Sample records for computer-assisted bone tumor

  1. Computer-assisted Navigation in Bone Tumor Surgery: Seamless Workflow Model and Evolution of Technique

    National Research Council Canada - National Science Library

    So, Timothy Y. C; Lam, Ying-Lee; Mak, Ka-Lok


    .... Registration techniques vary, although most existing systems use some form of surface matching.We developed and evaluated a workflow model of computer-assisted bone tumor surgery and evaluated (1...

  2. Bone tumor (United States)

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor; Bone tumor - benign ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects passed down ...

  3. Application of Computer-Assisted Design and Manufacturing-Fabricated Artificial Bone in the Reconstruction of Craniofacial Bone Defects. (United States)

    Liang, Weiqiang; Yao, Yuanyuan; Huang, Zixian; Chen, Yuhong; Ji, Chenyang; Zhang, Jinming


    The purpose of this study was to evaluate the clinical application of individual craniofacial bone fabrications using computer-assisted design (CAD)-computer-assisted manufacturing technology for the reconstruction of craniofacial bone defects. A total of 8 patients diagnosed with craniofacial bone defects were enrolled in this study between May 2007 and August 2010. After computed tomography scans were obtained, the patients were fitted with artificial bone that was created using CAD software, rapid prototyping technology, and epoxy-methyl acrylate resin and hydroxyapatite materials. The fabrication was fixed to the defect area with titanium screws, and soft tissue defects were repaired if necessary. The fabrications were precisely fixed to the defect areas, and all wounds healed well without any serious complications except for 1 case with intraoral incision dehiscence, which required further treatment. Postoperative curative effects were retrospectively observed after 6 to 48 months, acceptable anatomic and cosmetic outcomes were obtained, and no rejections or other complications occurred. The use of CAD-computer-assisted manufacturing technology-assisted epoxy-methyl acrylate resin and hydroxyapatite composite artificial bone to treat patients with craniofacial bone defects could enable the precise reconstruction of these defects and obtain good anatomic and cosmetic outcomes. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Computer-assisted percutaneous transiliac approach to tumorous malformation of the sacrum. (United States)

    Varga, P P; Hoffer, Z; Bors, I


    The object of this article is to present a new, minimally invasive, percutaneous image-guided technique for surgery of tumorous malformation of the sacrum. Using one of the available CAS systems, we developed a navigable working tube through which various surgical tools may be very precisely introduced into the tumorous malformation. The tube allows us to obtain histological samples and also perform tumor resections. For sacral procedures, the working tube was introduced percutaneously into the affected area of the sacrum through the sacroiliac joint with computer assistance. For successful matching, small titanium screws were inserted into the sacrum and pelvis percutaneously before CT examination to give precise landmark points. We have used the method in 12 cases. The aim of the surgery in biopsy cases was to obtain samples for histological diagnoses of unknown tumors. In the cases of tumor resection (all were metastatic), the indication was to obtain neurological decompression and decreased local pain. The pain response was very effective in all cases. The transiliac percutaneous approach to the sacrum has proven to be a safe and well-designed procedure. It can even be performed under local anesthesia, and is thus a very effective minimally invasive tool for obtaining pain relief in cases of sacral metastasis involving the first, second, and third segments. Copyright 2001 Wiley-Liss, Inc.

  5. Computer-assisted measurement of primary tumor area is prognostic of recurrence-free survival in stage IB melanoma patients. (United States)

    Rosenbaum, Brooke E; Schafer, Christine N; Han, Sung Won; Osman, Iman; Zhong, Hua; Brinster, Nooshin


    Current staging guidelines are insufficient to predict which patients with thin primary melanoma are at high risk of recurrence. Computer-assisted image analysis may allow for more practical and objective histopathological analysis of primary tumors than traditional light microscopy. We studied a prospective cohort of stage IB melanoma patients treated at NYU Langone Medical Center from 2002 to 2014. Primary tumor width, manual area, digital area, and conformation were evaluated in a patient subset via computer-assisted image analysis. The associations between histologic variables and survival were evaluated using Cox proportional hazards model. Logistic regressions were used to build a classifier with clinicopathological characteristics to predict recurrence status. Of the 655 patients with stage IB melanoma studied, a subset of 149 patient tumors (63 recurred, 86 did not recur) underwent computer-assisted histopathological analysis. Increasing tumor width (hazard ratios (HR): 1.17, P=0.01) and digital area (HR: 1.08, Pcomputer-assisted analysis may help identify high-risk patients with stage IB melanoma.

