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Biomedical subjects

R E Fechner

Publications and source records attributed to R E Fechner.

At least 73 records · Page 4Linked to original sources
PubMed1987

Idiopathic synovial chondromatosis in two unusual sites: inferior radioulnar joint and ischial bursa.

Synovial chondromatosis is a rare disorder of unknown cause characterized by multiple calcific bodies in the vicinity of the affected joint. It is most commonly seen in the knee, hip, elbow, and shoulder. We describe three cases of synovial chondromatosis in two extremely uncommon sites, the inferior radioulnar joint and the ischial bursa, and review the literature on the subject. The characteristic radiographic appearance, even if in an uncommon location, should prompt the radiologist to suggest the correct diagnosis preoperatively.

Adult↗
PubMed1987

Dedifferentiated chondrosarcoma of bone. An immunohistochemical and lectin-histochemical study.

Ten cases of dedifferentiated chondrosarcoma (DCS) were immunohistochemically and histochemically compared with 12 de novo malignant fibrous histiocytomas, 10 osteoblastic osteosarcomas, 9 conventional chondrosarcomas, and 4 fibrosarcomas (all of bone or soft tissues), in order to discern similarities and differences in the immunophenotypes of these neoplasms. All cases of DCS and malignant fibrous histiocytoma were reactive for alpha-1-antichymotrypsin, and several examples of both tumor types bound peanut agglutinin, and expressed positivity for alpha-1-antitrypsin and lysozyme. None of these four cellular markers was observed in de novo osteosarcoma and fibrosarcoma; in addition, conventional chondrosarcoma lacked all of them except for peanut agglutinin receptors. S100 protein reactivity and binding of wheat germ agglutinin were detectable in conventional chondrosarcomas and in rare cells of the anaplastic components of primary DCS, but not in malignant fibrous histiocytoma arising ab initio and the other sarcomas. These results suggest the evolution of a second neoplastic cellular clone in DCS, with primitive morphological and phenotypic characteristics.

Adult↗
PubMed1987

Endometrial metaplasia associated with endometrial adenocarcinoma.

Endometrial metaplasia is a complex group of epithelial proliferations. The relationship of metaplasia, other than squamous metaplasia, to endometrial adenocarcinoma has not been clearly established. Between 1969 and 1979, 183 patients diagnosed as having Stage I endometrial adenocarcinoma (according to International Federation of Gynecology and Obstetrics) were treated at the University of Virginia Medical Center. Sixty of the patients were treated with hysterectomy without preoperative irradiation. A histopathologic review was performed without knowledge of the clinical outcome and subsequent clinicopathologic correlations were analyzed. On review, 32/60 had carcinoma without metaplasia and 15/60 had both carcinoma and metaplasia. Thirteen of the 60 patients were judged not to have cancer: 12 had both hyperplasia and metaplasia and one had hyperplasia without metaplasia. None of the 12 patients reclassified as having metaplasia had a recurrence or died of endometrial carcinoma. Patients with both metaplasia and carcinoma were significantly younger than patients with only carcinoma and the associated carcinomas were more frequently well differentiated.

Adenocarcinoma↗
PubMed1987

Cervical ligamentous instability in a canine in vivo model.

A canine in vivo model of midcervical ligamentous instability was developed by dividing the anterior longitudinal ligament, anulus fibrosus, and all posterior ligamentous structures including the ligamentum flavum. The natural history of healing in the model, the effect on its healing by an adjacent one-level arthrodesis, and the effect of a one-level arthrodesis on normal adjacent ligamentous structures were studied radiographically, mechanically, and histologically. The authors determined that healing takes place primarily by anterior scar formation in their instability model but not to a degree sufficient to recreate normal mechanical stability. After three months, healing in the model was not affected by an adjacent arthrodesis; however, acutely, instability apparently was increased as three animals became quadriplegic between the second and fourth postoperative days. Arthrodesis did not affect adjacent normal ligamentous structures, during this period. Incomplete healing in the authors' model supports those who advocate arthrodesis as the treatment of choice for destabilizing cervical ligamentous injury. The authors previously reported the case of a patient who sustained bilateral facet dislocations adjacent to an arthrodesed segment and questioned whether this resulted from a stress-concentrating effect. This study indicates that this could well have been the case acutely. Thus, inadvertent exclusion of an unstable segment from an arthrodesis has potentially catastrophic results. Finally, the authors also have previously questioned whether arthrodesis of a midcervical segment could lead to instability of adjacent normal segments. This project does not support such a concern, at least for the three postoperative months of study.

Animals↗
PubMed1987

Immature teratoma of the larynx.

Teratomas are unusual tumors which occasionally occur in the head and neck. The tumor consists of the three basic germ-cell layers, in various degrees of maturation. Because of its malignant potential in adults, complete surgical excision is recommended. The patient we have described is believed to provide the first reported case of laryngeal teratoma in the English literature.

