lower than the initial stiffness in all treatments and in both regions. Differences in the repaired stiffness between the treatment groups in either region and differences in the mechanical parameters obtained by adding an additional 2 mL of BoneSource were not significant. CONCLUSION: Both materials in the volumes used either restored or increased VB strength, but none restored stiffness.

Aged↗
PubMed2002

Spontaneous auto-amputation of the foot in a case of diabetes, atherosclerosis and gangrene.

Auto-amputation is the spontaneous separation of non-viable tissue from viable tissue, and is usually associated with dry gangrene, occurring in the distal portions of the lower extremities. A 68-year-old female presented with dry gangrene of both feet and subsequent loss of the right foot and digits on the left foot over a period of one and half years. After about six months disarticulation of the right foot from the ankle joint resulted. She gradually lost the digits of the left foot two months later. She had pallor and showed absence of popliteal and distal pulses on both sides. The left foot showed absence of the digits with exposed 3rd and 4th metatarsals and some areas of gangrene and sloughing. Her Hb was 5.4 g/dl and random blood sugar was 340 mg%. Doppler study of the lower limbs showed blockage at the level of the superficial femoral artery on the right side and a patent popliteal artery on the left. She was managed conservatively as she was unwilling for surgical intervention.

Aged↗
PubMedDate not supplied

Extensible endoprostheses for bone tumors of the proximal femur in children.

Between 1983 and 1996, nine children were treated with extensible endoprosthetic replacements of the proximal femur after resection of primary bone tumors. Four patients died of their disease. The remaining five patients were observed for an average follow-up period of 7.6 years. In these five patients, the authors performed an average of 10.2 operations per patient, including five lengthenings and a mean total extension of 69.7 mm per patient. Acetabular loosening and hip dislocations were the most frequent complications. Only two patients have not had a revision or a major complication. Despite this, four children are alive with a functioning lower limb and a mean Musculoskeletal Tumor Society functional score of 77.6%. Extensible endoprosthesis of the proximal femur is a viable alternative to hip disarticulation and in selected children offers an opportunity for near-normal development of the lower limb by allowing equalization of limb length and the ability to walk without the use of mobility aids.

Adolescent↗
PubMedDate not supplied

Treatment of longitudinal deficiency affecting the femur: comparing patient mobility and satisfaction outcomes of Syme amputation against extension prosthesis.

Patients with proximal focal femoral deficiency or longitudinal deficiency affecting the femur were selected from a large regional center. Twenty-eight such patients were identified and were divided into two groups depending on how their condition was managed. Group 1 had opted for the surgical approach of ankle disarticulation (Syme amputation) and the fitting of an above-the-knee prosthesis. The patients in group 2 had been managed in a nonsurgical fashion using an extension prosthesis. They were asked about their level of mobility using the recognized Locomotor Index and their overall satisfaction using self-designed questions. The two groups' scores were similar for mobility whether using their prosthesis or not, but group 1 had lower satisfaction scores than group 2. Current opinion advocates the use of surgery in the management of proximal focal femoral deficiency because it is believed to have better cosmetic and functional results, but in the authors' comparison similar scores for mobility were shown. The nonsurgical extension prosthesis was associated with fewer musculoskeletal and residual limb problems, fewer problems with public transport, and greater satisfaction than Syme amputation. Overall, this small study suggests that the nonsurgical approach is preferable.

Adolescent↗
PubMed2003

Effect of hypothyroidism and thyroxin replacement on growth of long bones in prenatally treated albino rats.

OBJECTIVE: To study the effect of induced hypothyroidism and thyroxin replacement on bone growth. DESIGN: An animal study carried out on experimental Albino rats. PLACE AND DURATION OF STUDY: The study was carried out in the Department of Anatomy, Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Centre (JPMC), Karachi, from June 1999 to May 2002. METHOD: Pregnant female Albino rats obtained from the animal house of Basic Medical Sciences Institute, JPMC, Karachi were treated with carbimazole and carbimazole plus thyroxin from 10th day of gestation till parturition. Another group of pregnant rats did not receive any treatment and acted as controls. Pups born to the treated as well as control animals were sacrificed on 10th postnatal day and fixed in formal saline. They were then processed through 95% ethanol and acetone, bulk stained with alizarin red and cleared in 4% KOH to reveal their bony and cartilaginous elements. The ulna and tibia of both sides were disarticulated from the treated and control animals and measured for intact bone length and diameter. The measurements of the three groups were then compared statistically. RESULTS: The retardation in length observed at the end of experimental period in ulna was by 13.67% and in tibia by 27.84% in carbimazole treated group while in carbimazole plus thyroxin treated group the reduction in length of ulna was 5.08% and of tibia 3.91% when compared with their age matched controls. CONCLUSION: Prenatal hypothyroidism has an adverse effect on bone growth and results in reduction of long bone length.

Animals↗
PubMed1992

Tumoral calcium pyrophosphate dihydrate deposition disease. Report of a case with a review of the literature.

In a 56-year-old female patient with a mass at the proximal end of the left third finger for 22 years, the lesion enlarged obviously during the last 4 years. Initial diagnosis was chondroma with malignant change, and disarticulation of the finger was performed. Pathological diagnosis was "secondary chondrosarcoma". Microscopically, the mass contained a large amount of amorphous basophilic phosphate deposits surrounded by fibrous capsule. The pyrophosphate deposits consisted of birefringent needle shaped or rhomboid crystals which can be identified by polarizing microscope. It can be distinguished as tumoral calcium pyrophosphate dihydrate deposition disease, differing from tophaceous pseudogout, tumoral calcinosis and chondrocalcinosis. Nine cases were collected from the literature and the clinical, radiological and pathological features were discussed.

