骨肉瘤骨膜异常的影像表现与病理研究

目的 总结骨肉瘤骨膜异常的类型和影像特点,探讨骨肉瘤骨膜异常的病理基础.方法 经手术病理证实的骨肉瘤128例,男76例,女52例.年龄5～66岁,平均19岁.全部患者均经X线及MR检查,其中MR平扫加增强109例,扩散成像23例;CT检查48例,36例加行增强扫描;病理大体标本、大切片及定位取材常规切片共14例.将影像检查结果与手术、病理结果进行对照分析.结果 影像和病理表现:(1)骨膜水肿96例,只能在MRI上显示.病理上表现为骨膜结构疏松,无肿瘤细胞浸润.(2)骨膜掀起、增厚,可在CT、MRI上显示,但以MRI敏感(CT显示13例,MRI显示42例).病理上为骨膜掀起、增厚,无肿瘤浸润.(3)无骨膜新生骨的骨膜破坏48例,只能在MRI上显示.病理上为灶性或整个骨膜被肿瘤浸润.(4)线状骨膜新生骨,X线片、CT及MRI上各显示42、13及22例.病理上骨膜新生骨呈单层排列.(5)层状骨膜新生骨,X线片、CT及MRI上各显示21、6及21例.病理上,新生骨小梁呈多层排列.(6)放射状骨膜新生骨,X线片、CT及MRI上各显示13、7及14例,在X线片、CT上,越近病变中心针状影越长、密度越高.病理上,针状影间为肿瘤组织.(7)混合型骨膜新生骨,X线片、CT及MRI上各显示7、4及8例.为2种或2种以上的骨膜新生骨的混合表现.结论 (1)骨肉瘤可引起多种形态的骨膜异常,不同骨膜异常有不同的影像表现及病理基础.(2)所提出的对骨膜异常的分类,以病理所见为基础,较好地概括了骨膜各种病理改变的3种影像表现.(3)MRI可显示X线片、CT不能显示的骨膜水肿、无骨膜新生骨的骨膜破坏等更早期的骨膜异常,显示骨膜掀起、增厚也较CT更敏感.     

骨斑点症1例报告

患者女28岁。以车祸外伤来院就诊，平素体健；x线检查示：双肩、腕、膝关节各骨近关节端均见多发圆形、类圆形及斑点状致密影，大小在0．2—1．0crn之间，边界清晰，分布均匀，以近骨皮质下分布为主，未见与骨皮质相连，部分融合成稍大的片状，双侧对称性分布，未见骨膜反应。     

影响骨膜成骨的因素

影响骨膜成骨的因素１０００３７北京解放军第３０４医院李利综述朱盛修审校中国图书资料分类号Ｒ６８１．１自１７３９年Ｄｕｈａｍａｌ提出骨膜成骨理论以来，各国学者进行了大量的实验研究与临床应用。现就影响骨膜成骨的主要因素加以分析。１解剖本世纪６０年代的许多...     

11例颅骨骨膜下血肿CT诊断分析

目的：分析颅骨骨膜下血肿不同时期CT表现．探讨其诊断价值。方法：11例颅骨骨膜下血肿的患儿临床及CT资料。结果：11例患儿中，3周内血肿1例，为孤立性颅外丘状软组织影。3周至3月7例，CT表现为血肿周边弧状或壳状钙化。局部颅骨骨质疏松，骨外板骨质吸收、变薄，2例累及内板，骨密度减低区伴周边轻度骨质增生。3月至5岁3例．CT表现为血肿包膜骨化形成新外板，原来颅骨形成内板，血肿机化钙化形成板障，逐渐塑形。结论：CT对诊断颅骨骨膜下血肿有重要价值。     