  6. Pseudoanaplastic tumors of bone

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Won-Jong [Uijongbu St. Mary Hospital, The Catholic University of Korea, Department of Orthopaedic Surgery, Gyunggido, 480-821 (Korea); Mirra, Joseph M. [Orthopaedic Hospital, Orthopedic Oncology, Los Angeles, California (United States)


    To discuss the concept of pseudoanaplastic tumors of bone, which pathologically show hyperchromatism and marked pleomorphism with quite enlarged, pleomorphic nuclei, but with no to extremely rare, typical mitoses, and to propose guidelines for their diagnosis. From a database of 4,262 bone tumors covering from 1971 to 2001, 15 cases of pseudoanaplastic bone tumors (0.35% of total) were retrieved for clinical, radiographic and pathologic review. Postoperative follow-up after surgical treatment was at least 3 years and a maximum of 7 years. There were eight male and seven female patients. Their ages ranged from 10 to 64 years with average of 29.7 years. Pathologic diagnoses of pseudoanaplastic variants of benign bone tumors included: osteoblastoma (4 cases), giant cell tumor (4 cases), chondromyxoid fibroma (3 cases), fibrous dysplasia (2 cases), fibrous cortical defect (1 case) and aneurysmal bone cyst (1 case). Radiography of all cases showed features of a benign bone lesion. Six cases, one case each of osteoblastoma, fibrous dysplasia, aneurysmal bone cyst, chondromyxoid fibroma, giant cell tumor and osteoblastoma, were initially misdiagnosed as osteosarcoma. The remaining cases were referred for a second opinion to rule out sarcoma. Despite the presence of significant cytologic aberrations, none of our cases showed malignant behavior following simple curettage or removal of bony lesions. Our observation justifies the concept of pseudoanaplasia in some benign bone tumors as in benign soft tissue tumors, especially in their late evolutionary stage when bizarre cytologic alterations strongly mimic a sarcoma. (orig.)

  7. Evaluation of computer-assisted mandibular reconstruction with vascularized iliac crest bone graft compared to conventional surgery: a randomized prospective clinical trial (United States)


    Background Computer-assisted surgery plays an increasingly important role in mandibular reconstruction, ensuring the best possible masticatory function and aesthetic outcome. Methods Twenty patients were randomly assigned to computer-assisted or conventional mandibular reconstruction with vascularized iliac crest bone graft in a prospective study design. Virtual surgical planning was based on preoperative CT-data using specific surgical planning software. A rapid prototyping guide transferred the virtual surgery plan to the operation site. During surgery the transplant ischemic time, reconstruction time, time for shaping the transplant and amount of bone removed were measured. Additionally, the difference in the intercondylar distance before and after surgery was calculated. Results Computer-assisted surgery shortened the time of transplant ischemia (P < 0.005) and defect reconstruction (P < 0.001) compared to conventional surgery. The time to saw and shape the transplant at the donor site was shorter using conventional surgery (P < 0.005); therefore, the overall time for surgery didn’t change (P = 0.527). In the computer-assisted group, the amount of bone harvested equaled the defect size, whereas the transplant size in the conventional group exceeded the defect site by 16.8 ± 5.6 mm (P < 0.001) on average. The intercondylar distance before compared to after surgery was less affected in the computer-assisted than in the conventional group (P < 0.001). Conclusions The presented study shows that computer-assisted surgery can help reduce the time for mandibular defect reconstruction and consequently the transplant ischemic time. In the computer-assisted group, the iliac crest donor site defect was downsized and the postoperative condyle position was less altered, reducing possible risks of postoperative complications and donor site morbidity. Trial Registration DRKS00005181. PMID:24716651

  8. The accuracy of computer-assisted primary mandibular reconstruction with vascularized bone flaps: iliac crest bone flap versus osteomyocutaneous fibula flap

    Directory of Open Access Journals (Sweden)

    Modabber A


    Full Text Available Ali Modabber,1 Nassim Ayoub,1 Stephan Christian Möhlhenrich,1 Evgeny Goloborodko,1 Tolga Taha Sönmez,1 Mehrangiz Ghassemi,2 Christina Loberg,3 Bernd Lethaus,1 Alireza Ghassemi,1 Frank Hölzle1 1Department of Oral, Maxillofacial and Plastic Facial Surgery, 2Department of Orthodontics, 3Department of Diagnostic and Interventional Radiology, RWTH Aachen University Hospital, Aachen, Germany Background: The intention of mandibular reconstruction is to restore the complex anatomy with maximum possible functionality and high accuracy. The aim of this study was to evaluate the accuracy of computer-assisted surgery in primary mandibular reconstruction with an iliac crest bone flap compared with an osteomyocutaneous fibula flap. Materials and methods: Preoperative computed tomography data of the mandible and the iliac crest or fibula donor site were imported into a specific surgical planning software program. Surgical guides were manufactured using a rapid prototyping technique for translating the virtual plan, including information on the transplant dimensions and shape, into real-time surgery. Using postoperative computed tomography scans and an automatic surface-comparison algorithm, the actual postoperative situation was compared with the preoperative virtual simulation. Results: The actual flap position showed a mean difference from the virtual plan of 2.43 mm (standard deviation [SD] ±1.26 and a surface deviation of 39% <2 mm and 15% <1 mm for the iliac crest bone flap, and a mean difference of 2.18 mm (SD ±1.93 and a surface deviation of 60% <2 mm and 37% <1 mm for the osteomyocutaneous fibula flap. The position of the neomandible reconstructed with an osteomyocutaneous fibula flap indicated a mean difference from the virtual plan of 1.25 mm (SD ±1.31 and a surface deviation of 82% <2 mm and 57% <1 mm, in contrast to a mean difference of 1.68 mm (SD ±1.25 and a surface deviation of 63% <2 mm and 38% <1 mm for the neomandible after

