PubMed HealthSearch

Biomedical subjects

E U Conrad

Publications and source records attributed to E U Conrad.

8 recordsLinked to original sources

Comparison of STIR and spin-echo MR imaging at 1.5 T in 45 suspected extremity tumors: lesion conspicuity and extent.

Short inversion time inversion recovery (STIR) imaging and a double-echo spin-echo (SE) sequence at 1.5 T in 45 sequential patients with suspected extremity tumors were compared to assess the number of lesions detected, subjective conspicuity of lesions, approximate volume of abnormality detected in each lesion, and identification of peritumoral brightening in tissues adjacent to each lesion. STIR sequences enabled detection of all 45 lesions; 44 were detected with the SE sequence. Tumor appeared most conspicuous on STIR images in 35 patients (78%) and was most conspicuous on SE images in 10 patients (22%). Peritumoral brightening, which indicated either peritumoral edema or microscopic tumor infiltration, was detected in 20 patients but was detected only with STIR sequences in nine patients. It is concluded that, although STIR and SE sequences are comparable for lesion detection in the extremities, most lesions appear more conspicuous with STIR. STIR may enable detection of a greater volume of abnormality than SE sequences and may therefore have important implications for local staging and surgical and radiation therapy planning.

Adolescent

Pitfalls in diagnosis: pediatric musculoskeletal tumors.

In general, the 5-year survival for patients with most types of sarcomas has doubled since the 1970s; improved chemotherapy, surgery, radiographic, and pathologic techniques all have contributed to this accomplishment. The 5-year survival for patients with osteosarcoma, like most sarcomas, is approximately 60% when the disease is treated with appropriate chemotherapy, surgery or radiation therapy. The details of treatment are complex and many controversies remain. The initial workup, biopsy, chemotherapy, and surgery should be delivered by a center with experience in the treatment of sarcomas.

Bone Neoplasms

Contralateral total hip arthroplasty or ipsilateral total knee arthroplasty in patients who have a long-standing fusion of the hip.

We studied the cases of twenty patients who had had an ipsilateral total knee arthroplasty or a contralateral total hip arthroplasty, or both, long after one hip had been fused in an acceptable position. Between 1972 and 1986, we performed twenty-one total joint arthroplasties (on thirteen hips and eight knees) and followed two additional patients (one hip and one knee) in whom the operation had been performed elsewhere. The average age of the patients at the time of arthroplasty was fifty-seven years (range, thirty-one to eighty-one years), and the average time from arthrodesis to arthroplasty was thirty-two years (range, eleven to fifty-four years). The results of eighteen of the twenty-three arthroplasties were evaluated at an average of seven years and nine months postoperatively. Four of the remaining five patients, who were followed for an average of eight years, died of a cause that was unrelated to the arthroplasty. After the hip arthroplasty, five hips were rated excellent; five, good; one, fair; and three, poor. Each hip that had a poor result was revised twice for mechanical loosening. Three hips for which the result was not considered poor had progressive radiolucency. After the knee arthroplasty, three knees were rated excellent; four, good; one, fair; and one, poor (because of infection). Seven knees were manipulated a total of fifteen times. Only one patient had progressive symptomatic radiolucency, nine years after the insertion of a posterior stabilized prosthesis. Clinically important ligamentous instability was not encountered.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Fractures and sprains.

Everyone knows that some fractures in children have a great capacity for remodeling and require minimal care. Likewise, everyone knows that some growth-plate injuries have great potential for disaster. The skill comes in knowing which is which.

Arm Injuries

Pediatric spine tumors with spinal cord compromise.

Twenty-nine pediatric spine tumor patients with neurologic deficit were reviewed retrospectively to evaluate tumor control, neurologic course, spinal deformity, and response to treatment. Diagnoses included 10 neuroblastomas, nine sarcomas, eight astrocytomas, and two lymphomas. Mean duration of symptoms at presentation was 8 weeks. Mean clinical follow-up was 7 years 4 months, with patient survival of 66% and a local recurrence rate of 34%. Twenty-four percent (seven of 29) of patients recovered minimal neurologic function with treatment, 76% (22 of 29) showed significant recovery, and two thirds (20 of 29) developed spinal deformity. The initial clinical response to chemotherapy appeared to be most pronounced in sarcoma patients (66% positive response).

Adolescent