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PubMed1983

Thymoma in the dog: two case reports and review of 20 additional cases.

A 7-year-old German Shepherd Dog had a large cranial mediastinal mass that had resulted in chronic weight loss. A diagnosis of benign thymoma was made by transthoracic needle biopsy. The thymoma was removed surgically and the dog recovered without complications. At 4 months after surgery, the dog's activity was improved and it had gained weight. A 12-year-old mixed-breed dog was admitted for evaluation of dependent edema of the neck. Thoracic radiography revealed pleural effusion and lesions in the right lung and left scapula. Neoplastic epithelial cells were found in a needle aspiration specimen from the scapular lesion. The dog was euthanatized and necropsied. The primary tumor, a malignant thymoma, filled the cranial mediastinum and had invaded the cranial vena cava. Metastasis was confirmed in the right lung, liver, and left scapula. Eight cases of thymoma in the dog were retrieved from the Veterinary Medical Data Program. In 5 of the cases, the tumor was benign. The 3 dogs with malignant thymoma developed cranial vena caval syndrome, and they were euthanatized or died. Four of the dogs with benign thymoma were euthanatized for reasons unrelated to the tumor. One dog with benign thymoma was free of tumor when examined 5 years after surgical removal of the tumor.

Animals↗
PubMedDate not supplied

[Site of BCG vaccine administration and development of hypertrophic scars].

In this preliminary report, two groups of children were vaccinated with subcutaneous BCG, one on the deltoid area and the other one on the area between the spine and the scapula. The number of hypertrophic scars on the deltoid area was significantly higher that in the area between the spine and the scapula. Vaccination on this area is as effective in turning the P.P.D. positive as on the deltoid area and the risk of hypertrophic scars in minimized.

BCG Vaccine↗
PubMed1993

The normal shoulder during the butterfly swim stroke. An electromyographic and cinematographic analysis of twelve muscles.

This study describes shoulder muscle activity during the butterfly stroke. Upon hand entry, the deltoids and rotator cuff muscles demonstrated activity as the humerus was abducted, extended, and externally rotated. The rhomboids and upper trapezius were also active, retracting and upwardly rotating the scapula, which positioned the glenoid for the humerus. During propulsion, the pectoralis major and latissimus dorsi generated power. The subscapularis and teres minor were active to control humeral rotation. The serratus anterior helped to pull the body over the arm by reversing its origin and insertion. The posterior deltoid completed humeral extension at the end of propulsion and began to lift the arm out of the water. Then, the middle and anterior deltoids fired with the supraspinatus and infraspinatus to abduct and externally rotate the arm. The scapular muscles were also active, retracting the proximal portion of the scapula while protracting and upwardly rotating the distal tip. The glenoid then provided a platform for the humerus. Overall, the serratus anterior and the subscapularis maintained a high level of activation throughout the stroke; thus, these muscles were highly susceptible to fatigue and vulnerable to injury.

Adult↗
PubMed1996

Atraumatic loose shoulder: the treatment by pectoralis major muscle transfer.

From 1975, 40 shoulders of 34 patients with a loose shoulder were operated on by pectoralis major transfer. The insertions of the clavicular and sternal portions were transferred to the inferior angle of the scapula to bring the glenoid cavity upwards. The follow-up period was 5.3 years on average, and complaints of dullness of the shoulder, feeling of subluxation and dullness of the arm had decreased. However, complaints of dullness of the shoulder girdle had increased at follow-up. The inferior instability had improved in all but four shoulders because this method brings the glenoid cavity upwards and the changes of the upward rotating angle of the scapula were confirmed by roentgenographic investigations. The study of the tracking movement pointed out that this method did not affect the motion of the shoulder, and the high activity of the transferred pectoralis major muscle during the movement was thought to play an important role in reducing inferior instability. This method is most recommended for a patient who has multidirectional instability and can subluxate the head antero-inferiorly by the pectoralis major muscle, but it is not recommended for athletes as the power of the shoulder adductor is reduced to some extent after surgery.

Adult↗
PubMed1996

Electromyographic evaluation of the spared serratus anterior after postero-lateral thoracotomy.