  9. The accuracy of computer-assisted primary mandibular reconstruction with vascularized bone flaps: iliac crest bone flap versus osteomyocutaneous fibula flap. (United States)

    Modabber, Ali; Ayoub, Nassim; Möhlhenrich, Stephan Christian; Goloborodko, Evgeny; Sönmez, Tolga Taha; Ghassemi, Mehrangiz; Loberg, Christina; Lethaus, Bernd; Ghassemi, Alireza; Hölzle, Frank


    The intention of mandibular reconstruction is to restore the complex anatomy with maximum possible functionality and high accuracy. The aim of this study was to evaluate the accuracy of computer-assisted surgery in primary mandibular reconstruction with an iliac crest bone flap compared with an osteomyocutaneous fibula flap. Preoperative computed tomography data of the mandible and the iliac crest or fibula donor site were imported into a specific surgical planning software program. Surgical guides were manufactured using a rapid prototyping technique for translating the virtual plan, including information on the transplant dimensions and shape, into real-time surgery. Using postoperative computed tomography scans and an automatic surface-comparison algorithm, the actual postoperative situation was compared with the preoperative virtual simulation. The actual flap position showed a mean difference from the virtual plan of 2.43 mm (standard deviation [SD] ±1.26) and a surface deviation of 39% virtual plan of 1.25 mm (SD ±1.31) and a surface deviation of 82% Virtual surgical planning is an effective method for mandibular reconstruction with vascularized bone flaps, and can help to restore the anatomy of the mandible with high accuracy in position and shape. It seems that primary mandibular reconstruction with the osteomyocutaneous fibula flap is more accurate compared with the vascularized iliac crest bone flap.

  10. [Classification of primary bone tumors]. (United States)

    Dominok, G W; Frege, J


    An expanded classification for bone tumors is presented based on the well known international classification as well as earlier systems. The current status and future trends in this area are discussed.

  11. Bone marrow lesions in knee osteoarthritis: MR-assessment by manual segmentation and computer-assisted tresholding

    DEFF Research Database (Denmark)

    Krogh Nielsen, Flemming; Jurik, Anne Grethe; Peters, David Alberg


    Purpose To assess the potential of methods to register changes over time of MR detected bone marrow lesions (BML) in knee osteoarthritis (KOA). Methods & Materials Repeated (3 month – 1 year) Gd-enhanced sagittal T1 fat-suppressed MRI of 13 knees with medial KOA (ACR-criteria). Female/male=12...

  12. Digital subtraction angiography and computer assisted image analysis for the evaluation of the antiangiogenetic effect of ionizing radiation on tumor angiogenesis. (United States)

    Siablis, Dimitrios; Liatsikos, Evangelos N; Karnabatidis, Dimitrios; Kagadis, George C; Sakelaropoulos, George C; Maroulis, John; Kardamakis, Dimitrios; Athanassopoulos, Anastasios; Perimenis, Petros; Nikiforidis, George; Barbalias, George A


    The aim of the present study was to evaluate and quantify the antiangiogenetic effect of ionizing radiation on tumor angiogenesis using digital subtraction angiography (DSA) in conjunction with computer assisted image analysis (CAIA). Walker 256 carcinosarcoma was inoculated in both glutei of 12 Wistar rats. When the tumors reached a diameter of 1.5 cm, local irradiation of the right gluteus was performed. The left gluteus of each animal served as a control. After 24 hours of irradiation, angiography was performed, and images where digitized and subsequently processed. The effect of irradiation was observed both in big and small vessels (smaller or greater than 200 microm). Irradiated areas of both small and big vessels showed a statistically significant reduction in both total vessel area and length. Small vessels showed a greater trend toward suppression by irradiation (not statistically significant). Irradiation had a deleterious effect in both macro- and micro-blood supply of a tumor. The use of CAIA enhanced the efficacy of DSA and enabled the in vivo identification of the effect of irradiation on various caliber vessels as well as the ratios of total length and total area of small and big vessels.

