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Biomedical subjects

Edward F McCarthy

Publications and source records attributed to Edward F McCarthy.

At least 19 recordsLinked to original sources
PubMed2006

Musculoskeletal tumors: use of proton MR spectroscopic imaging for characterization.

PURPOSE: To determine the value of multivoxel proton magnetic resonance spectroscopic imaging (MRSI) in distinguishing malignant skeletal tumors from benign tumors and normal bone marrow using the metabolite choline (Cho) as a marker for malignancy. MATERIALS AND METHODS: Pathologic specimens obtained from 13 patients who had undergone wide resection for skeletal tumors underwent evaluation by MRSI at 1.5 T. Coronal T1-weighted gradient-echo sequence obtained for localization purposes (TR/TE = 250/1.8 msec, field of view [FOV] = 18 x 18), and single-slice MRSI (TR/TE = 2000/272 msec, FOV = 18 x 18, 10-mm slice-thickness) were performed. Water, lipid, and Cho images were reconstructed from MRSI data. Cho signal was measured in each specimen and expressed relative to background noise level (signal-to-noise ratio [SNR]) where noise was measured between 7.0 and 9.0 ppm. Cho SNRs were compared between areas containing malignant tumor and nonmalignant tissue (benign lesion or normal bone marrow) as determined by histopathology. RESULTS: Specimens included 13 skeletal sarcomas (seven osteosarcomas, three chondrosarcomas, one malignant fibrous histiocytoma, one fibrosarcoma, and one leiomyosarcoma). All specimens included a sample of normal bone marrow and two specimens also contained benign lesions. All sarcomas demonstrated a signal at 3.2 ppm assigned to Cho-containing metabolites in areas of malignancy. Peak Cho SNR was significantly different for areas containing histologically-proven malignancy compared to nonmalignant tissue (9.8 +/- 5.1 vs. 2.7 +/- 1.4, respectively, P < 0.002). CONCLUSION: These preliminary results indicate that MRSI at 1.5 T is a promising noninvasive method of differentiating malignant skeletal tumors from nonmalignant tissue. Using MRSI, Cho can be detected in skeletal tumors and may serve as a marker for malignancy.

Bone Neoplasms↗
PubMed2006

Parosteal osteosarcoma of the thumb metacarpal: a case report.

A 60-year-old man presented with increasing swelling of his right thumb, duration one year. Imaging studies demonstrated a bone-forming lesion extending from the dorsal cortex of the thumb metacarpal and involving the underlying medullary canal. Incisional biopsy yielded the diagnosis of parosteal osteosarcoma. The differential diagnosis for and rarity of parosteal osteosarcoma arising in the tubular bones of the hand are discussed.

Humans↗
PubMed2006

The toxins of William B. Coley and the treatment of bone and soft-tissue sarcomas.

In 1891, William B. Coley injected streptococcal organisms into a patient with inoperable cancer. He thought that the infection he produced would have the side effect of shrinking the malignant tumor. He was successful, and this was one of the first examples of immunotherapy. Over the next forty years, as head of the Bone Tumor Service at Memorial Hospital in New York, Coley injected more than 1000 cancer patients with bacteria or bacterial products. These products became known as Coley's Toxins. He and other doctors who used them reported excellent results, especially in bone and soft-tissue sarcomas. Despite his reported good results, Coley's Toxins came under a great deal of criticism because many doctors did not believe his results. This criticism, along with the development of radiation therapy and chemotherapy, caused Coley's Toxins to gradually disappear from use. However, the modern science of immunology has shown that Coley's principles were correct and that some cancers are sensitive to an enhanced immune system. Because research is very active in this field, William B. Coley, a bone sarcoma surgeon, deserves the title "Father of Immunotherapy".

Bacterial Toxins↗
PubMed2005

Tumoral calcinosis in infants: a report of three cases and review of the literature.

