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At least 613 records · Page 34Linked to original sources
PubMed2001

[A case of desmoplastic malignant pleural mesothelioma].

A 71-year-old woman with no history of asbestos exposure was referred to our hospital for evaluation of mediastinal soft tissue density. Six months prior to the admission, she had developed back pain and had been diagnosed as having intercostal neuralgia. Since the symptoms progressed, she was referred to another hospital. While chest radiography revealed no abnormality, chest computed tomography showed the prominence of mediastinal soft tissue, extending to the left hilum and partially destroying the nearby vertebrae. However, no pleural effusion was noted. After admission, a thoracoscopic examination was performed, and a whitish mass was found on the pleural surface partially adhering to the chest wall. Histological examination of the biopsied material showed dense areas of collagenous tissue with small foci of slightly atypical spindle cells. These findings led to the diagnosis of desmoplastic malignant pleural mesothelioma. The patient was treated with combined chemo-radiotherapy, but the response to this treatment was unclear. To date, reports for this subgroup of malignant mesothelioma are still rare.

Aged↗
PubMed2001

Radiologists' productivity in the interpretation of CT scans: a comparison of PACS with conventional film.

OBJECTIVE: We compared radiologists' times in the interpretation of CT using hardcopy films with the interpretation using a soft-copy picture archiving and communication system (PACS) computer workstation. MATERIALS AND METHODS: One hundred CT examinations were selected at random and reviewed by four board-certified radiologists experienced in soft-copy interpretation. We performed time-motion analysis to determine the total time required to display, interpret, and dictate the individual findings of CT using conventional hard-copy interpretation on a viewbox and soft-copy interpretation, using a four-monitor high-resolution (2048 x 1536 pixel) workstation. RESULTS: Time-motion analysis showed a reduction of 16.2% in the overall time required for soft-copy interpretation of CT compared with that of film. Time savings with soft-copy interpretation were observed for all four participating radiologists. The benefit of soft-copy interpretation was increased for examinations in which there were comparison studies. CONCLUSION: We found that soft-copy interpretation of CT using a PACS workstation requires less time than interpretation using conventional film hung on a viewbox. The transition to filmless imaging has the potential to improve radiologists' productivity and report-turnaround time.

Efficiency↗
PubMed1997

Cutaneous melanoma in patients with sarcoma.

BACKGROUND: The authors became interested in an association between cutaneous melanoma and sarcoma when they reviewed their experience with other malignancies occurring in patients with a diagnosis of sarcoma. METHODS: The authors identified 48 patients with both melanoma and bone or soft tissue sarcoma (STS) by a computer search of all sarcoma patients entered into their institution's cancer registry between 1943 and 1996 who had an additional diagnosis of melanoma. The medical records were reviewed and clinical and pathologic data collected. RESULTS: The median age at diagnosis was 46 years for patients with melanoma and 50 years for patients with sarcoma, which was consistent with population-based data. Among patients with STS (n = 41), malignant peripheral nerve sheath tumors (MPNT) were more common in patients with both diagnoses (5 of 41; 13%) when compared with all adults with STS admitted to the study center between 1982 to date (125 of 2901; 4%; P < 0.05). Liposarcoma occurred in only 1 patient with both melanoma and STS (1 of 41; 2%), despite the fact that it was the most common histologic diagnosis in all adults with STS (625 of 2901; 22%; P < 0.001). The anatomic site of STS was more commonly visceral (11 of 41; 27%) when compared with all adults with STS (424 of 2901; 15%; P < 0.05). A positive family history of cancer was noted in 50% of the patients, and 25% of patients had a third primary tumor. CONCLUSIONS: Although a distinct "melanoma/sarcoma" syndrome was not identified, MPNT as well as visceral sarcomas were more common than expected in this study. The authors also noted strong family histories of cancer as well as additional primary malignancies in patients with melanoma and sarcoma, suggesting a predisposition toward cancer.

Adolescent↗
PubMed1998

[Three-dimensional imaging with computerized tomography. Etiologic considerations and methods for studying temporo-mandibular joints].