  13. Computer-assisted craniomaxillofacial surgery. (United States)

    Edwards, Sean P


    Computer-assisted surgery (CAS) describes all forms of surgery planning or execution that incorporate various forms of advanced imaging, software, analysis, and planning and, in some cases, rapid prototyping technology, robotics, and image-guidance systems. Innovation is progressing rapidly, and new forms of technology continue to be incorporated and evaluated for their value in improving daily operations. This article reviews imaging, enhanced three-dimensional diagnostics, tactile models, CAS concepts, reconstructive surgery, bone flap shaping, distraction osteogenesis, and orthognathic surgery in relation to craniomaxillofacial surgery. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  14. Diagnostic performance of a computer-assisted diagnosis system for bone scintigraphy of newly developed skeletal metastasis in prostate cancer patients: search for low-sensitivity subgroups. (United States)

    Koizumi, Mitsuru; Motegi, Kazuki; Koyama, Masamichi; Terauchi, Takashi; Yuasa, Takeshi; Yonese, Junji


    The computer-assisted diagnostic system for bone scintigraphy (BS) BONENAVI is used to evaluate skeletal metastasis. We investigated its diagnostic performance in prostate cancer patients with and without skeletal metastasis and searched for the problems. An artificial neural network (ANN) value was calculated in 226 prostate cancer patients (124 with skeletal metastasis and 101 without) using BS. Receiver operating characteristic curve analysis was performed and the sensitivity and specificity determined (cutoff ANN = 0.5). Patient's situation at the time of diagnosis of skeletal metastasis, computed tomography (CT) type, extent of disease (EOD), and BS uptake grade were analyzed. False-negative and false-positive results were recorded. BONENAVI showed 82% (102/124) of sensitivity and 83% (84/101) specificity for metastasis detection. There were no significant differences among CT types, although low EOD and faint BS uptake were associated with low ANN values and low sensitivity. Patients showed lower sensitivity during the follow-up period than staging work-up. False-negative lesions were often located in the pelvis or adjacent to it. They comprised not only solitary, faint BS lesions but also overlaying to urinary excretion. BONENAVI with BS has good sensitivity and specificity for detecting prostate cancer's osseous metastasis. Low EOD and faint BS uptake are associated with low sensitivity but not the CT type. Prostate cancer patients likely to have false-negative results during the follow-up period had a solitary lesion in the pelvis with faint BS uptake or lesions overlaying to urinary excretion.

  15. Primary bone tumors of the spine. (United States)

    Cañete, A Navas; Bloem, H L; Kroon, H M


    Primary bone tumors of the spine are less common than metastases or multiple myeloma. Based on the patient's age and the radiologic pattern and topography of the tumor, a very approximate differential diagnosis can be established for an osseous vertebral lesion. This article shows the radiologic manifestations of the principal primary bone tumors of the spine from a practical point of view, based on our personal experience and a review of the literature. If bone metastases, multiple myeloma, lymphomas, hemangiomas, and enostoses are excluded, only eight types of tumors account for 80% of all vertebral tumors. These are chordomas, osteoblastomas, chondrosarcomas, giant-cell tumors, osteoid osteomas, Ewing's sarcomas, osteosarcomas, and aneurysmal bone cysts. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  16. Vascular tumors of bone : Imaging findings

    NARCIS (Netherlands)

    Vermaat, Marieke; Vanel, Daniel; Kroon, Herman M.; Verbeke, Sofie L. J.; Alberghini, Marco; Bovee, Judith V. M. G.; Bloem, Johan L.

    Purpose: To identify radiological features of malignant vascular tumors of bone, which can be used to avoid erroneously diagnosing metastases based on radiological multifocality, and histological epitheloid phenotype. Materials and methods: From the databases of the Bologna & Netherlands Committee

  17. Bone tumor and soft tissue sarcomas

    Directory of Open Access Journals (Sweden)

    Reynaldo Jesus Garcia Filho


    Full Text Available When we evaluate a rheumatologic patient we have to think aboutthe differential diagnosis among primary bone tunors, secondarybone tumors and soft tissue sarcomas. Muscle skeletal tumors,like rheumatologic diseases, have a predilection for old patients.Their knowledge is very important for a correct diagnosis andtreatment.

  18. Computer assisted SCFE osteotomy planning

    Energy Technology Data Exchange (ETDEWEB)

    Drapikowski, Pawel [Poznan University of Technology, Institute of Control and Information Engineering, Poznan (Poland); Tyrakowski, Marcin; Czubak, Jaroslaw; Czwojdzinski, Adam [Postgraduate Medical Education Center, Department of Orthopaedics, Warsaw (Poland)


    Slipped capital femoral epiphysis (SCFE) is a common pediatric orthopedic disorder that requires surgical correction. Preoperative planning of a proximal femoral osteotomy is essential in cases of SCFE. This planning is usually done using 2D radiographs, but 3D data can be acquired with CT and analyzed with 3D visualization software. SCFEanalyzer is a computer program developed for preoperative planning of proximal femoral osteotomy to correct SCFE. Computed tomography scans were performed on human bone specimens: one pelvis and two femoral bones (right and left) and volume data of a patient. The CT data were used to test the abilities of the SCFEanalyzer software, which utilizes 3D virtual models of anatomic structures constructed from CT image data. Separation of anatomical bone structures is done by means of ''cutting'' 3D surface model of the pelvis. The software enables qualitative and quantitative spatial analysis of chosen parameters analogous to those done on the basis of plain radiographs. SCFEanalyzer makes it possible to evaluate the function of the hip joint by calculating the range of motion depending on the shape of bone structures based on oriented bounding box object representation. Pelvic and hip CT scans from a patient with SCFE were subjected to femoral geometry analysis and hip joint function assessment. These were done to plan and simulate osteotomy of the proximal femur. Analogous qualitative and quantitative evaluation after performing the virtual surgery were evaluated to determine the potential treatment effects. The use of computer assistance in preoperative planning enable us to increase objectivity and repeatability, and to compare the results of different types of osteotomy on the proximal femur, and thus to choose the optimal operation in each individual case. (orig.)

