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At least 253 records · Page 14Linked to original sources

PubMed2006

Chondrosarcoma of the ring finger: a case report and review of the literature.

Enchondromas are the most common benign cartilaginous bone tumors arising in the medullary cavity of the small bones of the hand. In contrast, chondrosarcomas, commonly occurring in the pelvis and proximal femur and humerus, are very uncommon at this site. We report an unusual case of chondrosarcoma arising in the ring finger proximal phalanx with its radiological and histological features and reviewed the literature. The patient was an 80-year-old man whose chief complaint was swelling and pain for seven years. The findings of cortical irregular thickening by plain radiography and computed tomography and soft tissue extension by magnetic resonance imaging suggested the tumor was chondrosarcoma rather than a common enchondroma. Thorough curettage and artificial bone grafting was performed because of the age of the patient, his senile dementia and the strong desire of the patient and his family. Histological examination revealed that the tumor was composed of polygonal cells with eosinophilic cytoplasm proliferating in the chondromatous matrix with partially myxoid changes. Nuclear irregularity, binucleated cells, bone permeation and encasement were observed and the tumor was diagnosed as grade 2 chondrosarcoma. The tumor recurred five months after surgery. Amputation of the ring finger including the distal part of the 4th metacarpal was performed. At two years after surgery, the patient was free from recurrence or lung metastasis. In conclusion, details of radiological as well as pathological findings are essential for differential diagnosis between benign enchondroma and chondrosarcoma in the hand. Chondrosarcoma of the hand requires a prompt and more radical treatment than enchondroma. Wide excision is recommended to avoid local recurrence or metastasis.

Aged, 80 and over↗

PubMed2003

A model of fracture testing of soft viscoelastic tissues.

Fracture, or tear, toughness of soft tissues can be computed from the work of fracture divided by the area of new crack surface. For soft tissues without significant plastic deformation, total work, which can be measured experimentally, is composed of the sum of fracture and viscoelastic work. In order to deduce fracture work, a method is needed to estimate viscoelastic work. Two different methods (Ph.D. Dissertation, University of Minnesota, 2000; J. Mater. Sci.: Mater. Med. 12 (2001) 327) have been proposed to estimate viscoelastic work in a fracture test of a soft tissue. The relative merits of these methods are unknown because the true viscoelastic work in an experiment is unknown. In order to characterize the accuracy of these methods, a theoretical model of crack propagation of viscoelastic soft tissue in a tensile test is presented, from which the exact viscoelastic work is calculated. The material is assumed to obey the standard linear solid model. The "exact" solution for the viscoelastic work during the fracture is computed from the model and compared with the work estimated by the two methods. It was found that both methods tend to underestimate the viscoelastic work done, and thus overestimate the fracture work and fracture toughness, although the errors were greater with the Fedewa method. It was further found that low displacement rates can give rise to a "snap" effect, where rapid crack growth can cause a disproportionate amount of viscoelastic energy to be dissipated during unloading. This modeling approach may be useful in evaluating other experimental methods of soft tissue fracture.

Computer Simulation↗

PubMed1997

Smoking, alcohol use, dietary factors and risk of small intestinal adenocarcinoma.

To investigate the role of tobacco and alcohol use and dietary factors in the etiology of small intestinal adenocarcinoma, we analyzed data from a large population-based case-control study of multi-site cancers conducted in Los Angeles County between 1975 and 1984. The present analysis included interview information on 36 small intestinal adenocarcinoma patients and 998 population controls. After adjusting for age and ethnicity, men who smoked more than 100 cigarettes during their lifetimes were at a non-significantly 3-fold increased risk for small intestinal adenocarcinoma; this association was substantially weaker in women. In men and women combined, a significant 3-fold increased risk in heavy drinkers (80+ g ethanol/day) relative to more moderate drinkers and non-drinkers was observed. Although frequent (>6 times vs. less than 2 times of intake a week) intake of foods rich in heterocyclic aromatic amines (based on the combined intake of fried bacon and ham, barbecued and/or smoked meat and smoked fish) was associated with a significant 4.5-fold increased risk of small intestinal adenocarcinoma in men; this association was not present in women. Based on 2 questions that provided a crude assessment of sugar intake, risk of small intestinal adenocarcinoma in men and women appeared to be associated with adding sugar regularly in coffee or tea and daily intake of non-diet carbonated soft drinks. When we computed total sugar intake from tea, coffee and non-diet carbonated soft drinks, there was a consistent and significant trend of increasing sugar intake and risk of small intestinal adenocarcinomas. Compared with the lowest intake level a day (<5 g), medium (5-25 g) and high intakes (>25 g) were associated with ORs of 2.5 and 3.8, respectively.