Tumoral calcinosis is the deposition of calcium crystals and salts in the periarticular soft tissues. It commonly is seen as a complication of renal dialysis or in patients with a hereditary disposition. Occasionally, it is seen as an isolated condition with no known cause. Tumoral calcinosis usually affects adults and rarely, children. This disorder is extremely uncommon in infants. Only 13 cases have been reported. In this study three additional infants with tumoral calcinosis are reported, bringing the total to 16 cases. These 16 cases provide the opportunity to compare tumoral calcinosis in infants (younger than 18 months) with the disease in older patients. Although histologic and radiologic features in infants and adults are identical, some clinical features differ. In almost all infants, the disease develops without any predisposing factors, such as a family history. Surgical removal of lesions in infants is curative. By contrast, lesions in adults tend to recur after surgery.

Bone Neoplasms↗
PubMed2005

Unicameral bone cysts of the pelvis: a study of 16 cases.

Unicameral bone cysts of the pelvis are extremely rare. This study summarizes the clinical, radiologic and pathologic features of 16 cases. Patients ranged in age from nine to 69. Most lesions were in the anterior portion of the iliac wing; many appeared to be related to an open iliac crest apophysis. This suggests that the pathogenesis of unicameral bone cysts in this portion of the ilium is similar to that seen in the proximal humerus and the proximal femur. The correct diagnosis was made preoperatively in only five cases. This indicates that, although they are well documented, unicameral bone cysts of the pelvis remain a diagnostic problem. Patients received a spectrum of treatments from curettage to observation. There appeared to be no difference in the outcome after any form of treatment. Therefore, unicameral bone cysts of the pelvis can be managed conservatively. The choice to manage patients conservatively depends on making the correct diagnosis based on clinical history and imaging. The most effective imaging is a combination of plain radiographs, computed tomography (CT) and magnetic resonance imaging (MRI).

Adolescent↗
PubMed2005

Quantification of the microstructural anisotropy of distraction osteogenesis in the rabbit tibia.

A longitudinal orientation of fibers and trabeculae has been observed histologically within distracted callus. This study quantified the intensity and angle of orientation of trabeculae within a distracted callus. Sixteen New Zealand white rabbits underwent unilateral tibial callus distraction with an external fixator across a mid-diaphyseal osteotomy. Included were: a seven-day postoperative latency period, ten days of distraction at 0.5 mm every 12 hours, and 20 days of post-distraction consolidation before euthanasia. Tibiae were removed, stripped of soft tissue, sectioned, and processed for decalcified histology. Micrographs of mid-coronal sections of the callus were evenly divided into 12 regions and underwent Fast Fourier Transform (FFT) analysis of the digitized image to determine the angle and intensity of the orientation of the bony trabeculae within the callus. The microstructure of the regenerate callus demonstrated an angle of orientation that uniformly matched that of cortical bone in all of regions of the callus and an intensity of orientation which approached that of cortical bone.

Animals↗
PubMed2004

Eosinophilic granuloma of the atlas presenting as torticollis in a child.

STUDY DESIGN: This report describes a case of successful surgical treatment of eosinophilic granuloma of the atlas in a 3.5-year-old boy who presented with torticollis. OBJECTIVE: The purpose of this report was to illustrate the rare clinical presentation of eosinophilic granuloma in the atlas. SUMMARY OF BACKGROUND DATA: Eosinophilic granuloma, a benign solitary lesion that commonly affects children, has a variable clinical course. Although eosinophilic granuloma has been reported to occur in the cervical spine, there have been only five reported cases of eosinophilic granuloma affecting the atlas. The management of eosinophilic granuloma ranges from observation and immobilization of the cervical spine to surgical excision. METHODS: The tumor was located on the left lateral mass of the atlas. Biopsy and curettage were performed through an oblique incision through the posterior border of the sternocleidomastoid muscle. A histopathologic evaluation confirmed the diagnosis of eosinophilic granuloma. RESULTS: The patient tolerated the procedure with no complications, and his torticollis has completely resolved. CONCLUSION: Eosinophilic granuloma of the atlas initially presented in this patient as torticollis. Biopsy for confirmation of diagnosis and curettage for treatment provided a successful outcome in this patient. We suggest biopsy of the lesion and histopathologic evaluation to confirm the diagnosis in atypical cases.

