PubMed Health⌕ Search

Biomedical subjects

Dempsey S Springfield

Publications and source records attributed to Dempsey S Springfield.

10 recordsLinked to original sources
PubMed2006

Primary periosteal lymphoma--rare and unusual.

We describe a primary periosteal lymphoma that involved only the periosteum without affecting the adjacent medulla or the regional lymph nodes. No other lymphomatous foci were found in either the distant lymph nodes or viscera. This unusual presentation simulates the imaging appearance of surface lesions of bone, namely benign and malignant tumors, and departs from the typical appearance of primary lymphoma of bone. Therefore, this rare type of lymphoma should be considered in the differential diagnosis of surface bone lesions.

Adult↗
PubMed2005

A novel surgical procedure for bridging of massive bone defects.

BACKGROUND: Bony defects arising from tumor resection or debridement after infection, non-union or trauma present a challenging problem to orthopedic surgeons, as well as patients due to compliance issues. Current treatment options are time intensive, require more than one operation and are associated with high rate of complications. For this reason, we developed a new surgical procedure to bridge a massive long bone defect. METHODS: To bridge the gap, an in situ periosteal sleeve is elevated circumferentially off of healthy diaphyseal bone adjacent to the bone defect. Then, the adjacent bone is osteotomized and the transport segment is moved along an intramedullary nail, out of the periosteal sleeve and into the original diaphyseal defect, where it is docked. Vascularity is maintained through retention of the soft tissue attachments to the in situ periosteal sleeve. In addition, periosteal osteogenesis can be augmented through utilization of cancellous bone graft or in situ cortical bone adherent to the periosteal sleeve. RESULTS: The proposed procedure is novel in that it exploits the osteogenic potential of the periosteum by replacing the defect arising from resection of tissue out of a pathological area with a defect in a healthy area of tissue, through transport of the adjacent bone segment. Furthermore, the proposed procedure has several advantages over the current standard of care including ease of implementation, rapid patient mobilization, and no need for specialized implants (intramedullary nails are standard inventory for surgical oncology and trauma departments) or costly orthobiologics. CONCLUSIONS: The proposed procedure offers a viable and potentially preferable alternative to the current standard treatment modalities, particularly in areas of the world where few surgeons are trained for procedures such as distraction osteogenesis (e.g. the Ilizarov procedure) as well as areas of the world where surgeons have little access to expensive, complex devices and orthobiologics.

Journal Article↗
PubMed2004

A solitary lesion of talus with mixed sclerotic and lytic changes: Rosai-Dorfman disease of 25 years' duration.

Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy) is an unusual form of histiocytic disorder predominantly affecting children and young adults. Bone lesions are infrequent. We describe a 63-year-old woman with a solitary lesion of the talus which was misdiagnosed for 25 years. The patient never had adenopathy or other organ involvement. The radiographic findings were a mixture of sclerotic and lytic changes, an extremely rare and unusual presentation of the disease.

Female↗
PubMed2002

Clinical outcome in chordoma: utility of flow cytometry in DNA determination.

STUDY DESIGN: A retrospective review of 100 patients with chordoma of the lumbar spine and sacrum. Twenty-three patients had flow cytometry data available and a minimum follow-up period of 5 years. OBJECTIVES: To determine whether DNA content and cell cycle analysis were associated with patient outcome. SUMMARY OF BACKGROUND DATA: DNA flow cytometry has been shown to be predictive for biologic behavior of various tumors. Chordoma has been evaluated in very small numbers of patients using DNA flow cytometric analysis, and the utility of DNA patterns in predicting outcome has not been clearly demonstrated. METHODS: Between January 1979 and December 1995, 100 patients underwent surgical resection for chordoma, and 23 had a minimum follow-up period of 5 years with flow cytometry data. DNA content and cell cycle analysis were determined by enzymatically staining cells with propidium iodide dye and passing them through a flow cytometer. DNA histograms were generated. Survivorship and freedom from local recurrence curves were constructed by the Kaplan-Meier method and compared by the log-rank test. RESULTS: The mean follow-up period was 7.3 years. For this group of 23 patients, mortality was 61% (14 patients) and local recurrence was 78% (18 patients). Eleven patients had tumors with diploid DNA content, and 12 patients had tumors with aneuploid DNA content. Metastases occurred in 4 of the 11 patients with a diploid pattern and 6 of the 12 with an aneuploid pattern. Six of the 11 patients with the diploid pattern died, in comparison with 8 of 12 patients with the aneuploid pattern. The Kaplan-Meier estimated survivorship (95% confidence interval) was 78% (66-90%) at a follow-up period of 5 years and 36% at a follow-up period of 10 years (22-50%), and no significant differences were found between patients with diploid and aneuploid patterns. CONCLUSIONS: Patients in whom metastases did not develop had a more favorable clinical outcome. DNA pattern was not associated with local recurrence or survival.

Adult↗
PubMedDate not supplied

Tumors of the shoulder girdle: a review of 194 cases.

The upper extremity is the third most common site of primary bone and soft-tissue tumors. The purpose of this study was to determine the types and prevalence of bone and soft-tissue tumors that occur in the shoulder girdle and to identify physical findings that may be indicative of malignancy. This is a retrospective review of 194 consecutive neoplasms of the shoulder girdle seen by the senior author from 1996 through 2000. Benign tumors (n = 139) were more common than malignant tumors (n = 55). The presence of pain and the presence of mass were not risk factors for malignancy (P = .41 and P = .16, respectively). Malignant tumors occurred in an older population (P < .0007). Tenderness and tumor location in the scapula were also found to be risk factors for malignancy (P = .0002 and P = .0001, respectively). In summary, we have identified 3 variables that were found to be associated with malignancy in the shoulder girdle: older age, tenderness on palpation, and a lesion in the scapula.

Adolescent↗
PubMedDate not supplied

Metaphyseal fibrous defects.

Nonossifying fibromas and fibrous cortical defects are the most common benign lesions of the skeletal system. They are frequently detected incidentally on radiographs taken for an unrelated reason. The diagnosis is routinely made solely on the basis of the history, physical examination, and radiographic appearance. The incidence of multifocal nonossifying fibroma is typically underestimated in patients initially found to have a solitary lesion; the use of a limited skeletal survey rather than bone scan may help detect multifocal lesions in this population. Small, asymptomatic lesions may be followed over time using serial radiographs. Incisional biopsy, curettage, and bone grafting are indicated for large lesions that raise concern for impending pathologic fracture, for lesions that have become painful, and for lesions whose characteristics prevent a definitive radiographic diagnosis. Pathologic fractures involving these lesions should be treated with cast immobilization until the fracture has healed, followed by biopsy, curettage, and bone grafting.

Adolescent↗