  19. [Chemotherapy of malignant bone tumors]. (United States)

    Höffken, K; Seeber, S; Gallmeier, W M; Bruntsch, U; Hossfeld, D K; Schmidt, C G


    In several primary malignant tumors significant improvement of formely bad prognosis has been achieved by the introduction of new cytostatic compounds and the study of new cytostatic combination regimens. Adjuvant chemotherapy in osteosarcoma and Ewing's sarcoma led to remarkable increase in survival rates. Leaning on natural history and on remission rates reached by cytostatic treatment in metastasizing stages of disease, proposals for adjuvant chemotherapy are made and chemotherapy regimen appliable on out-patient basis is described.

  20. Giant Cell Tumor of Bone - an Overview

    Directory of Open Access Journals (Sweden)

    Anshul Sobti


    Full Text Available Giant Cell tumors (GCT are benign tumors with potential for aggressive behavior and capacity to metastasize. Although rarely lethal, benign bone tumors may be associated with a substantial disturbance of the local bony architecture that can be particularly troublesome in peri-articular locations. Its histogenesis remains unclear. It is characterized by a proliferation of mononuclear stromal cells and the presence of many multi- nucleated giant cells with homogenous distribution. There is no widely held consensus regarding the ideal treatment method selection. There are advocates of varying surgical techniques ranging from intra-lesional curettage to wide resection. As most giant cell tumors are benign and are located near a joint in young adults, several authors favor an intralesional approach that preserves anatomy of bone in lieu of resection. Although GCT is classified as a benign lesion, few patients develop progressive lung metastases with poor outcomes. Treatment is mainly surgical. Options of chemotherapy and radiotherapy are reserved for selected cases. Recent advances in the understanding of pathogenesis are essential to develop new treatments for this locally destructive primary bone tumor.

  1. Osteogenic tumors of bone; Osteogene Tumoren

    Energy Technology Data Exchange (ETDEWEB)

    Jobke, B. [Deutsches Krebsforschungszentrum (DKFZ), Abtl. Radiologie, Heidelberg (Germany); Werner, M. [MVZ des HELIOS Klinikum Emil von Behring, Orthopaedische Pathologie - Referenzzentrum, Institut fuer Gewebediagnostik Berlin, Berlin (Germany)


    Osteogenic tumors include malignant and benign tumors that produce tumor osteoid and/or bone tissue. Osteosarcoma is the most common malignant bone tumor, especially in children and young adults. The entities with their characteristic morphological features are described to enable the reader to come to a diagnosis and differential diagnosis on the basis of patient age, history and predominant location of the tumor. For this review we selectively used mainly large published patient cohorts. Our own and externally published data on widely accepted tumor criteria were also compared. Detection is the initial diagnostic step for an osseous lesion, and is determined by the sensitivity of the method applied. Plain X-ray films in two planes and CT are the basics in the radiological toolkit for osteogenic tumors. For evaluation of local tumor extension and biopsy planning MRI or scintigraphy should be combined. MRI as a stand-alone diagnostic tool is insufficient. For malignant bone tumors staging should be performed, applying a variable combination of thoracic CT, MRI, scintigraphy, and positron emission tomography (PET). Osteosarcoma, along with Ewing sarcoma and chondrosarcoma, are the most common malignant bone tumors; all sub-entities are significantly rarer. Among benign bone tumors, osteoid osteomas have the highest incidence, presenting with typical pain, location, and age predilection. Diagnostics and treatment of malignant bone tumors should preferably be performed in specialized centers because of significant therapeutic implications for patients. In uncertain cases, a second opinion should always be obtained. (orig.) [German] Osteogene Tumoren umfassen maligne und benigne Tumoren, die eine tumoreigene Produktion von Osteoid und/oder Knochengewebe aufweisen. Das Osteosarkom ist der haeufigste maligne Knochentumor v. a. bei Kindern und jungen Erwachsenen. Es werden die Entitaeten mit ihren morphologischen Charakteristika beschrieben, um anhand wichtiger

  2. Complications of bone tumors after multimodal therapy

    Energy Technology Data Exchange (ETDEWEB)

    Shapeero, L.G., E-mail: [Department of Radiology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Bone and Soft Tissue Program, United States Military Cancer Institute, 6900 Georgia Ave, NW, Washington, DC 20307 (United States); Poffyn, B. [Department of Orthopaedic Surgery, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); De Visschere, P.J.L. [Department of Radiology and Magnetic Resonance/MR-1K12 IB, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Sys, G. [Department of Orthopaedic Surgery, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Uyttendaele, D. [Department of Radiology and Magnetic Resonance/MR-1K12 IB, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Vanel, D. [Department of Radiology, Rizzoli Institute, 40136 Bologna (Italy); Forsyth, R. [Department of Pathology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Verstraete, K.L. [Department of Radiology and Magnetic Resonance/MR-1K12 IB, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium)