INTRODUCTION: The temporomandibular joint (TMJ) had always been studied with conventional tomography and, more recently, with Magnetic Resonance Imaging. Computed Tomography (CT) can demonstrate periarticular soft tissues only. Recently, the introduction of three-dimensional (3D) CT reconstructions with dedicated softwares permitted to demonstrate functional changes in the TMJ with a simple and accurate measurement system. MATERIAL AND METHODS: We examined 347 patients with TMJ disorders using two different 3rd generation CT units and acquiring two series of scans, with the mouth closed and in maximum opening. 3D reconstructions on predefined planes were obtained with a dedicated software and integrated with the electronic measurements of the following morphologic and functional parameters: zygomatic tubercle height, axis of sagittal inclination of the mandibular condyle, TMJ movement range and changes in torsion/dislocation of condylar angle. RESULTS AND DISCUSSION: CT showed the TMJ easily. This examination lasts about 10 minutes, plus 10-15 more minutes for 3D reconstructions. Some artifacts were found on 3D images--thresholding artifacts, defined as pseudoforamina and pseudocalcifications. Neverthless, 3D imaging can easily demonstrate an articular district which is very complex in both morphology and function, supporting or replacing similar subconscious processes made by radiologists themselves. This technique was well accepted by all our patients and functional results were always in agreement with clinical findings. Moreover, CT is the only technique showing both TMJ sides at the same time. Our measurement system was easy to perform, repeatable and comparable also thanks to its potentials of standardization on different CT units. CONCLUSIONS: CT with 3D reconstructions appears the gold standard technique for functional TMJ studies. Even though it provides no information on the joint disk--which MRI does--3D CT permits easy and accurate measurements of both TMJ sides which can support clinical findings.

Humans↗
PubMed2006

Orbital blow-out fractures: surgical timing and technique.

PURPOSE: To recommend a tailored approach to surgical timing in the repair of orbital blow-out fractures, and to offer suggestions for improved functional and aesthetic surgical outcomes. METHODS: Traditional guidelines for surgical timing are reviewed. An evidence-based approach that considers soft-tissue disruption relative to bone-fragment separation is presented. The author's techniques for repair of isolated orbital floor, isolated medial wall, and combined floor-medial wall fractures are presented. RESULTS: As demonstrated previously, greater degrees of soft-tissue incarceration or displacement, with presumably greater intrinsic damage and subsequent fibrosis, result in poorer motility outcomes despite complete release of soft tissues. There is a suggestion that earlier intervention for such injuries might improve outcomes. Lower fornix and transcaruncular incisions, careful extrication of incarcerated tissue, and thin alloplastic implants have proven successful in the author's hands. CONCLUSIONS: The degree of soft-tissue displacement relative to bone fragment distraction, as depicted in preoperative computed tomography (CT) scans, should be considered in the timing of surgery. Incisions, soft-tissue handling, and implant material, thickness, and positioning can all affect the functional and aesthetic outcomes.

Esthetics↗
PubMedDate not supplied

Magnetic resonance imaging of podiatric disorders: a pictorial essay.

Cross-sectional imaging techniques, including computed tomography and magnetic resonance imaging, have become increasingly important in the evaluation of a variety of podiatric disorders. Illustrative cases are used to emphasize the relative merits of the two methods. Generally, magnetic resonance imaging is superior for soft tissue and bone marrow disease, whereas computed tomography affords optional depiction of cortical bone abnormalities.

Foot Diseases↗
PubMed1999

Evaluation of colour and hardness changes of soft lining materials in food colorant solutions.

The aim of this study was to measure the colour stability and viscoelastic properties of three commercially available soft lining materials in vitro, by exposing them to 3% erythrosine, tartrazine and sunset yellow solutions. The colour changes were determined using a computer controlled spectrophotometer. The colour change of three soft lining materials--Molloplast B, Flexor and Coe Super Soft--were determined after 1, 3 and 6 months storage in three different food colorant solutions. The colour changes of Molloplast B was not noticeable. Only the initial colour value of Flexor was significantly different from the other time interval colour measurements. On the other hand, the colour difference of Coe Super Soft was found to be significantly different at all comparative time interval measurements (P<0.05). According to Shore A hardness values, Molloplast B had an initial hardness of 44 in all three solutions, and there was a slight increase after 6 months. Flexor had an initial hardness of 39, at the end of 6 months the hardness changed a little. Coe Super Soft was fairly hard after processing and Shore A hardness was initially 89 which increased to 95 later on. According to these results, only the hardness values of Coe Super Soft showed a statistically significant difference when compared using Wilcoxon signed rank test at the P<0.05 level. As a conclusion, silicon type soft lining material seems to be more resistant to colour change and hardness than the acrylic type soft liners.

Acrylic Resins↗
PubMed1994

The accuracy of computerized prediction of the soft tissue profile: a study of 25 patients treated by means of the Le Fort I osteotomy.

