Biomedical subjects
Publications and source records attributed to W K Taconis.
2 cases with primary malignant bone tumour - 1 with osteosarcoma in the distal femur and 1 with chondrosarcoma in the proximal humerus - are described in which treatment with limb-saving procedures instead of ablative surgery was possible. In connection with these two case studies a review and discussion is given about the value and limitations of different imaging studies, particularly CT, angiography and scintigraphy.
The salient radiological features of 102 cases of fibrosarcoma and of so-called malignant fibrous histiocytoma (MFH) of the long bones are presented. All cases registered with the Netherlands Committee on Bone Tumours in the period 1953-1976, were originally classified as fibrosarcoma. In a recent review of the pathological material approximately half of these tumours were reinterpreted as malignant fibrous histiocytoma. As the two neoplasms demonstrate no difference in their clinical picture, radiological appearance, and survival statistics, we did not study both groups separately. Favourable radiographic signs which suggest a longer survival rate included: a geographic type of bone destruction, eccentric location, and cortical destruction involving no more than two quadrants of the bone circumference. Based on these findings a grading system is presented which differs from that proposed by Lodwick et al. [21].
Radiologic morphometry was performed in 125 patients with femoral neck fractures and 74 elderly control subjects to evaluate simple parameters for screening of the population at risk. Reproducibility of metacarpal cortical thickness was high when measured in six metacarpals. Values of this parameter were similar in patients and control subjects. Reproducibility of the Singh index was poor. The patients with femoral neck fractures had a higher vertebral index, more vertebral crush fractures, and a lower Singh index than the control subjects. There was no significant difference in these radiologic indices between cervical and intertrochanteric fractures. The radiologic indices correlated poorly with each other and with histomorphometric data from transilial bone biopsies of the patients. Stepwise discriminant analysis allowed correct classification as patient or control subject in only 69.8% of the cases, with the Singh index having the highest predictive value. The reported observations indicate a need for a more accurate technique for local assessment of the bone mass in the femoral neck.
The possible scintigraphic detection of active inflammation of the bowel was studied after injection of Tc diethylene triamine pentacetic acid (DTPA). The study included 5 cases of proven active colitis ulcerosa or Crohn's disease and 6 volunteers without any gastrointestinal complaints. No significant differences in the images of both groups could be demonstrated. In both groups some accumulation of radioactivity in the intestines was found, but it was impossible to distinguish any anatomical entity. The sensitivity of Tc DTPA scanning seems to be insufficient to differentiate between a reactivation and a chronic inflammatory process.
The accuracy of scintigraphy in focal liver disease was evaluated by comparing the scintigraphic and autopsy findings in 59 patients. The interval between scintigraphy and autopsy was not more than a few weeks. The overall agreement rate was 49 in 59 (83%), with four out of 26 (15%) false positive and six out of 33 (18%) false negative reports. Defects smaller than 2 1/2 cm were the principal source of false negative reports. The accuracy of interpretation in cases with liver weights up to 2000 g was significantly (P less than 0.025) lower than for higher weights. Detection of a single focal lesion by scintigraphy was found to be unreliable (only two out of 13 correct). Estimation of spleen weights by scintigraphy was disappointing. Liver weight estimates were somewhat more satisfactory.
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This paper describes radiological characteristics of the skeleton in a patient suffering from type II fucosidosis. The early symptom of anterior beaking of the vertebral bodies, in combination with mental retardation and angiokeratoma corporis diffusum, can suggest the possibility of type II fucosidosis.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.