    Purpose: To define and compare the complications of bone tumors after resection, extracorporeal irradiation and re-implantation, with or without radiotherapy. Materials and methods: Eighty patients (40 males and 40 females, ages 4-77 years) with 61 malignant and 19 benign bone tumors were evaluated for local and distant complications after treatment. Two groups of patients were studied: (1) 53 patients had resection without (43 patients) or with external beam radiotherapy (RadRx) (10 patients) and (2) 27 patients underwent extracorporeal irradiation and re-implantation without (22 patients) or with RadRx (5 patients). Patient follow-up varied from 1 month to 13.63 years with mean follow-up of 4.7 years. Imaging studies included bone and chest radiography, spin echo T1- and T2-weighted (or STIR) magnetic resonance imaging (MRI), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), computed tomography (CT) for thoracic and abdominopelvic metastases and 3-phase technetium-99m-labeled-methylene-diphosphonate (Tc99m MDP) scintigraphy for bone metastases. Results: DCE-MRI differentiated the rapidly enhancing recurrences, residual tumors and metastases from the slowly enhancing inflammation, and the non-enhancing seromas and fibrosis. Recurrences, metastases (mainly to lung and bone), and seromas were greater than twice as frequent in patients after resection than after ECCRI. Although 11.3% of post-resection patients had residual tumor, no ECRRI-treated patient had residual tumor. In contrast, after ECRRI, infection was almost three times as frequent and aseptic loosening twice as frequent as compared with the post-resection patients. Bones treated with RadRx and/or ECRRI showed increased prevalence of fractures and osteoporosis. In addition, muscle inflammation was more common in the externally irradiated patient as compared with the patient who did not receive this therapy. However, another soft tissue complication, heterotopic ossification, was rare in the

  3. [Selected immunologic indicators in malignant bone tumors]. (United States)

    Keleová, A; Huraj, E; Jahnová, E; Janota, S; Nyulassy, S


    In patients with the malignant tumor of bone (17 osteosarcomas, 8 Ewing tumors) longterm observations were made, and namely at the beginning of the disease, after the surgical removal of the tumor, during chemotherapy and in the terminal phase of the disease. The observations concentrated on the following selected immunology parameters: active lymphocytes T, lymphocytes T, lymphocytes B, large granular lymphocytes, IgG, IgA, IgM and circulating immune complexes. In non-treated patients prior to diagnosing the disease, reduction of active lymphocytes T was found out while the total lymphocytes T remained unchanged. However, no significant differences were found out between benign and malignant tumors. The surgical removal of the tumor results in the change in imunologic indicators, the increase of active lyphocytes T, lymphocytes T and the decrease in the circulating immune complexes. The change is of temporary nature, the subsequent deterioration is caused by both the progression of the disease and chemotherapy. The values of immunoglobulins and lymphocytes B fluctuated during the whole course of the disease in physiological levels. The observation of active lymphocytes T and lymphocytes T can be used for monitoring of the immunosuppression in cytostatic treatment. The levl of IgG is differentially diagnostically used to distinguish between the tumor and inflammatory processes.


    African Journals Online (AJOL)

    COMPUTER ASSISTED INVENTORY CONTROL SYSTEM. Alebachew Dessalegn and R. N. Roy. Department of Mechanical Engineering. Addis Ababa University. ABSTRACT. The basic purpose of holding inventories is to provide an essential decoupling between demand and unequal flow rate of materials in a supp~v ...

  5. Computer assisted medical history taking

    NARCIS (Netherlands)

    M.J. Quaak; A.P.M. Hasman (Arie)


    textabstractIn this thesis a study is described which was performed to explore the possibilities of computer-assisted history taking to support patient care. A system was developed by which the patient himself enters his medical data into a computer. The system enables an unexperienced user, i.e.

  6. The Role of Hedgehog Signaling in Tumor Induced Bone Disease

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    Cannonier, Shellese A.; Sterling, Julie A., E-mail: [Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN 37235 (United States); Vanderbilt Center for Bone Biology, Department of Medicine, Division of Clinical Pharmacology Vanderbilt University, Nashville, TN 372335 (United States); Department of Cancer Biology, Vanderbilt University, Nashville, TN 37235 (United States)


    Despite significant progress in cancer treatments, tumor induced bone disease continues to cause significant morbidities. While tumors show distinct mutations and clinical characteristics, they behave similarly once they establish in bone. Tumors can metastasize to bone from distant sites (breast, prostate, lung), directly invade into bone (head and neck) or originate from the bone (melanoma, chondrosarcoma) where they cause pain, fractures, hypercalcemia, and ultimately, poor prognoses and outcomes. Tumors in bone secrete factors (interleukins and parathyroid hormone-related protein) that induce RANKL expression from osteoblasts, causing an increase in osteoclast mediated bone resorption. While the mechanisms involved varies slightly between tumor types, many tumors display an increase in Hedgehog signaling components that lead to increased tumor growth, therapy failure, and metastasis. The work of multiple laboratories has detailed Hh signaling in several tumor types and revealed that tumor establishment in bone can be controlled by both canonical and non-canonical Hh signaling in a cell type specific manner. This review will explore the role of Hh signaling in the modulation of tumor induced bone disease, and will shed insight into possible therapeutic interventions for blocking Hh signaling in these tumors.