Postero-lateral thoracotomy is the standard access in thoracic surgery, and can be carried out dividing or preserving the serratus anterior muscle. This last method, besides its advantages, is still a matter of discussion, in fact traction has been claimed to cause severe muscular damage equal to section. We have studied 20 patients (16 males and 4 females, mean age 63 years), who underwent postero-lateral thoracotomy sparing the serratus anterior, after 6 months from surgery, both clinically and by means of electromyography (EMG), to evaluate the functional status of the spared muscles. In 4 cases (20%) there wasn't any neurogenic damage nor clinical evidence of winging scapula; 3 cases (15%) had medium neurogenic damage. The remaining 13 (65%) cases had a medium neurogenic damage and only one patient showed a winging scapula, neverthless being able to lift the arm to shoulder level. Our data confirmed that retraction during surgery does not damage the serratus anterior, leaving a functionally valid muscle.

Aged↗
PubMed1997

Epidemiologic evaluation of decubital ulcers in farrowing sows.

OBJECTIVE: To define temporal patterns and risk factors for development of decubital ulcers over the tuber of the spine of the scapula (tuber) of lactating sows. DESIGN: Prospective study. ANIMALS: 147 late-gestation sows and gilts. PROCEDURE: Females were examined for skin lesions over the tubers, and body condition score, depth of back fat, and depth of soft tissues over the tuber (tuber depth) were determined (day 0). On days 5, 12, 18, 40, 54, and 68, sows were examined for lesions over the tubers. Data on sow parity, date of farrowing, total number of pigs born/litter, and number of stillborn pigs/ litter were obtained from farm records. RESULTS: Ulcers were recorded for 33 of 206 (16%) shoulders by day 5. Peak prevalence (99/206; 48% of shoulders) was on day 12, and all ulcers had resolved by day 68. Ulcers were more common on the right shoulder. Considerable resolution of ulcers was evident between days 12 and 18, when sows still were housed in farrowing crates. Parity and tuber depth were significantly associated with ulcers and ulcer severity (size) on day 12. CLINICAL IMPLICATIONS: Decubital ulcers in lactating sows are a multifactorial condition. Factors such as floor type are important, but other physiologic and behavioral factors of periparturient swine, including body weight, body condition and mobility of late-gestation animals, duration of farrowing, and patterns of recumbency and activity, appear to be important in the pathogenesis of lesions. Housing sows on hard floors is not a sufficient cause of decubital ulcers over the scapula.

Adipose Tissue↗
PubMed1977

Dyssegmental dwarfism: a new syndrome of lethal dwarfism.

Dyssegmental dwarfism is an autosomal, recessively inherited, lethal, generalized chondrodysplasia characterized by micromelia, cleft palate, and variable limited mobility at the elbow, wrist, hip, knee, and ankle joints and, in some cases, by occipital encephalocele, inguinal hernia, hydronephrosis, hydrocephalus, and patent ductus arteriosus. Roentgenographically, there is a marked variation in the size of all vertebrae with some anterior wedging, coronal clefts, and lack of caudal interpediculate widening. In addition, there are short, broad tubular bones with metaphyseal widening, variable bowing of the tibia, fistula, femur, radius, and minimally the ulna. In the feet, the talus and calcaneus are poorly modeled, and the 1st metatarsal and 1st proximal phalanx are enlarged. The striking similarities among these cases, as well as the others in the literature, argue strongly for their being a common defect in embryogenesis. However, there is also evidence of heterogeneity. Our case reported here has distinct hypoplasia of the scapulae, absence of carpal ossification centers, and lack of flaring of the ilia, whereas the other cases show well-developed scapulas, accelerated carpal bone maturation, and a wide-flared ilia.

Diagnosis, Differential↗
PubMed1998

[Double oblique MR images of the shoulder: comparison with conventional images].