Adenocarcinoma↗

PubMed1993

Diagnosis and surgical treatment of small papillary carcinomas of the thyroid gland.

The preoperative and pathological findings of 38 cases of small papillary carcinoma of the thyroid gland measuring < or = 10 mm in diameter and 74 cases of large papillary carcinoma measuring more than 10 mm were compared. In the small carcinoma cases, the sensitivity of palpation, ultrasonography, and fine-needle aspiration biopsy (FNAB) was higher than that of computed tomography and soft tissue roentgenography of the neck. Therefore, palpation, US, and FNAB should be instituted as reliable diagnostic methods, but other examinations seem unsuitable as methods for preoperative qualitative diagnosis. No definite correlation was found between the intraglandular dissemination and the size of the carcinoma, and the frequency of metastasis was relatively high even in the small carcinoma cases. If the patient elects to undergo surgery, subtotal thyroidectomy with lymph node dissection should be performed for small thyroid carcinomas as well as large carcinomas.

Adult↗

PubMed1993

Aggressive fibrous dysplasia of the maxillary sinus.

Fibrous dysplasia is usually a slowly progressive, benign disease that develops over several years and presents with deformity or mild symptomatology. Five of 34 patients (ages 4-21 years), who were subsequently diagnosed histologically as having fibrous dysplasia of the maxillary sinus, rapidly developed soft tissue masses of the malar region over a period of less than 4 months with accompanying pain (2 patients) and nasal obstruction and exophthalmos (2 patients). Each was clinically suspected of having a sarcoma; two had been thought to have an "osteofibrosarcoma" on initial biopsy at outside hospitals. After resection, all lesions developed regrowth. At histopathologic examination, both initial and recurrent masses proved to be typical fibrous dysplasia with spicules of woven bone in cellular, sometimes vascular, fibrous tissue. No malignant degeneration was found. On conventional radiography, aggressive fibrous dysplasia produced opacification and expansion of the maxillary sinus and apparent disruption of its wall with an associated soft tissue mass. Computed tomography (CT) demonstrated voluminous heterogeneous masses with "ground glass appearance", calcifications, areas of enhancement, low attenuation, cystic areas, and a thinned, sometimes interrupted, maxillary wall. Despite the aggressive clinical course for both initial and recurrent lesions, the CT findings of a "ground glass" mass with calcifications surrounded by a maxillary sinus wall, even if incomplete, can suggest the diagnosis of aggressive fibrous dysplasia.

Adolescent↗

PubMed2000

[Fulminant necrotizing fasciitis secondary to Crohn's disease].

Necrotizing fasciitis is a life-threatening infection, commonly caused by group A streptococci, which has to be treated by surgical exploration and debridement during the first 24 h. Clinical clues are severe pain, in some cases followed by the appearance of bullous formations, and the detection of gas in the soft tissues by computed tomography or MRI. In addition to that, the infection is characterized by rapid inflammatory progression, producing a highly life-threatening situation. Diagnosis is finally based on surgical exploration obtaining specimens for culture and histopathologic examination. Debridement and exploration, in some cases amputation of the extremity, are indicated as soon as possible. Antibiotic therapy increases efficacy too, but there is no substitute for surgical treatment. Inflammatory bowel disease (Crohn's disease in this case) followed by necrotizing fasciitis is rarely mentioned in the literature. Therapeutic management in a situation of immunosuppression is discussed by illustration of an actual case.

Adult↗

PubMed2006

A case of metastases to the paranasal sinus from rectal mucinous adenocarcinoma.