  7. The Role of Hedgehog Signaling in Tumor Induced Bone Disease

    Directory of Open Access Journals (Sweden)

    Shellese A. Cannonier


    Full Text Available Despite significant progress in cancer treatments, tumor induced bone disease continues to cause significant morbidities. While tumors show distinct mutations and clinical characteristics, they behave similarly once they establish in bone. Tumors can metastasize to bone from distant sites (breast, prostate, lung, directly invade into bone (head and neck or originate from the bone (melanoma, chondrosarcoma where they cause pain, fractures, hypercalcemia, and ultimately, poor prognoses and outcomes. Tumors in bone secrete factors (interleukins and parathyroid hormone-related protein that induce RANKL expression from osteoblasts, causing an increase in osteoclast mediated bone resorption. While the mechanisms involved varies slightly between tumor types, many tumors display an increase in Hedgehog signaling components that lead to increased tumor growth, therapy failure, and metastasis. The work of multiple laboratories has detailed Hh signaling in several tumor types and revealed that tumor establishment in bone can be controlled by both canonical and non-canonical Hh signaling in a cell type specific manner. This review will explore the role of Hh signaling in the modulation of tumor induced bone disease, and will shed insight into possible therapeutic interventions for blocking Hh signaling in these tumors.

  8. Megaendoprosthesis in the treatment of bone tumors in the knee and hip region

    Directory of Open Access Journals (Sweden)

    Barjaktarović Radoslav


    Full Text Available Background/Aim. For almost two decades extremity amputation has not been the only viable option for patients with from bone cancer in the region of the hip and knee. Remarkable advances in implant technology, surgical reconstructive technique and adoption of new chemotherapy protocols provide a new option for surgeons who diagnose and treat bone tumors. Megaendoprosthesis has become widely accepted alternative in limb salvage surgery of the extremities. The aim of this study was to present an outcome of the treatment of bone tumors in the knee and hip region by the use of custom made megaendoprothesis. Methods. In the period 2006-2008 we adopted new clinical practice protocols for preoperative management in candidates for tumor megaprostheses of the hip and knee including: surgical tumor staging, histopathological verification, determinants of anatomical-mechanical defect, status of soft tissues, CT evaluation of the referent measures of pelvis, femur and tibia necessary for creation of custom made endoprosthesis and surgery plan, as well as modern, less invasive surgical approach. The patients were monitored during ≥ 24 months after the surgery for detecting possible complications. Results. All procedures were performed without complications during and immediately after the surgery. During the follow-up period not less than 24 months we failed to record any significant complications. Conclusion. Custom made megaendoprosthesis are the method of choice in the treatment of bone tumors in the region of the hip and knee at the Orthopedics and Traumatology Clinic, Military Medical Academy, Belgrade. The greatest challenge - ensuring longevity of a prosthesis can be achieved not only by prevention of common complications of arthroplasty procedures but, certainly, with the introduction of new methods for preoperative planning - computer-assisted technique of measuring referent sizes and software solutions for the selection and design of custom

  9. Detectability of metastatic bone tumor by Ga-67 scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Koizumi, Kiyoshi; Uchiyama, Guio; Araki, Tsutomu; Hihara, Toshihiko; Ogata, Hitoshi; Monzawa, Shuichi; Kachi, Kenji; Matsusako, Masaki


    Ga-67 scintigrams in patients with malignant diseases sometimes reveal uptake of the tracer in the bone metastases. Detectability of Ga-67 scintigraphy for metastatic bone tumors and benign bone lesions was compared with that of Tc-99m bone scintigraphy. Countable bone metastases detected by bone scintigraphy were evaluated whether the lesion showed apparent, faint, or negative Ga-67 uptake. Of 47 lesions 23 (49%) showed apparent uptake and 17 (36%) showed negative uptake, only 7 (10%) mostly fracture/osteotomy, showed apparent uptake of the tracer. Uptake in the other benign lesions such as trauma of the ribs, spondylosis deformans, and arthrosis deformans was rather faint. In patients with multiple bone metastases, 9 patients (82%) out of 11 showed more prominent abnormal findings in Tc-99m MDP bone scintigraphy than in Ga-67 scintigraphy; that is, Ga-67 scintigraphy was not able to reveal all metastatic bone lesions. In patients with untreated or recurrent tumors, relation between Ga-67 uptake in the tumors and that in the bone metastases was evaluated. Of 7 patients with negative Ga-67 uptake in the bone metastases; that is, there seemed to be little relation between Ga-67 affinity to the primary tumors and that to the bone metastases. Mechanisms of the Ga-67 uptake in the bone metastases were discussed. Not only the tumor cells or tissues in the bone metastases but also bone mineral or osteoclasts might be the deposition sites of Ga-67.