PURPOSE: Because the scapula is not only slanted on transverse sections but also inclines on sagittal section, we now perform shoulder MR imaging using double oblique images (DOI), which are planes perpendicular or parallel to the long axis of the scapula obtained with oblique sagittal scout imaging. The purpose of this study was to evaluate the usefulness of double oblique shoulder MR imaging. MATERIALS AND METHODS: MR images of shoulders with operatively or arthroscopically proven lesions (20 cases) that had been examined on both conventional images (CI) and DOI were retrospectively reviewed. DOI were compared with CI not only in terms of diagnostic performance but also in their ability to identify the details of shoulder anatomy. All MR studies were done with a shoulder coil on a high-field (1.5T) unit. RESULTS: Although the accuracy of DOI in diagnosing shoulder disorders such as rotator cuff tear and labrum injury was not as good as that of CI, DOI were better for identifying or discriminating muscles and tendons of the rotator cuff, labralbicipital junction and anterior band of the inferior gleno-humeral ligament, and for recognizing the correct position of the glenoid labrum. CONCLUSION: MR double oblique imaging of the shoulder provides more detailed information about shoulder anatomy and disorders than conventional imaging.

Adolescent↗
PubMed1985

Trapezius osteomyocutaneous flap for mandibular reconstruction.

The recent introduction of myocutaneous flaps has kindled the interest in including bone in the flap to reconstruct the anterior mandibular arch and floor of mouth--still one of the most challenging reconstructions in head and neck surgery. The trapezius osteomyocutaneous compound flap has certain advantages over other osteomyocutaneous flaps; the scapula, being a flat bone, receives relatively more blood supply from the periosteum. The absence of bone resorption at more than two years postoperatively has been encouraging, and it has been possible to reconstruct mandible from angle to angle.

Adult↗
PubMed1999

Clinical outcome of total scapulectomy in 10 patients with primary malignant bone and soft-tissue tumors.

BACKGROUND AND OBJECTIVES: Limb reconstruction after total scapulectomy for malignant bone and soft-tissue tumors around the scapula is difficult. This study was undertaken to clarify the clinical results of total scapulectomy in patients with malignant bone and soft-tissue tumors around the shoulder girdle in our institute between 1984 and 1998. METHODS: Ten patients undergoing total scapulectomy had an age range of 12-82 years (average = 56 years). There were 5 cases of bone tumor and 5 cases of soft-tissue tumor. The follow-up period ranged from 8 months to 13 years 5 months. RESULTS: Seven patients are currently alive; the remaining 3 patients died of other diseases. One case of local recurrence was detected. The 2-year survival rate of all cases was 78.8%, and the 5-year survival rate was 52.5%. The average function evaluated by Enneking's criteria was 64.6%. Although the range of motion in the shoulder joint was seriously limited in all patients, the elbow and hand functions were almost normal. Recently, we have used a bone-anchoring system to suture between the clavicle and muscles, including the biceps, triceps, and deltoid muscles. CONCLUSIONS: Patients who undergo total scapulectomy may achieve much better upper limb function than those who undergo forequarter amputation (interscapulothoracic amputation).

Adolescent↗
PubMed1997

Myxoid chondrosarcoma (chordoid sarcoma) of bone: a report of two cases and review of the literature.

BACKGROUND: Chondrosarcoma of bone is a well recognized, relatively common clinicopathologic entity. Morphologically distinct soft tissue chordoid sarcoma (CS), or extraskeletal myxoid chondrosarcoma, is a relatively rare tumor that has generally been documented in extraosseous soft tissues. METHODS: The clinical and pathologic features of two patients with biopsy-proven CS from the pathology files of the Mayo Clinic and St. Thomas's Hospital were evaluated. Routine hematoxylin and eosin-stained slides were reviewed in both cases. Sections from both were examined immunohistochemically using the avidin-biotin-peroxidase technique and employing commercially available antibodies to the following antigens: S-100 protein, cytokeratin (AE1/AE3), epithelial membrane antigen (EMA), CD31, and factor VIII. Appropriate positive and negative controls were utilized throughout these procedures. Cytogenetic analysis was performed on fresh samples obtained from one tumor. Clinical data were obtained from the patients' medical records. RESULTS: The two cases of primary CS of bone arose from the right distal femur and right scapula, respectively, in 2 men ages 48 and 76 years, respectively. Morphologically, the tumors were lobulated, multinodular, and comprised of a uniform population of rounded to slightly spindled cells. Nuclei were hyperchromatic with inconspicuous nucleoli and surrounded by clear, vacuolated to eosinophilic cytoplasm. Neoplastic cells were arranged in anastomosing chords, strands, and, less often, nests and pseudopapillary structures embedded in an abundant, mostly hypovascular, mucinous matrix. Foci of hemorrhage and cystic degeneration were present in both tumors. No well developed hyaline cartilage or neoplastic osteoid was observed. Immunohistochemically, one neoplasm showed focal positivity for S-100 protein but was uniformly negative for cytokeratin (AE1/AE3), factor VIII, and CD31. The other tumor showed no immunopositivity with cytokeratin, EMA, or S-100 protein. Cytogenetic analysis in the latter tumor revealed a nonrandom reciprocal chromosomal translocation, t(9;22)(q22-31;q11-12). Both patients developed local recurrences and widespread distant metastases. Wide surgical excision was the primary mode of therapy. One patient died of tumor. CONCLUSIONS: Skeletal CS is an extraordinarily rare neoplasm with a distinct morphology. Although follow-up data were limited to only four examples, including two from the literature, the clinical course appears worse than that for usual chondrosarcoma of bone. Wide surgical resection appears to represent the best mode of therapy. The role of chemotherapy and radiation therapy has not been clearly defined.