Calcinosis↗
PubMed1992

Induction chemotherapy in non-metastatic high grade osteo sarcomas--results of pilot study at Cancer Institute (WIA), Madras.

Twelve patients with high grade osteosarcomas of the extremities were treated with two cycles of induction chemotherapy using adriamycin and cis-platinum and sandwich radiation between the two cycles (4000 rads). Ten patients underwent amputation or disarticulation, two patients had wide excision followed by endoprosthesis. The specimen was assessed for grade of necrosis. The Disease Free Survival at a minimum follow-up period of 26 months and median follow-up period of 35.5%. All the five patients who developed distant metastases had shown only a grade I necrosis in the tumour.

Adolescent↗
PubMed1992

[Profuse hemorrhage from the axillary artery in electric burn: prevention and treatment].

A total of 53 cases of electric burns were admitted to our unit during the 1977-1985 period. In 19 cases an upper limb was involved, accounting 35.8 percent of the total. In 15 cases disarticulation of the shoulder was done, and in 3 of them a profuse hemorrhage from the axillary artery occurred as a result of infection of the amputation stumps. The second segment of the axillary artery was ligated during the amputations in the other 4 cases, no hemorrhage occurred in them.

Adult↗
PubMed1992

Metastatic clostridial myonecrosis associated with intra-uterine clostridial infection: a report of three cases.

Three cases of metastatic Clostridial myonecrosis are reported, two following spontaneous and one following criminal abortion. This particular combination has not been reported before. The two survivors were managed by hysterectomy and disarticulation of the leg through the hip. The patient who died did so before surgery could be undertaken. The literature on gas gangrene infections of the uterus and metastatic Clostridial myonecrosis is reviewed and guidelines for management are discussed.

Abortion, Illegal↗
PubMed1992

Human osteology: key to the sequence of events in a postmortem shooting.

Forensic anthropologic examination of human skeletal remains found when a field was plowed provides evidence of both perimortem trauma, suggesting cause of death, and of subsequent shooting of the disarticulated skeleton. The case exemplifies the application of the specialized skills and knowledge of the physical anthropologist to determination of the postmortem sequence of events.

Adult↗
PubMed1992

An alternative bent-knee prosthesis.

Prosthetic fitting in patients with below-knee amputations and concurrent knee flexion contractures poses inherent difficulties to the prosthetic rehabilitation team. The standard bent-knee prosthesis is bulky and awkward. It treats the patient functionally as a knee disarticulation and yields no potential for improving the patient's degree of contracture. This paper describes a case report with an alternative to the bent-knee prosthesis that not only offered improved function relative to the standard bent-knee prosthesis, but also acted therapeutically by reducing the patient's knee-flexion contracture.

Amputation, Surgical↗
PubMed1992

The rotary influence of articular contours during passive glenohumeral abduction.

Automatic external rotation at the glenohumeral joint is an essential component of active as well as passive elevation of the arm through abduction. Recent studies have demonstrated this automatic rotation to be present during passive abduction using cadaveric glenohumeral joints even in the absence of extra-articular influences like the coraco-acromial arch and glenohumeral muscles. In the present study, simulated abduction in disarticulated cadaveric joints was shown to be associated with automatic external rotation suggesting a role in this mechanism for the articular contours.

Aged↗
PubMed1992

Prognosis of osteosarcoma treated by limb-salvage surgery: the ten-year intergroup study in Japan.

We report the prognoses for 107 patients treated by limb-salvage surgery and 147 treated by amputation or disarticulation, during the period 1980-1985, at 22 university hospitals, cancer centers and national hospitals in Japan. In this multi-institute non-randomized study, the five-year cumulative survival rate was 70% for the former group and 49% for the latter. The prognosis was more favorable among patients who responded to preoperative chemotherapy than among those who did not. Limb-salvage surgery was feasible for most of the surgical stage IIB patients with small extraosseous tumor extensions who had responded to preoperative chemotherapy. Local tumor recurrences were seen in 15 (14%) of the 107 patients in the limb-salvage surgery group, nine of whom died of the metastasis. While limb-salvage surgery is being increasingly used in Japan, present indications show the procedure not to reduce survival rate for osteosarcoma patients. The survival rate of patients with wide-with-marginal margins was similar to that of patients with wide margins. Taking into account the long-term survival of osteosarcoma patients, limb-salvage surgery can be recommended when the osteosarcoma responds to preoperative chemotherapy.

Adolescent↗
PubMed2003

The fate of the arachnoid villi in humans.

Villi arachnoidales undergoes in the course of life changes in relation to the skull bones and sinuses. Our aim was to determine the relations of the villi arachnoidales to the skull bone and/or sinuses from the neonatal period to adults. The investigations were performed on collection of 50 disarticulated macerated skull bones from the new-born to 30 years of age and on 20 skulls from individuals in the life period from 30 to 80 years of age. Villi arachnoidales produced imprints on the skull bones in the shape of holes and/or furrows corresponding to different shape of the villi arachnoidales. These imprints appeared very early in the period when the bony sprouts of the large skull bones received a thin covering of compact bone, the future lamina vitrea. At that time villi arachnoidales had no connection with the dural sinuses but with the diploe and with the diploic veins. By agglomeration of the villi in larger and large formations, granula meningea, Pacchionian granulations, the contact to sinuses was realized by means of short channels. The structural changes of villi arachnoidales may produce thrombophlebitis and hydrocephalus externus, especially in children. The fate and the relations of the villi arachnoidales are therefore of great importance for neurologist, neurosurgeon and otorhinolaryngologist.

Adolescent↗