Adult↗
PubMed1987

Carcinosarcoma of the breast: radiologic, ultrasonographic, and pathologic correlation.

Carcinosarcoma of the breast is a rare neoplasm which has been reported less than 20 times. Comprised of both malignant epithelial and malignant connective tissue components, it may radiographically exhibit features of either cellular element. We report the first film-screen mammographic description of such a lesion in a breast. Osteoid matrix calcification demonstrated mammographically should, in retrospect, have suggested osteogenic elements preoperatively.

Aged↗
PubMed1987

Sinonasal undifferentiated carcinoma: a distinctive and highly aggressive neoplasm.

Eleven cases of sinonasal undifferentiated carcinoma were treated between 1975 and 1986. This distinctive neoplasm involved the orbital cavity in 6 of 11 patients (55%) and the cranial cavity in 7 of 11 patients (64%) at the time of presentation. Of the eight patients (73%) who died of disease, six died within 13 months after the diagnosis. One patient has no evidence of disease 10 months after therapy, and two are alive with disease after 15 and 22 months.

Adult↗
PubMed1986

Has monitoring of the contralateral breast improved the prognosis in patients treated for primary breast cancer?

Bilateral breast cancer has a cumulative incidence of about 7% in patients with primary operable breast cancer, and most of these lesions are metachronous. Most retrospective studies have shown that a majority of these patients have invasive cancer in the second breast, and varying percentages have nodal metastases, which may be of a higher stage than the first cancer. Physicians are now more aware of the importance of careful monitoring of the second breast after ipsilateral mastectomy, and improvements have been made in mammographic surveillance. A retrospective, comparative analysis of two separate breast cancer populations at risk for bilateral breast cancer was done on patients who entered into the system before effective mammographic monitoring (BEM) and after effective mammographic monitoring (AEM). The first group of patients consisted of 500 consecutive patients with primary breast cancer diagnosed during the years 1969 through 1975, of whom 37 (7.4%) had bilateral breast cancer. The second group consisted of 557 consecutive patients diagnosed during the years 1977 through 1984, of whom 36 (6.5%) had bilateral breast cancer. The staging percentages of the second breast cancer in the BEM group were Stage 0, 5.4%; Stage I, 48.6%; Stage II, 10.8%; Stage III, 21.6%; and Stage IV, 13.5%. The second group had an improvement in stage, with 33.3% being Stage 0, 22.2% Stage I, 29.6% Stage II, 3.7% Stage III, and 3.7% Stage IV (P less than 0.05). The median interval between primary lesions was 39 months in the first group and 19 months in the second group (in part, this difference may represent increased identification of synchronous cancers). The second breast cancer was undetected by mammography in 9 of 34 (26%) patients. Six were detected by contralateral biopsy (all were lobular carcinomas in situ), and three were found by clinical examination (all were invasive cancers). It was concluded that more aggressive monitoring of the second breast by frequent clinical examination, mammography, and selected contralateral biopsy appears to have increased the early detection rate of second breast cancers in patients under observation.

Breast Neoplasms↗
PubMed1986

Annulus fibrosus calcification in the cervical spine: radiologic-pathologic correlation.

Intervertebral disc calcification can be secondary to a variety of pathologic processes including some of the arthritides, metabolic diseases, and trauma. The annulus fibrosus is the most commonly calcified component and may mimic vertebral body fracture, limbus vertebra, or a persistent ring apophysis. We describe two young patients who developed calcification in the anterior annulus fibrosus and present radiologic-pathologic correlation in this condition in another case. This calcification may actually be secondary to subclinical or chronic stress on the involved intervertebral disc.

Adult↗
PubMed1986

Pleural malignant mesothelioma following Wilms' tumor.

A 28-year-old woman had a left pleural malignant mesothelioma develop, which resulted in her death. At age four, she had undergone a left nephrectomy for Wilms' tumor and had received radiation therapy to the left renal fossa and to the right lung, the latter for a presumed diagnosis of metastatic tumor. Asbestos body counts of digested lung tissue were within the normal range. This is the fourth reported case of malignant mesothelioma following Wilms' tumor and is the first to provide quantitative analysis of asbestos in the lung.

Adult↗
PubMed1986

Dedifferentiated chondrosarcoma: radiographic features.

Dedifferentiated chondrosarcomas, unlike ordinary chondrosarcomas, are highly aggressive tumors that frequently metastasize. The lesion is characterized by a lytic intraosseous or extraosseous soft-tissue mass that is devoid of the calcifications that are usually associated with a chondroid tumor. We describe the radiographic and pathologic features of five cases involving dedifferentiated chondrosarcoma.

Acetabulum↗