Aged↗
PubMed1996

Relative frequency of a subclavian vs. a transverse cervical origin for the dorsal scapular artery in humans.

BACKGROUND: The origin of the dorsal scapular artery to the rhomboid muscles in humans has been the subject of uncertainty. The present study sought to clarify which of its two most common sources (the transverse cervical artery or the subclavian artery) is the major source of the dorsal scapular artery. METHODS: Gross anatomical dissection was used to visualize the origin and course of the dorsal scapular artery in human cadavers. RESULTS: We found that the dorsal scapular artery typically arises from either of two main sources: the subclavian artery (about 75% of all sides) or the transverse cervical artery (about 25% of all sides). Subclavian origins were approximately equally divided between its second and third part. Other origins for the dorsal scapular artery were negligible in frequency. Those dorsal scapular arteries that arose from the subclavian artery passed between the upper and middle or middle and lower trunks of the brachial plexus to course to the rhomboid muscles. In the case of transverse cervical artery origin, the dorsal scapular artery arose as a branch that passed deep to the levator scapulae muscle before coursing to the rhomboid muscles. No noteworthy differences were observed between males and females. CONCLUSIONS: These results strongly support the simple view, which does not appear widely accepted, that the subclavian artery is the most common source of the dorsal scapular artery to the rhomboid muscles and the transverse cervical artery a major but secondary source.

Aged↗
PubMed1997

SEM corrosion-casts study of the microcirculation of the flat bones in the rat.

BACKGROUND: Little is known about the organization of microcirculation in flat bones in comparison with long bones. This study, therefore, helps us to determine the design of this vascular system in flat bones in relation to their structure and function. METHODS: The organization of microvasculature in parietal, scapula, and ileum bones of 15 young sexually mature rats, aged 6-7 weeks, was studied by light and scanning electron microscopy (SEM) from vascular corrosion cast (vcc), a resin-cast obtained material. RESULTS: Our observations show that the pattern of the microcirculation in flat bones is different in the thick and thin parts of such bones. Where the bone is thinner than 0.4 mm, only periosteal and dural network exist. Larger vessels which do not form a real network connect the two tables of the bones in these regions. In thicker areas, the organization of the microvasculature is similar to that in long bones, with distinct periosteal, cortical and bone marrow networks. Moreover, in different bones, outer networks show slightly different characteristics according to the different adjacent structures (dura mater, muscles etc.). Different types of vessels were recognized by comparing their different diameter, course and endothelial imprints. CONCLUSIONS: The microvascular patterns of the flat bones are strongly influenced by the bone thickness. The different microvascular systems can interact both with the bone modelling and remodeling and with the variable metabolic needs, modifying the microvascular pattern and the blood flow. This is even more important in view of the reciprocal influence of the different networks within the same bone.

Animals↗
PubMed1979

Hemangioendothelioma of bone with pulmonary metastases: a 25-year course: report of a case.

A unique case of hemangioendothelioma of bone arising in the right scapula of a 15-year-old boy is reported. The patient has been followed for over 25 years. After a symptom-free interval of 15 years, he developed a solitary pulmonary metastasis which was removed by left lower lobectomy. Five years later another metastasis was resected from his left upper lobe. During the subsequent five year period he has remained free of further evidence of metastases, attesting to the indolent course which may be taken occasionally by these malignant vascular tumors.

