Auger-electron-spectroscopy analysis of chemical states in ion-beam-deposited carbon layers on graphite.
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Biomedical subjects
Publications and source records attributed to D Marton.
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Polymorphic B-cell lymphoma seen in four patients with congenital immunodeficiencies and in two patients with leukemia receiving chemotherapy was associated with the Epstein-Barr virus (EBV). The tumors had characteristic histologic features: they were polymorphic consisting of a mixture of lymphoblasts and differentiated cells including plasma cells, and areas of hemorrhagic necrosis were prominent. The tumors were either polyclonal, monoclonal, or multiclonal. Patients with congenital immunodeficiencies who developed these tumors died despite radiotherapy, corticosteroids plus acyclovir, or a combination of intravenous (IV) immunoglobulins and alpha 2 interferon. Patients with leukemia recovered when immunosuppressive drugs were discontinued and leukemia has not recurred over a period of 2 and 4 years, respectively, in the two patients.
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Twenty-one primary bone tumours of the hand in children from 8 paediatric hospitals are reported. Osteochondromas and enchondromas were not included. Our material consisted of 16 patients with common tumours (3 Ewing's sarcoma, 5 aneurysmal bone cyst, 6 osteoid osteoma and 2 epidermoid cyst) and 5 patients with uncommon tumours (osteoma, simple bone cyst, haemangiopericytoma, capillary angiomatous tumour and benign ossifying fibroma or osteoblastoma). The X-ray diagnosis of the common tumours should have high concordance with histology, whereas that of uncommon tumours is much more difficult and uncertain. The characteristic features of Ewing's sarcoma are stressed as all our children with this tumour had a delayed diagnosis and a fatal outcome. Differential diagnosis with other short tubular bone lesions of the hand - specifically osteomyelitis - is discussed and the possibilities of microscopic diagnosis are stressed.
Chondromyxoid fibroma is a relatively rare benign bone tumor whose histologic and radiologic patterns are well known. In this article, we describe a 16-year-old boy with such a tumor in his left tibia. Scintigraphically, this tumor is represented by a "doughnut sign". This aspect, though not pathognomonic, has been reported sporadically in a few diseases: osteoporosis circumscripta cranii, angioblastic meningioma, cranial coccidioidomycosis, and aseptic necrosis of frontal bone. Because of their sites, it is easy to reject these diagnoses in our patient. The most pertinent differential diagnosis with regard to the clinical, radiological, and scintigraphic aspects in the patient is that of a giant cell tumor.
This study reports 12 cases of chronic sclerosing osteomyelitis in children. The authors recall the past history of this disease and describe the clinical, radiological and pathological picture found nowadays. They insist upon the salient features that allow to differentiate this lesion from other types of infectious osteomyelitis and osteoid osteoma.
Thirteen cases of osteoid osteoma and nine cases of osteoblastoma are reported. Diagnostic difficulties of osteoblastoma are illustrated by the versatile radiographic appearances of this tumour. The authors stress the importance of nuclear scan and CT in diagnosis and management.
We report three patients with subperiosteal osteoid osteoma of the talus. All showed an erosion of the dorsal surface of the talus with medullary bone sclerosis. Adjacent paraosseous soft tissue calcification was seen in two lesions. Computed tomography demonstrated the nidus of the osteoid osteoma in two cases.
The authors describe an osteoid osteoma of the upper femoral epiphysis in a child of nine years. Healing was obtained after trans-articular curettage through an anterior approach. The authors have found no other similar case in the literature.
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Dysplasia epiphysealis hemimelica (DEH) is an osteocartilaginous overgrowth involving one or multiple epiphyses or ossification centers, usually in a lower extremity on one side of the body. Characteristically the involvement is hemimelic i.e. either the medial or lateral part of the ossification center is involved. We have studied 24 patients with DEH and are adding 15 new cases to the literature. Because of the variable manifestations of the dysplasia and its different degrees of involvement in the affected children, we have subdivided it into localized, classical and generalized forms. In the generalized form, there is involvement of a whole lower extremity from the pelvis to the foot, and some of these patients show megaepiphyses with enlargement of a whole epiphyseal center, not only its medial or lateral part. We have also described and illustrated other special features of the dysplasia especially the advanced bone age and the metaphyseal and growth plate involvement.
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Two patients with infantile cortical hyperostosis (Caffey's disease) are presented in whom radionuclide imaging with 99mTc-MDP and 67Gallium-citrate was performed to eliminate multifocal osteomyelitis as a diagnosis. The scintigraphic appearance of this relatively uncommon disease of children was similar to that obtained in multifocal osteomyelitis; all osseous lesions showed a marked uptake of both radiotracers. However, the distribution of abnormalities (mandible, scapulae) and the degree of extension (mainly diaphyseal) of the lesions are important characteristics in the scintigraphic differential diagnosis but bone radiographs are best used in making the diagnosis.
Multiple, irregular ball-and-socket deformities at the ends of long bones were noted in four children several years after they had had meningococcemia. Even though these lesions were clinically unsuspected at the time of the fulminant disease, they were probably the result of ischemia secondary to septic emboli to the epiphyseal vessels, which occurred at the same time as soft-tissue necrosis elsewhere. The individual lesions were radiologically identical to the metaphyseal cupping that has been reported following trauma to the growth plate.
Double-curved scoliosis was present in 18.5 of 750 scolioses operated on at the St. Justine Hospital in Montreal. 128 cases were reviewed with a follow up of more than 3 years. Pre-operative curves measured 61 and 58 degrees on average and post-operative curves measured 27 and 23 degrees. At the time of review, the curves were 39 and 36 degrees. The loss of correction varied with the age of the patient and the severity of deformity. The technique of early ambulation improved the post-operative results. However, it was concluded that compression rods did not provide a better correction of the curve or of the thoracic kyphosis.
Osteofibrous dysplasia is a benign, slowly progressive lesion which generally involves one tibia of an infant or young child, and presents as anterior bowing associated with a painless mass. Surgical intervention is usually not indicated but, when carried out, recurrences are common. Osteofibrous dysplasia is readily distinguished histologically from fibrous dysplasia by fibrous stroma, containing bone trabeculae which are rimmed by osteoblasts, and by a "zonal architecture." The radiographic appearance is that of a benign, lucent, intracortical lesion which is expansile and produces bowing of the tibia. Four patients with this condition are presented.
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