This study was performed to compare the soft tissue movements in facial profile predicted by a computer package with those that had actually occurred following a maxillary advancement osteotomy. The source of the material was serial lateral cephalograms for 25 consecutive patients who had received similar Le Fort I osteotomies primarily to correct an anteroposterior skeletal discrepancy. Many of the digitized points on the soft tissue profile were surprisingly well predicted by the computer package. The chin and profile changes resulting from mandibular autorotation and/or a genioplasty were generally predicted accurately. However, in some cases prediction was less consistent, particularly in the region of the nose and upper lip. In this latter group of patients, initial size, thickness, and morphology of the soft tissues appeared to be important factors to which some consideration could be given in the further refinement of this type of software.

Adolescent↗
PubMedDate not supplied

Plasma cell granuloma of the temporal bone: a case report.

BACKGROUND: Plasma cell granuloma is a rare benign lesion which is found most frequently in the lungs, and a few cases have been described in the head and neck. In the middle ear and mastoid, a case of plasma cell granuloma was reported by Benton et al. METHODS AND RESULTS: A 24-year-old woman was seen with a 7-month history of otalgia and decreased hearing. A computed tomographic (CT) scan showed a soft tissue mass occupying most of the mastoid bone. The mass and the contiguous dura were enhanced homogeneously on magnetic resonance imaging (MRI) scan. Microscopic examination showed plasma cell aggregates mixed with other inflammatory cells and Russell's bodies in a fibrous stroma. Immunoperoxidase studies revealed intracytoplasmic kappa and lambda light chains, and the lesion was confirmed as non-neoplastic and of polyclonal origin (ie, plasma cell granuloma). The patient was treated with conservative surgical excision (a canal-down mastoidectomy) and postoperative radiotherapy (5,040 cGy in 28 fractions) and remains free of disease 1 year after treatment. CONCLUSIONS: A case of plasma cell granuloma is reported, and we believe this is the second case report of plasma cell granuloma affecting the temporal bone.

Adult↗
PubMed2006

[MRI in staging of lung cancer].

PURPOSE: Overview of magnetic resonance imaging (MRI) in staging of lung cancer. MATERIAL AND METHODS: Currently available methods of imaging lung cancer, lymph node and distant metastases by MRI are explained. At present, MRI is mainly used in the detection of cerebral metastases and assessment of infiltration of the thoracic wall and of the mediastinum. The capabilities of T2-weighted single-shot TSE (HASTE) and T1-weighted 3D gradient echo techniques (VIBE) are demonstrated. RESULTS: With the advent of new fast sequences like HASTE and VIBE the spatial resolution comes close to that of computed tomography but with an outstanding soft tissue contrast and without radiation exposure. The introduction of lymph node specific contrast media will improve sensitivity and specificity in N staging. Additionally, whole-body MRI is capable of detecting distant metastases, in particular in the organs at risk, i.e. brain, upper abdomen and musculoskeletal system. CONCLUSION: MRI is gaining importance as part of a multimodal imaging approach for staging of lung cancer.

Humans↗
PubMed2000

[Biomechanics of the shoulder].

The shoulder joint takes a special position among all the other joints of the human body because of its special requirements of stability and mobility. Knowledge of the biomechanics of the shoulder joint forms the basis for the development of modern concepts of reconstructive surgery and arthroplasty. Most of the biomechanical findings are the result of research performed on cadaver shoulders using increasingly sophisticated methods of measurement. These studies elucidate the interaction of the static and dynamic factors which contribute to the delicate balance of the glenohumeral joint. Recently performed research is increasingly being focussed on more detailed analyses of muscle forces and stress distribution in the subchondral bone and periarticular soft tissues. The efficiency of the computer systems now available has enabled the development of complex, virtual shoulder models and three-dimensional finite element analyses. In the future a pure mechanical understanding has to be modified to extend to a concept which includes more data obtained from living subjects, especially with regard to muscle activity under varying loads and neuromuscular feedback systems which currently are difficult to assess.

Biomechanical Phenomena↗
PubMed2005

Five-year evolution of a telangiectatic osteosarcoma initially managed as an aneurysmal bone cyst.

We present the clinical, radiographic, and pathologic features of a telangiectatic osteosarcoma (TOS) of the right femoral neck in a 20-year-old man which was initially diagnosed and managed as an aneurysmal bone cyst (ABC). The lesion recurred twice. At the second recurrence TOS was diagnosed. The first local recurrence was recognized 4 years 8 months after the first operation. The clinical diagnosis for the recurrent lesion was recurrent ABC, and curettage and bone graft with internal fixation were performed. The second local recurrence was observed 8 months after the second surgery. The right lesser trochanter appeared destroyed on the radiograph, and a large medial soft tissue mass was demonstrated by computed tomography. The patient underwent wide resection of the tumor with prosthetic replacement of the right proximal femur. The histologic section for this lesion showed a blood-filled cystic lesion, and its wall contained sarcomatous cells with atypical mitoses and tumor osteoid. The histologic diagnosis for the second recurrent lesion was high-grade TOS. The retrospective review of the histologic section for the primary lesion showed similar features to ABC except for a few bizarre cells without mitosis in the tissue of cystic wall. The patient demonstrates no evidence of disease 13 months after the last surgery without adjuvant therapy (he declined chemotherapy).

