PubMed Health⌕ Search

Biomedical subjects

L D Weis

Publications and source records attributed to L D Weis.

14 recordsLinked to original sources
PubMed1999

The success of limb-salvage surgery in the adolescent patient with osteogenic sarcoma.

Malignant bone tumors in the adolescent population are rare but serious problems that are both life- and limb-threatening. Most of these tumors originate in the extremities, hip girdle, or pelvic girdle and require complete surgical resection for adequate therapy. The greatest majority of these tumors are diagnosed as osteogenic sarcomas. In the past, limb ablation was the only effective therapeutic option available to surgical oncologists in adolescent osteosarcoma patients. However, today, after two decades of advances in chemotherapy protocols and reconstructive surgical techniques, limb-salvage surgery has become an accepted treatment standard. Because skeletal immaturity and future bone growth is generally not a major reconstructive consideration in adolescents, 90% of the patients in this age group are today treated with limb-sparing surgery. The most significant question regarding the successful use of limb-salvage surgery is whether it adversely affects long-term outcome compared with standard amputations. The principal studies, both single- and multi-institutional, that compared the risk of local tumor recurrence and overall disease-free survival rate of the two types of procedures, demonstrated no significant difference in disease-free survival rates between the two groups. Similarly, multivariant analyses have shown no survival benefit for choice of surgical procedure in osteosarcoma patients. As a result, limb-sparing surgery for osteosarcoma patients has now been firmly established as a safe, effective, and successful oncology procedure compared with limb ablation.

Adolescent↗
PubMed1987

Increased MR signal intensity in skeletal muscle adjacent to malignant tumors: pathologic correlation and clinical relevance.

Increased signal on T2-weighted magnetic resonance (MR) images has been demonstrated in skeletal muscle adjacent to neoplasms. Clinical significance of this sign was evaluated by reviewing MR images of 50 patients with musculoskeletal disorders. Increased signal in adjacent muscle was present in 22 patients, including 13 of 25 with primary or secondary malignancies of the musculoskeletal system. Biopsy specimens from the affected area in 11 of these 13 patients revealed edema (n = 8) more often than tumor invasion (n = 3). Nine of 25 patients with nonneoplastic processes had increased signal intensity in skeletal muscle because of infection, myositis, or hematoma. In patients who have not undergone previous surgery or radiation therapy and are without an inflammatory mass, increased signal intensity may be a useful indicator of malignancy.

Bone Neoplasms↗
PubMed1986

Rotator cuff lesions of the shoulder: evaluation by direct sagittal CT arthrography.

Direct sagittal computed tomographic scanning (DSCT) of the shoulder was performed in 42 symptomatic patients, six healthy volunteers, and two cadaver shoulders. Axial CT scanning and double-contrast arthrography with plain radiographs were performed in 41 patients for comparison. DSCT enabled correct identification of 27 of 29 lesions in 24 patients. Seventeen patients had normal shoulders. Axial CT scanning and DSCT together enabled correct identification of all lesions and were markedly superior to plain-film arthrography. DSCT enabled diagnosis of all cases of complete rotator cuff tear plus three cases of incomplete tear and three of rotator cuff atrophy not identified by the other techniques. Axial CT scanning was better than DSCT for diagnosis of Bankart lesions.

Adolescent↗
PubMed1986

Total knee arthroplasty in chronic hemophilic arthropathy.

Nine total knee arthroplasties were performed in seven patients with either Hemophilia A (factor VIII deficiency) or Hemophilia B (factor IX deficiency) and followed for an average of 52 months. A total condylar prosthesis was used in eight virgin knees and a stemmed variable axis prosthesis was used in one revision case. All knees demonstrated the severe joint destruction and cartilage erosion characteristic of chronic hemophilic arthropathy. The average age at operation was 32 years. All patients were evaluated using the knee disability assessment of The Hospital for Special Surgery. All knees were postoperatively rated as either excellent or good. Pain, function, and range of motion were markedly improved. Postoperative radiographic alignment averaged 4 degrees of valgus with half of the virgin knees demonstrating 1 mm or less of non-progressive tibial radiolucency without clinical loosening. The only complication was hemarthrosis from 37 to 59 months postoperatively. This was thought to be secondary to trauma to residual synovium. Total knee arthroplasty in the hemophiliac is a viable alternative to conventional methods of treatment for chronic arthropathy and expectations for pain relief and functional gain can be high.