高原地区陈旧性腕舟状骨骨折治疗方法的选择

目的：在高原地区，选择更为有效的腕舟状骨陈旧性骨折的治疗方法。充分发挥骨膜移植的膜内化骨作用。方法：分别应用单纯植骨内固定，带血管蒂桡骨条移植内固定及带血管蒂骨膜面桡骨条髓内移植内固定方法（ｔｈｅｖａｓｃｕｌａｒｉｚｅｄｒａｄｉｕｓｅａｎｄｕｐｓｅｔｐｅｒｉｏｓｔｅａｌｆｌａｐｓｇｒａｆｔ，ＶＲＰＦＧ）治疗舟状骨陈旧性骨折８例，１２例及１６例，共３６例，并对上述方法的疗效进行了比较研究，结果：术后     

带血管蒂桡骨茎突翻面骨膜骨条髓内移植治疗陈旧性舟状骨骨折

带血管蒂桡骨茎突翻面骨膜骨条髓内移植治疗陈旧性舟状骨骨折武警总医院骨科邢更彦,姚建祥,姜川,李禾,王振宇,杜明奎,王明新（北京１０００３９）关键词翻面骨膜骨条移植,陈旧性舟状骨骨折,髓内移植陈旧性舟状骨骨折不连接是临床常见的病损,由于舟状骨的特殊解剖...     

骨膜的取材方法对游离骨膜移植后成骨的影响

用X线和组织学检查等手段观察不同方法取材的骨膜组织移植后的成骨能力,结果表明,锐性切取骨膜能最大程度保留生发层组织。切取后骨膜组织细胞完整,且移植后良好的成骨能力,能修复骨缺损。提示锐性切取骨膜组织是移植后骨膜能充分发挥功能的关键环节。     

自体骨膜一双相多孔生物活性陶瓷复合肌内植入的生物力学和成骨活性研究

目的：考察自体骨膜吸附包裹多孔双相磷酸钙生的活性陶瓷肌内植入生物力学和成骨活性，为骨缺损修复替代材料的选择和制备提供实验依据。方法：用自体骨膜包裹多孔双相磷酸钙生物活性陶瓷植入21只狗的肌肉，与未包裹骨膜和同样材料肌内植入和骨内植入作对照，进行生物力学测定，X线衍射和红外光谱分析以及组织学观察。结果：发现实验组材料的抗弯强度随着时间的延长而增加，其程度虽不如骨内植入者，但远高于未包裹骨膜的肌内植入试样，3月和6月时巳接近或达到正常骨水平；X线衍射结果，实验组TCP的峰值下降明显快于未包裹骨膜的肌内植入组，6月时X线转靶谱图和红外光谱图己接近正常骨的谱图。组织学观察也证实实验组试样的成骨速度和质量显著的高于未包裹骨膜的肌内植入试样。结论：活体骨膜可为多孔生物活性陶瓷材料提供丰富的生长因子，激活和提高材料的成骨活性，有利于骨诱导和新骨形成，促进骨的修复替代。     

应用带骨膜蒂桡骨块植入修复腕舟骨骨折不愈合1例

腕舟状骨骨折不愈合治疗方法很多,我科采用带骨膜蒂桡骨块植入治疗腕舟骨骨折不愈合1例,效果满意,现报告如下.临床资料患者,男性,20岁,因右腕摔伤致舟骨骨折2年入院.X线片示舟骨腰部骨折,骨折端     

颅骨骨膜下血肿影像诊断

目的 :探讨颅骨骨膜下血肿的影像特征。方法 :1 7例全部作头颅 X线平片 ,3例作 CT,1例作 MRI。结果 :1 7例中 ,共存在 1 8个孤立的颅骨骨膜下血肿 ,全部位于顶部 ,早期 2例 ,中期 1 4例 ,晚期后遗改变 1例。结论 :颅骨骨膜下血肿早期影像呈镰状稍高密度软组织块影 ,紧贴颅外板 ,不跨越颅缝 :中期影像呈紧贴颅外板的不跨颅缝的弧状或壳状或丘状均匀钙化影 ;晚期后遗症为不跨颅缝的增厚外凸的颅骨骨样结构     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.