Adult↗
PubMed2005

Primary malignant fibrous histiocytoma of the ascending colon: report of a case.

We report a rare case of primary malignant fibrous histiocytoma (MFH) of the ascending colon. A 66-year-old man presented to our hospital with epigastralgia, and abdominal ultrasonography and computed tomography showed a large soft-tissue mass in the ascending colon. Barium enema and endoscopic examination showed a huge tumor in the ascending colon. At laparotomy, we found a tumor in the ascending colon and performed a right hemicolectomy with en bloc lymph node dissection. The resected specimen contained a tumor measuring 14.5 x 8.0 x 4.5 cm, the cut surface of which was yellowish. Based on histological and immunohistological studies, the tumor was diagnosed as MFH of the ascending colon. To our knowledge, only 20 cases of colorectal MFH, including our case, have been documented, which we review following this case report.

Aged↗
PubMed1992

Kasabach-Merritt syndrome in two neonates.

Two neonates with a giant hemangioma associated with thrombocytopenia (Kasabach-Marritt syndrome) have been managed at Kure National Hospital. The first case was initially difficult to distinguish from overwhelming infection or other tumors but improved after radiotherapy. The second case was resistant to radiation and steroid therapy. Magnetic resonance imaging determined a tumor extending into the surrounding soft tissues better than did enhanced computed tomography. Subtotal excision of the tumor and various drugs were effective only transiently and 51Cr-labeled platelets sequestrated into the residual hemangioma. Severe thrombocytopenia persisted for approximately 15 months requiring extra care for head and body contusions, but finally improved by treatment with platelet-active drugs such as acetylsalicylic acid, dipyridamole, and pentoxifylline.

Disseminated Intravascular Coagulation↗
PubMed2005

Orbital inflammation after sub-Tenon's anesthesia.

Two cases of orbital swelling after sub-Tenon's anesthesia are reported. The first patient presented 3 days postoperatively with proptosis and conjunctival chemosis. Computed tomography showed nonspecific inflammation of the orbital soft tissue. Signs and symptoms resolved after systemic steroids. The second patient presented with similar signs and mild pain on the fourth postoperative day. Computed tomography showed a similar diffuse orbital inflammation. The patient was treated with oral steroids and antibiotics, and all inflammation subsided within 4 weeks. Both patients had uneventful cataract surgery, were apyrexial, and were generally well. A few possible mechanisms for these episodes are infection, reaction to povidone-iodine or sub-Tenon's anesthetic, or trauma due to the sub-Tenon's cannula.

Aged↗
PubMed1998

Advantage of appropriate K-edge filters for one-shot dual-energy subtraction sialography.

OBJECTIVES: To determine the optimal added filtration for use for one-shot dual energy subtraction sialography. METHODS: Test phantoms composed of bone and soft tissue materials were imaged with computed radiography using one-shot dual energy subtraction radiography. Eight different additional filter materials were compared with gadolinium contrast. Two numerical measures (absorption ratio and separation index) were used to compare the subtracted images obtained with the various filter/contrast combinations. The K-edge spectra were measured for each filter/contrast combination. A preliminary comparison of a 1.5 M iodine contrast medium with a 1.5 M gadolinium was performed using canine sialography. RESULTS: The gadolinium contrast/samarium filter combination had a larger separation index (P < 0.05). The same combination yielded better sialograms than iodine contrast. CONCLUSIONS: Samarium filter has an optimal k-edge for one-shot dual-energy sialography with gadolinium contrast.

Animals↗
PubMed1979

[Computer tomography of the sacroiliac joints (author's transl)].

Computer tomography, like conventional radiography, can demonstrate inflammatory, degenerative or reparative, traumatic and neoplastic lesions of the sacroiliac joints. In some cases computer tomography adds important information, for instance as regards soft tissue changes near the S.I. joints in the presence of neoplastic or posttraumatic lesions (tumour extension, hematoma). Computer tomography is also able to demonstrate minor disalignment of the sacro-iliac joints (so-called sacro-listhesis).

Bone Diseases↗