Metastases of malignancies to the sinonasal tract are rare. We report a case of metastases to the paranasal sinus from rectal adenocarcinoma. A 72-year-old woman, who had a history of therapy with rectal adenocarcinoma, came to our hospital for visual loss in her right eye. Computed tomography revealed soft tissue in the right paranasal sinus. She underwent endoscopic sinus surgery immediately and an easily bleeding tumor was found in the paranasal sinus. Magnetic resonance imaging showed a mass involving the posterior ethmoid, the sphenoid sinus, and the orbit. From the surgical specimen, we found that the tumor was a metastasis of a previously managed rectal mucinous adenocarcinoma. Metastatic carcinomas of the sinonasal tract have a high risk of heavy hemorrhage during endoscopic sinus surgery. When a patient with visual loss has a history of malignancy, a possible metastatic tumor should be considered before surgery.

Adenocarcinoma↗

PubMed1995

Ankle arthroscopy in industrial injuries of the ankle.

Industry-related injuries to the foot and ankle are not uncommon. These cases are often difficult to evaluate with respect to degree of damage and even more difficult to quantitate with regard to functional impairment. This article represents an attempt to determine the role of ankle arthroscopy in the evaluation of ankle injuries that involve compensation or liability. A retrospective review was conducted. The study group consisted of 40 patients who underwent a total of 42 arthroscopic procedures. The patients were evaluated with regard to the mechanism of injury and clinical manifestations. Pain and swelling were the most common preoperative symptoms. The majority of patients had pain localized to the lateral and anterolateral ankle. There were a high percentage of positive bone scans that correlated well with bone pathology but poorly with soft-tissue pathology. Computed tomography (CT) scans were equivalent to tomograms in the demonstration of bone pathology. Follow-up was obtained in 24 patients. At least 50% of the patients had some improvement in their symptoms. Thirty-three percent believed there was no change, and 17% said they were worse. Over 70% of the patients were able to return to work, although 20% had to change their occupation. Fifteen percent were considered disabled. In patients without a specific diagnosis, ankle arthroscopy was helpful in establishing a diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Occupational↗

PubMed2006

Cross-modal interactions between olfaction and touch.

We report two experiments designed to investigate the nature of any cross-modal interactions between olfactory and tactile information processing. In Experiment 1, we assessed the influence of olfactory cues on the tactile perception of fabric softness using computer-controlled stimulus presentation. The results showed that participants rated fabric swatches as feeling significantly softer when presented with a lemon odor than when presented with an animal-like odor, demonstrating that olfactory cues can modulate tactile perception. In Experiment 2, we assessed whether this modulatory effect varied as a function of the particular odors being used and/or of the spatial coincidence between the olfactory and tactile stimuli. The results replicated those reported in Experiment 1 thus further supporting the claim that people's rating of tactile stimuli can be modulated by the presence of an odor. Taken together, the results of the two experiments reported here support the existence of a cross-modal interaction between olfaction and touch.

Adolescent↗

PubMed1997

Magnetic resonance imaging of the musculoskeletal system. Part 8. The spine, section 1.

Magnetic resonance has assumed a preeminent role in the imaging evaluation of the spine. Owing to its multiplanar capability and superior soft tissue contrast, magnetic resonance imaging is the procedure of choice for a host of spinal disorders including degenerative disc disease, tumor evaluation, trauma, and spinal deformities. It represents the most accurate means of distinguishing between recurrent disc herniation and epidural fibrosis, and it excels at the assessment of many postoperative abnormalities such as infection, adjacent segment disc degeneration, and arachnoiditis. Magnetic resonance imaging is also helpful in the evaluation of numerous diagnostic challenges that are less well resolved by other means. This includes the distinction between disc herniation and epidural hematoma, synovial cyst from nonspecific fibrous thickening of a facet capsule, and the evaluation of numerous other soft tissue abnormalities. Computed tomography, computed tomography myelography, and scintigraphy continue to be useful for numerous specific disorders and in those patients with metal hardware or contraindications to magnetic resonance scanning. Overall, however, magnetic resonance is the imaging procedure preferred for many spinal disorders. This article is the first installment of a 3-part series discussing the role of magnetic resonance imaging of spinal disorders. Section 1 will describe the varying imaging modalities available and their relative advantages and disadvantages. A consideration of magnetic resonance imaging techniques will follow, followed by a discussion of the imaging manifestations of early degenerative disc disease. Section 2 will be devoted to an in depth discussion of specific pathologic processes encountered in patients with degenerative disc disease. Section 3 will end the series with a consideration of postoperative imaging followed by a discussion of spinal deformities, trauma, and neoplasms.