Cefazolin↗
PubMed2004

Clear cell sarcoma case report: complex karyotype including t(12;22) in primary and metastatic tumor.

Clear cell sarcoma (CCS) is a rare and aggressive tumor, arising mainly in the soft tissue of the extremities in young adults. A distinctive chromosomal translocation, t(12;22)(q13;q12), has been found in most reported cases. We performed cytogenetic analyses on a primary and subsequent metastatic CCS that contained the t(12;22), along with other complex karyotypic changes. G-banding chromosome analysis was supplemented by spectral karyotyping (SKY), a 24-color chromosome-paint FISH technique, thus allowing identification of three marker chromosomes, unbalanced translocations, and other complex abnormalities. Four of these involved additional copies and structural abnormalities of chromosome 8. Clarifying such secondary karyotypic changes in CCS may prove valuable to the understanding of tumor cell biology and clinical behavior.

Chromosome Aberrations↗
PubMed2004

Phalangeal osteoid osteomas in the hand: a diagnostic problem.

Osteoid osteomas in the phalanges of the hand often present with atypical clinical and radiologic characteristics. These unusual presentations may cause a delay in diagnosis and treatment. In this study, seven cases (seven patients) of phalangeal osteoid osteomas in the hand were examined, six of which were misdiagnosed for long periods of time. These seven cases illustrate unusual presentations, including absence of reactive bone, monoarticular arthritis, clubbing, macrodactyly, painless swelling, and absence of bony lysis. Phalangeal osteoid osteomas also have unusual histologic features. Recognition of these unusual clinical, radiographic, and histologic features may prevent misdiagnosis and lead to prompt definitive therapy.

Adolescent↗
PubMed2004

Vertebral synovial chondromatosis. Report of two cases and review of the literature.

Synovial chondromatosis is an uncommon disorder characterized by the formation of multiple cartilaginous nodules within the synovium, most commonly affecting large joints. Its involvement with the spine is rare; only six cases have been reported. The authors describe two patients with synovial chondromatosis involving the cervical spine. In the first case, synovial chondromatosis arose from the left C1-2 facet joint. This patient underwent a two-stage procedure including a posterior approach for tumor resection and occipitocervical fusion as well as a transmandibular circumglossal approach to the anterior craniocervical junction to complete the tumor removal. Interestingly, on histopathological examination, scattered foci of low-grade chondrosarcoma were intermixed within the synovial chondromatosis. To the authors' knowledge, this is the first report of secondary low-grade chondrosarcoma arising in vertebral synovial chondromatosis. In the second case, synovial chondromatosis involved the left C4-5 facet joint. Tumor resection and cervical fusion were performed via a posterior approach. In this report, the authors describe the clinical presentation, radiographic findings, operative details, histopathological features, and clinicoradiological follow-up data obtained in these two patients and review the literature pertaining to this rare entity.

Adult↗
PubMed2004

Drug therapy increases bone density in osteonecrosis of the femoral head in canines.

Although many different pathogenetic mechanisms have been proposed for osteonecrosis of the femoral head, the repair process leads to structural collapse when bone resorption exceeds production. The purpose of the current study was to determine the effects of two agents with known bone-altering qualities, alendronate and simvastatin, on the healing response of a cryosurgically induced necrotic lesion of the femoral head in canines. Eighteen beagles had cryosurgical necrosis of the right femoral head. After 2 weeks, in a blinded, placebo-controlled, randomized fashion, a 10-mg dose of oral alendronate (n = 6), a 40 mg dose of simvastatin (n = 6), or a placebo (n = 6) was administered daily for 12 weeks. At sacrifice, bone densitometry and histomorphometry quantified bone in the femoral head. In the alendronate-treated animals, a 16% increase in bone mineral density of the femoral head with induced osteonecrosis was found compared with the placebo group. Increases in bone volume and trabecular thickness also were detected in the alendronate and simvastatin groups, with alendronate having the greatest effect. Clinically, increasing the amount of bone in the femoral head may forestall mechanisms leading to joint collapse characteristic of advanced osteonecrosis of the femoral head.

