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1.
Limb-salvage treatment versus amputation for osteosarcoma of the distal end of the femur 总被引:14,自引:0,他引:14
M A Simon M A Aschliman N Thomas H J Mankin 《The Journal of bone and joint surgery. American volume》1986,68(9):1331-1337
A retrospective multi-institutional study of 227 patients with osteosarcoma of the distal end of the femur was done to compare rates of local recurrence, metastasis, and survival. Three cohorts of patients who had had either a limb-sparing procedure, an above-the-knee amputation, or disarticulation of the hip were compared. The results revealed prevalences of eight of seventy-three, nine of 115, and zero of thirty-nine as to local recurrence; forty-three of seventy-three, sixty-five of 115, and twenty-one of thirty-nine as to metastasis; and thirty-three of seventy-three, forty-eight of 115, and eighteen of thirty-nine as to death. Of the seventeen patients who had a local recurrence, sixteen died. In the limb-salvage group, eighteen patients required amputation, because of local recurrence in eight and other local complications in ten. The Kaplan-Meier estimates of the percentage of patients who survived and the percentage of patients without recurrent disease showed no difference among the three surgical groups (Mantel-Cox test statistic: p = 0.8) after a median length of follow-up of five and one-half years. Various covariant adjusted estimates yielded similar results. For the entire group of patients, the rate of continuously disease-free survival was 42 per cent, and the over-all rate of survival was 55 per cent at five years. It appears that, compared with above-the-knee amputation or disarticulation of the hip, the use of a limb-salvage procedure for osteosarcoma of the distal end of the femur did not shorten the disease-free interval or compromise long-term survival. 相似文献
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Digital radiography of subtle pulmonary abnormalities: an ROC study of the effect of pixel size on observer performance 总被引:3,自引:0,他引:3
Forty conventional radiographs with examples of mild interstitial infiltrates and subtle pneumothoraces and 40 normal studies of the chest were selected and digitized, with pixel sizes of 1.0, 0.5, 0.2, and 0.1 mm. Observer performance tests were carried out using receiver operating characteristic analysis. Conventional radiographs and digitized images were compared. The results indicate that, in such cases, diagnostic accuracy increases significantly as the pixel size is reduced, at least to the 0.1-mm level. We conclude that, for digital systems using screen-film or similar image receptors, use of a pixel size substantially larger than 0.1 mm may result in some loss of diagnostic accuracy. 相似文献
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Chronic exercise-induced compartment pressure elevation measured with a miniaturized fluid pressure monitor. A laboratory and clinical study 总被引:1,自引:0,他引:1
Increased pressure within an osteofascial compartment may produce a compartment syndrome, one of the principal causes of circulatory compromise in acute traumatic and chronic exercise-induced elevated compartment pressure. Acute and chronic diagnostic quantitation of compartment pressures are a valuable adjunct to clinical diagnosis, particularly when used to evaluate the athlete with exercise-induced pain. This study evaluated a prototype hand-held, digital, fluid pressure monitor used for the measurement of compartment pressure in the exercising athlete. A laboratory water and mercury manometer study, in which 50 paired, single-blind measurements were taken, revealed that the digital monitor was accurate to +/- 0.8 mm Hg (SD) of actual pressure with no individual reading more than 1 mm Hg from the actual pressure when compared directly with a mercury and a water column. Laboratory study of bovine muscle placed within a pressure chamber revealed that the digital monitor, when assembled in the same manner as used for clinical measurement, was accurate to +/- 0.9 mm Hg. The needle manometer technique was also found to be accurate to +/- 3 mm Hg from actual pressure. Twenty-one paired measurements of the anterolateral and posterior compartments of the hindlimbs of eight anesthetized New Zealand White rabbits by both the needle manometer and digital monitor methods by two examiners demonstrated the digital monitor to be reproducible to +/- 1.0 mm Hg [Coefficient of variation (CV) less than 7%] and needle manometer method to +/- 3.4 mm Hg (CV less than 16%) with r = 0.94.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
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PL Macken FRACO FRACS CJ Pavlin FRCS R Tuli MD GE Trope PhD FRCS 《Clinical & experimental ophthalmology》1995,23(3):217-220
Background: Spherophakia is an uncommon diagnosis. This is the first case report of spherophakia evaluated by ultrasound biomicroscopy.
Methods: Ultrasound biomicroscopy is a new diagnostic technique developed by one of the authors and provides images with microscopic resolution of the anterior segment. A patient with spherophakia was evaluated by ultrasound biomicroscopy (Zeiss-Humphrey, 50MHz) before and after YAG laser iridotomy.
Results: Ultrasound biomicroscopic assessment revealed a shallow anterior chamber, a very steep anterior lens curvature, iridolenticular contact, elongated zonules, and an increased distance between the lens equator and the ciliary processes. Angle closure glaucoma was due to a pupil block mechanism. The pupil block was relieved by YAG laser iridotomy.
Conclusions: Ultrasound biomicroscopy is a useful technique to confirm the diagnosis of spherophakia. The pupil block in spherophakia is relieved by YAG laser iridotomy. 相似文献
Methods: Ultrasound biomicroscopy is a new diagnostic technique developed by one of the authors and provides images with microscopic resolution of the anterior segment. A patient with spherophakia was evaluated by ultrasound biomicroscopy (Zeiss-Humphrey, 50MHz) before and after YAG laser iridotomy.
Results: Ultrasound biomicroscopic assessment revealed a shallow anterior chamber, a very steep anterior lens curvature, iridolenticular contact, elongated zonules, and an increased distance between the lens equator and the ciliary processes. Angle closure glaucoma was due to a pupil block mechanism. The pupil block was relieved by YAG laser iridotomy.
Conclusions: Ultrasound biomicroscopy is a useful technique to confirm the diagnosis of spherophakia. The pupil block in spherophakia is relieved by YAG laser iridotomy. 相似文献
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The development of both adenocarcinoma of the jejunum and in situ squamous carcinoma of the oesophagus in an adult coeliac patient is described. Good evidence that adenocarcinoma of jejunum occurs more frequently in patients with coeliac disease has recently become available though this association has been suggested for some time. While oesophageal carcinoma has long been associated with coeliac disease, in situ carcinoma of oesophagus has not been previously described in these circumstances. We feel that the risk of this complication, as calculated from published series, warrants a screening programme for oesophageal malignancy in adult coeliacs. 相似文献