Adolescent↗
PubMed1988

Effects of diphosphonate and x-rays on bone lesions induced in rats by prostate cancer cells.

Prostate adenocarcinoma-III (PA-III) cells deposited over the scapula of Lobund-Wistar (L-W) rats induced osteolytic and osteoplastic changes in that bone. The osteolytic process was prevented and interrupted by administrations of dichloromethylene diphosphonate (Cl2MDP); but the osteoplastic process, once initiated, continued. The latter process was interrupted by ionizing radiation. Treatments of PA-III-affected bones with Cl2MDP and x-rays immobilized both osteolytic and osteoplastic processes.

Adenocarcinoma↗
PubMed1993

Primary extracranial rhabdoid tumors. Clinicopathologic features and response to ifosfamide.

BACKGROUND: Malignant rhabdoid tumor (MRT) is an aggressive, invariably lethal tumor that is resistant to multimodal therapy. METHODS: The authors reviewed the clinicopathologic features, treatment, and outcome of 13 children (7 boys and 6 girls) with diagnoses of primary extracranial MRT at St. Jude Children's Research Hospital between 1981 and 1990. RESULTS: The median age at diagnosis was 8 months (range, 10 weeks-18 years). Primary sites included the kidney (seven patients), liver (three patients), soft tissue of scapula, posterior mediastinum, and retroperitoneum. Seven patients had metastatic disease (lungs, six patients; cutaneous hemangioma, one patient). Ten patients had surgical resection of primary tumor (complete, nine patients; incomplete, one patient). Eleven patients had chemotherapy with multiple agents. Three of four chemotherapy responses observed were with regimens containing ifosfamide. Partial responses (PR, > 50% reduction in tumor size) were obtained in one patient who received single-agent ifosfamide during disease relapse (PR lasting 2 months), one patient who received a combination of ifosfamide, carboplatin, and etoposide at diagnosis (PR lasting 5 months), and one patient who was treated with bleomycin, cyclophosphamide, doxorubicin, and vincristine at diagnosis (PR lasting 5 months) and subsequently with ifosfamide in combination with carboplatin and etoposide during disease relapse (PR lasting 4 months). All patients died at a median period of 5 months (range, 0.5-30 months) after diagnosis. CONCLUSIONS: Based on this review, the authors recommend using ifosfamide alone or in combination with carboplatin and etoposide in front-line therapy for malignant rhabdoid tumor.

Adolescent↗
PubMed2000

Elastofibroma dorsi: elaboration of cytologic features and review of its pathogenesis.

Elastofibroma is a slow-growing soft tissue lesion characteristically found between the inferior scapula and chest wall. Because it behaves clinically in a benign manner, fine-needle aspiration (FNA) represents the simplest and quickest method of obtaining a definitive diagnosis, thus obviating more invasive means of obtaining a tissue diagnosis. However, due to the nature of this lesion a correct diagnosis can inadvertently be missed. Herein we describe the findings of a recent FNA that obtained abundant diagnostic material and elaborate upon the spectrum of cytologic features of the elastic fibers that can be identified. These features should be recognized, since aspiration biopsy in elastofibromas can lead to hypocellular smears. In addition, we discuss recent developments in the pathophysiology of elastic fibers and their application toward understanding the generation of an elastofibroma.

Aged↗
PubMed1986

Quantitative genetic variation in the skeleton of the mouse: II. Description of variation within and between inbred strains.

Variation in the skeletons of over 400 male and female mice from 12 genotypes was investigated by using multivariate statistical methods. A series of discriminant functions explains the differences in the shape of six bones: mandible, os coxae, femur, tibia-fibula, scapula, and humerus. The anatomical features of bone shape described by these functions are summarized together with illustrations of the typical shapes of each bone from the 12 genotypes. Variability within genotypes was investigated by using the Mahalanobis D2 distance--a measure of the difference between two points representing multivariate data--from the group mean. A series of variants were detected ranging from grossly abnormal bones to bones showing subtle differences localized to specific regions. Examples of the variants found are illustrated.

Animals↗