Alendronate↗
PubMed2003

Fetal bony pelvis in the bladder exstrophy complex: normal potential for growth?

OBJECTIVES: To provide the first look at the bony histologic features of fetuses with the exstrophy complex, specifically evaluating the endochondral ossification, stage of development, and microscopic potential for normal growth. METHODS: Three fetuses between 28 and 30 weeks of gestation, one with classic bladder exstrophy, one with cloacal exstrophy, and one control, were obtained from France. The bony pelves were dissected and preserved in formalin, and multiple representative sections were sliced from all pelvic areas: pubis, ischium, ilium, and sacrum. These slices were sequentially processed as slides, stained with hematoxylin-eosin, and evaluated microscopically for histologic changes, developmental stage, and degree of endochondral ossification. RESULTS: All slides from the three specimens showed cartilage analogue with endochondral ossification. Histologically the exstrophy specimens were identical to the control and appeared completely normal; bone development was occurring at an expected rate with the potential for continued normal growth. CONCLUSIONS: These new findings illustrate that fetal bone in the exstrophy complex displays normal microscopic growth patterns and unhindered endochondral ossification at 28 weeks of gestation, well beyond the embryologic period. With no evident microscopic bony defect, the gross bony anomalies in exstrophy should be surgically correctable, leading us to conclude that early reapproximation of the physiologic shape of the pelvis could lead to more normal gross bone growth, decreased shortage of bone, and a more appropriate distribution of the mechanical and developmental forces on a closed, normally functioning pelvic ring.

Abortion, Legal↗
PubMed2003

Mechanisms responsible for longitudinal growth of the cortex: coalescence of trabecular bone into cortical bone.

BACKGROUND: The purpose of the present study was to determine whether longitudinal growth of the cortex occurs through intramembranous bone formation involving the periosteum or through endochondral bone formation involving the growth plate and to explore the cellular and biochemical mechanisms responsible for this process. METHODS: Cortical bone formation was studied in the metaphyses of growing New Zealand White rabbits by means of (1) oxytetracycline labeling and fluorescence microscopy, (2) computer-assisted histomorphometry, (3) osteoblast culture and [(3) H]-thymidine incorporation in the presence of periosteum or periosteum-conditioned medium, and (4) surgical insertion of membranes between the periosteum and the underlying spongiosa. RESULTS: Within the metaphyseal cortex, oxytetracycline labeling produced fluorescent closed curves outlining enlarging trabeculae derived from coalescing endochondral trabecular bone. In this region of coalescing trabeculae close to the periosteum, osteoblast surface was increased compared with trabeculae farther from the periosteum (p < 0.001). The osteoclast surface did not differ. In vitro, osteoblast proliferation was increased in the presence of periosteum (p < 0.001) or periosteum-conditioned medium (p < 0.001). Surgical insertion of permeable or impermeable membranes between the periosteum and the spongiosa did not prevent cortex formation. CONCLUSIONS: These observations demonstrate that metaphyseal cortical bone is formed by coalescence of endochondral trabecular bone. This coalescence is associated with increased osteoblast surface in the peripheral spongiosa. The increased osteoblast surface could be due to inductive effects of periosteum; in the present study, periosteum stimulated osteoblast proliferation in vitro but was not required for metaphyseal cortical bone formation in vivo. CLINICAL RELEVANCE: Understanding metaphyseal cortical growth may help to elucidate the pathophysiology of osseous growth disorders in children.

Analysis of Variance↗