Adult↗
PubMed1985

Metastatic carcinoma of the distal ulna from an occult pancreatic carcinoma.

A case of pancreatic carcinoma presenting as a pathologic fracture of the distal ulna is reported. To the best of our knowledge, metastatic pancreatic carcinoma distal to the elbow has never been reported. An attempt to stabilize the fracture with intramedullary fixation and methacrylate augmentation was unsuccessful. Because of the dismal prognosis of pancreatic carcinoma, therapy should be directed toward pain control and maintenance of function in these patients.

Adenocarcinoma↗
PubMed1978

Cryosurgery in the treatment of giant cell tumors of bone. A report of 52 consecutive cases.

Cryosurgery combined with routine "second look" biopsy has been previously reported in our initial series of 25 cases and has been demonstrated to be a promising modality in the treatment of giant cell tumors of bone. Further refinement of this surgical technique by more careful preliminary curettage has now significantly improved the rate of local tumor control and has markedly reduced the incidence of associated complications. While the problems of infection, fracture, delayed bone healing and local tumor recurrence have not been completely eliminated, our experience with 27 additional cases shows that it has been possible to develop a highly reliable procedure for the eradication of tumor while usually preserving joint motion and avoiding arthrodesis or amputation. The 1.9% malignancy rate is much lower than the previously reported papers by Hutter and Jaffe.

Adolescent↗
PubMedDate not supplied

MR imaging of parosteal osteosarcoma in two skeletally immature patients.

Parosteal osteogenic sarcoma is an unusual tumor in young children. It usually has a tendency to affect people with mature skeletons. The biological behavior of this tumor in children appears to be identical to that in adults, resulting in excellent prognosis after curative operative procedures, even if there is minimal extension to the bone marrow. Magnetic resonance imaging has a significant role in staging the tumor, as other imaging modalities are inferior in demonstrating early bone marrow involvement.

Biopsy↗
PubMedDate not supplied

MRI of elastofibroma dorsi.

OBJECTIVE: To determine if the MR features of elastofibroma are sufficient for diagnosis of this neoplasm. MATERIALS AND METHODS: The MR studies of two patients with pathologically proven bilateral elastofibromas were reviewed retrospectively. RESULTS: In each patient, bilateral semilunar soft-tissue masses demonstrating signal intensities isointense to that of muscle were identified in the periscapular regions deep to the posterolateral musculature of the chest. Focal linear areas of fat were present. The biopsy specimens of both patients demonstrated a positive reaction to the elastin stains. CONCLUSION: A periscapular soft-tissue neoplasm demonstrating a pattern of linear alternating regions of high and intermediate signal intensity on T1- and T2-weighted spin-echo MRI should be sufficient to allow the diagnosis of elastofibroma.

Adult↗
PubMedDate not supplied

Cryosurgery in the treatment of giant cell tumors of bone: a report of 52 consecutive cases.

Fifty-two cases of giant cell tumor of bone have been treated by cryosurgery--an extensive freezing of residual tumor after curettage. Cryosurgery is performed by direct pouring of liquid nitrogen into the tumor cavity through a funnel. The cavity is filled with methylmethacrylate and corticocancellous onlay grafts until peripheral bone regeneration occurs to provide bone stability and prevent postoperative pathologic fracture. Patients with lesions in a weight bearing bone are placed in a long leg ischial weight bearing brace until sufficient healing has taken place. Rebiopsy (a second stage diagnostic procedure) is performed 3-6 months after the original cryosurgery. By comparison of pathology, results and complications between our first series of 25 cases and the additional 27, we have observed only one frank malignant giant cell tumor (1.9% incidence). This is much lower than the previously reported 16% fully malignant complication rate, and may be the result of the rapid elimination of the giant cell tumor by cryosurgery.

Adolescent↗