Bone Marrow↗

PubMed1989

Spontaneous atlantoaxial subluxation: an unusual presenting manifestation of Reiter's syndrome.

A male Sikh presented with spontaneous neck pain. Plain cervical radiography showed gross atlantoaxial subluxation (AAS). Computed tomography showed soft tissue anterior to a subluxed odontoid peg. A diagnosis of atlantoaxial tuberculosis was considered. Confirmation of this would have required a trans-oral anterior cervical biopsy. Despite the paucity of other rheumatic symptoms a diagnosis of Reiter's syndrome with spondylitis was made, and the only surgical procedure required was posterior fusion of C1 and C2, with resultant spinal stability and pain relief. This is the first report of Reiter's syndrome presenting with AAS.

Adult↗

PubMed1992

Sternocostoclavicular hyperostosis: its progression and radiological features. A study of 12 cases.

Twelve cases of sternocostoclavicular hyperostosis were followed up over four to 16 years. The patients underwent repeated radiological examinations of the sternocostoclavicular joints and the sternum, and the extrasternal osseous manifestations of the disease were studied to show changes in the radiological features during long term follow up. Five of 12 (41%) patients had extrasternal manifestations. With the exception of one patient extrasternal manifestations were first detected by scintigraphs because they were asymptomatic. With respect to the sternal manifestations the initial radiological diagnosis was made during an acute phase while painful swelling over the sternum and decreased mobility of the shoulders occurred. The radiological examinations showed the signs of a proliferative destructive arthritis in most patients. In contrast with the frequent occurrences of clinical symptoms, the radiological signs of progression take several years to become detectable. There are no specific bacteriological, serological or histological findings. Usually a permanent increase in the erythrocyte sedimentation rates is found. Sternocostoclavicular hyperostosis is a slowly progressing disease, characterised by a chronic aseptic destructive sternoclavicular arthritis with a reactive low turnover sclerosis that begins in a similar way to an enthesopathy and ends after several decades with total ankylosis. The radiological identification of retrosternal proliferation of soft tissue by computed tomography was found to be a valuable criterion for the differential diagnosis from other benign hyperostotic processes of the sternoclavicular region.

Cervical Vertebrae↗

PubMed2002

Cosmic rays: are air crew at risk?

This article reviews the current knowledge about cosmic rays and their possible effects on health of air crew, discusses research directions necessary for establishing and measuring the risks, and highlights the need for physicians and air crew to be informed, despite the inconclusiveness of the evidence. A literature review of computerised medical and scientific databases was carried out. Recent reports highlighting increased incidence of cancer among airline pilots and cabin crew have renewed concerns about possible exposure to harmful levels of cosmic radiation at altitude. Such low energy ionising radiation has been shown to cause double stranded DNA deletions and induce genomic instability in human chromosomes. In the field of microelectronics, cosmic rays have been shown to cause "hard" and "soft" errors in computer microchips, in a dose-response fashion with increasing altitude. Pregnant cabin crew members are of special concern. Although the epidemiological evidence is still inconclusive, we know enough to warrant a cautionary stance. The European Union (EU) leads the way in legislation.

Aerospace Medicine↗

PubMed1991

Magnetic resonance imaging of the upper airway in obstructive sleep apnea before and after chronic nasal continuous positive airway pressure therapy.

