Liposarcoma of the lower extremity

Twenty patients with primary liposarcoma of the lower extremity were treated over a 25-year period. The adequacy of the initial surgical procedure and histological grade of malignancy both influenced survival rates. In addition local recurrence was noted only in patients who had undergone "inadequate" initial excision. Inguinal lymph nodes were uninvolved by tumor in all cases. In general, patients with liposarcomas of myxoid and/or round cell type survived for long periods of time. However, even patients with myxoid lesions occasionally exhibited evidence of early blood-borne metastases. This study suggests an important relationship between an inadequate primary resection, local recurrence, and eventual retroperitoneal spread. In the majority of cases, this may have resulted from failure to control the primary distal extremity tumor, with subsequent contiguous spread of metastases into the ipsilateral retroperitoneal space. If feasible, radical soft part resection should be performed as the primary surgical therapy of these neoplasms. Tumors contiguous to the knee or ankle joint should be treated by primary amputation. Failure to control local disease may result in blood-borne dissemination or local spread along musculoaponeurotic planes to involve proximal groin or retroperitoneal space.     

Comparison of Electromyographic Activity in Normal Lumbar Sacrospinalis Musculature during continuous and Intermittent Pelvic Traction

This study investigates whether there is a difference in electromyographic activity in the lumbar sacrospinalis musculature during continuous and intermittent pelvic traction. Twenty-nine normal subjects were randomly assigned to a control group, a continuous traction group, or an intermittent traction group. Electromyographic activity was recorded at specific timed intervals. Myoelectric activity increased with the onset of either type of traction, but by the third recording both groups had returned to their normal initial resting myoelectric recordings. The myoelectric patterns over time were similar for the two treatment groups. No significant difference in electromyographic activity of the lumbar sacrospinalis musculature during intermittent or continuous pelvic traction was found. J Orthop Sports Phys Ther 1981;2(3):137-141.     

Cell adhesion receptor expression during melanoma progression and metastasis

Summary Many steps in melanoma metastasis involve cell-cell or cell-matrix adhesive interactions. The surface molecules which mediate these processes therefore play an important role in regulating melanoma dissemination and their level of expression may alter during the course of tumor progression. Human melanocyte strains and melanoma cell lines have been characterised with regard to levels of cell surface receptors of the integrin family. Increased amounts of at least two integrins, VLA-4 (₄₁) and VnR (_V3), appeared to correlate with progression in this tumor, type. A novel VnR composed of an _V1 association has been observed in one melanoma cell line and there is the possibility that heterogeneity of integrin composition could affect biological behavior of these tumors.CD44, a cell surface glycoprotein which functions as the major receptor for hyaluronate, is another molecule whose expression increases in transformed cells of the melanocytic lineage. Iterative sorting on the FACS for stable variants, of both human and murine melanomas, expressing low and high levels of CD44 established that lack of expression of this molecule correlated with impaired ability to form pulmonary tumor nodules subsequent to i.v. injection into appropriate recipient mice. These findings illustrate that an understanding of the regulation of melanoma adhesion receptors could provide insights into the process of tumor spread.     

Reliability of reciprocal isokinetic testing of the knee extensors and flexors

This study was conducted to assess the reliability of torque measurements across different trials and different test sessions. Each trial consisted of three maximal, reciprocal contractions of the knee extensors and flexors at test velocities of 60 and 180 degrees /sec. Three trials were conducted on each of three test sessions, with each session separated by 48 hours. Results indicate that reliability of reciprocal isokinetic testing of the knee can be improved by 1) testing in more than one occasion, 2) testing more than three trials during a single session if testing during more than one session is impossible, and 3) allowing the subject to become familiar with the isokinetic test procedure and to warm up adequately. Data obtained in this study indicated performance variability was predominantly associated with between subject differences and secondarily related to within subject changes over trials and days. Dynamometer calibration remained stable across all test sessions, indicating that the method was reliable for recording torque output during all testing procedures. J Orthop Sports Phys Ther 1991;14(3):121-127.     

Blue toe syndrome.

Taking a precise history from a patient who presents with a "bruised" toe in the absence of trauma requires sharp assessment skills and an investigative nature. Looking beyond the obvious in an otherwise healthy appearing individual calls for knowledge of many different disease processes including blue toe syndrome. Rapid identification, proper diagnosis, and correct medical and nursing management are essential for a positive outcome.     

The evaluation of facial, head, neck, and temporomandibular joint pain patients

The purposes of this paper are 1) to present an evaluation procedure for patients with signs and symptoms of temporomandibular joint (TMJ) pain dysfunction syndrome (PDS) and 2) to describe the findings of the evaluation procedure on 12 patients with TMJ PDS. The evaluation emphasizes the collection of subjective and objective data. Records from 12 patients with facial, head, and neck pain were reviewed. The most frequent symptoms were: headache (1 00%), neckache (83.3%), and ear pain (58.3%). The most frequent signs were: muscle tenderness (100%) and mandibular deviation on opening (66.7%). Subjects with lateral pterygoid muscle tenderness had digastric muscle tenderness as well. Subjects with medial pterygoid muscle tenderness had masseter and hyoid muscle tenderness. Masseter muscle tenderness was strongly related to sternocleidomastoid and mylohyoid muscle tenderness and neckache. J Orthop Sports Phys Ther 1982;3(4):193-199.