Magnetic resonance imaging (MRI) provides high-resolution images of the upper airway and is useful for assessing conditions associated with increased tissue water content. To determine whether nasal continuous positive airway pressure (CPAP) changes awake upper airway morphology in obstructive sleep apnea (OSA), we performed awake upper airway MRI scans on five male patients with moderate to severe OSA before and after 4 to 6 wk of nasal CPAP therapy. MRI scans were performed using spin echo pulse sequences to examine detailed anatomy and inversion recovery sequences to assess mucosal water content. Patients did not have nasal CPAP applied during the MRI scans. Axial and sagittal images were obtained, and tracings were made of the upper airway, tongue, and soft palate. Utilizing computer graphics, cross-sectional areas and volumes were calculated for each anatomic structure. A subjective grading system was used to assess upper airway mucosal water content. Pharyngeal volume and minimum pharyngeal cross-sectional area increased (p less than 0.05) and tongue volume decreased (p less than 0.01) following chronic nasal CPAP therapy. The increase in pharyngeal volume occurred mainly in the oropharynx (p less than 0.01). Upper airway mucosal water content decreased in the oropharynx (p less than 0.05). We conclude that chronic nasal CPAP therapy during sleep in patients with OSA produces changes in awake upper airway morphology. These changes may be due to resolution of upper airway edema. The upper airway of patients with OSA can be accurately and repeatedly assessed using MRI.

Adult↗

PubMed1980

Intervertebral disc space infection in a child presenting as a psoas abscess: case report.

Intervertebral disc space infection in children is usually a benign, self-limiting process. We report on what is, to our knowledge, the first case of discitis in a child that developed into an anterior paraspinous abscess. This 13-year-old girl had a 3-month history of low back and leg pain and low grade fever. Roentgenograms of the spine showed collapse of the L-5, S-1 interspace with destruction of the L-5 vertebral body and, on the lateral lumbar view, an anterior soft tissue mass. Computed tomography showed a paraspinous mass to the right of the L-4 and L-5 vertebral bodies. Access to a right psoas abscess was gained through a retroperitoneal abdominal approach; draining of the abscess revealed necrotic disc material extruding from the L-5, S-1 interspace. Her recovery was uneventful. The causative organism proved to be Staphylococcus aureus.

Abscess↗

PubMed1996

Review article: some cost-benefit considerations for PACS: a radiological perspective.

Some cost-benefit considerations for a picture archiving and communication system (PACS) are discussed in relation to a hospital-wide PACS. The acquisition of plain radiography by phosphor f2p4ing plate technology (currently state of the art computed radiography), the soft copy display of the clinical history and radiological reports in association with the corresponding images, and the retrieval and simultaneous display of past with current images, are all considered to be integral to a true PACS. Cost-benefit considerations for a PACS extend far beyond the purely economic issues. More important and far reaching consequences relate to efficient data management provided by a PACS properly interfaced to hospital and radiological information systems. The hardware required to install and operate a hospital-wide PACS is now ubiquitously available and its performance has been amply demonstrated by a number of filmless hospitals. Software design and implementation is now the outstanding consideration determining the clinical and, in particular, the radiological benefit of a PACS.

Cost-Benefit Analysis↗

PubMed2003

[A case of lipoleiomyosarcoma of the spermatic cord].

A 54-year-old male was referred to our hospital with the chief complaint of a painless inguinal mass. A hard mass was palpable beside the left spermatic cord, which was covered with a soft tissue mass. Computed tomographic scan showed an inguinal mass, which was well enhanced to vascular density. The operative appearance indicated a tumor in the left spermatic cord, so we performed a radical orchiectomy. Histopathological diagnosis was lipoleiomyosarcoma. Lipoleiomyosarcoma of the spermatic cord is quite rare, and our case was considered as the first report in Japan.

Genital Neoplasms, Male↗

PubMed1992

[Digital radiology with storage phosphors in cephalometric study in orthodontics].

Conventional radiology is continually modified with the development of digital systems which can be used for several types of radiologic examinations. Our study was aimed at evaluating the advantages of these new technologies in the orthodontic field, where the problems associated with image quality and radiation protection are major especially in young patients; the latter goal is achievable by dramatically reducing radiation dose and by avoiding repeating the exam. In our study, we compared lateral teleradiographs of the skull for cephalometric analysis obtained using conventional and digital diagnostic methods. The preliminary results demonstrated that the two imaging techniques did not differ relative to bone structure representation, even though the digital system provided better visualization of soft tissue structures. Computed radiography also allowed a marked reduction in the number of repeats and reduced radiation dose. The current disadvantages of this imaging method are the high initial cost of the equipment, reduced work rate, and the need of frequent technical assistance.

Adolescent↗