  10. Bone tumors of the pediatric foot: imaging appearances

    Energy Technology Data Exchange (ETDEWEB)

    Caro-Dominguez, Pablo; Navarro, Oscar M. [University of Toronto, Department of Medical Imaging, Toronto, ON (Canada); The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)


    Tumors of the foot are rare in children. This review illustrates radiographic, CT and MR imaging findings of foot bone tumors in children based on all cases presented in a tertiary pediatric hospital during the 15-year period of 1999-2014. This search revealed 155 tumors of the foot, 72 of the bones and 83 of the soft tissues. Osteochondroma, bone cyst and fibrous dysplasia were the most frequent benign bone lesions. Ewing sarcoma was the most common malignant osseous tumor. Some tumors showed higher prevalence in certain age ranges and others showed predilection for specific bones. Radiographs are useful for diagnosis in the majority of cases but CT and MR imaging provide additional valuable information in select cases for diagnosis and determining extent of the lesions. Radiologists should be aware of some typical imaging findings in bone tumors of the foot in order to establish diagnosis and facilitate patient management. (orig.)

  11. Biochemical parameters of bone metabolism in bone metastases of solid tumors (Review)

    NARCIS (Netherlands)

    Meijer, Wilhelmus; van der Veer, E; Willemse, P H


    The role of biochemical markers of bone metabolism in the diagnosis and monitoring of bone metastases in solid tumors is reviewed. Emphasis is on the recently developed markers, which may provide a more accurate quantitation of bone metabolism. In metastatic bone disease, bone formation and

  12. Surface primary bone tumors: Systematic approach and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Mendez Diaz, Cristina; Soler Fernandez, Rafaela; Rodriguez Garcia, Esther; Fernandez Armendariz, Pablo; Diaz Angulo, Carolina [Complejo Hospitalario Universitario A Coruna, Department of Radiology, A Coruna (Spain)


    Surface primary bone tumors may appear similar to their intramedullary counterpart, but because they are rare, they may pose diagnostic challenges when showing different characteristics compared to their intramedullary counterpart. It is important for radiologists to recognize the imaging findings for various uncommon surface primary bone tumors, which may help to reduce the differential diagnosis or to lead to a specific diagnosis. Radiography is typically used for first-line imaging. If necessary, it is followed by CT or MRI for evaluation and characterization of surface bone tumors. The aim of this article is to review the imaging findings and differential diagnosis for surface primary bone tumors. (orig.)

  13. Computer Assisted Parallel Program Generation

    CERN Document Server

    Kawata, Shigeo


    Parallel computation is widely employed in scientific researches, engineering activities and product development. Parallel program writing itself is not always a simple task depending on problems solved. Large-scale scientific computing, huge data analyses and precise visualizations, for example, would require parallel computations, and the parallel computing needs the parallelization techniques. In this Chapter a parallel program generation support is discussed, and a computer-assisted parallel program generation system P-NCAS is introduced. Computer assisted problem solving is one of key methods to promote innovations in science and engineering, and contributes to enrich our society and our life toward a programming-free environment in computing science. Problem solving environments (PSE) research activities had started to enhance the programming power in 1970's. The P-NCAS is one of the PSEs; The PSE concept provides an integrated human-friendly computational software and hardware system to solve a target ...

  14. Current diagnostic approach of bone tumors in childhood; Abordagem diagnostica atual dos tumores osseos na infancia

    Energy Technology Data Exchange (ETDEWEB)

    Torre, Marcia Barbosa; Scatigno Neto, Andre [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Hospital das Clinicas


    The authors analyze the magnetic resonance imaging (MRI) as the imaging modality of choice for evaluation of patients with bone tumors or soft tissue tumors. The advent of such a sensitive imaging modality is fortuitous and coincides with a recent change in the therapeutic approach to primary bone tumors. MRI is extremely valuable in monitoring the tumor response to the initial chemotherapy and is accurate defining the margins of tumor, facilitating planning of limb salvage surgical procedures. (author). 5 refs., 8 figs.

  15. Risk factors for postoperative deep infection in bone tumors.

    Directory of Open Access Journals (Sweden)

    Shinji Miwa

    Full Text Available Postoperative deep infection after bone tumor surgery remains a serious complication. Although there are numerous reports about risk factors for postoperative deep infection in general surgery, there is only a small number of reports about those for bone tumor surgery. This retrospective study aimed to identify risk factors for postoperative deep infection after bone tumor resection.We reviewed data of 681 patients (844 bone tumors who underwent surgery. Associations between variables, including age, recurrent tumor, pathological fracture, surgical site (pelvis/other, chemotherapy, biological reconstruction, augmentation of artificial bone or bone cement, the use of an implant, intraoperative blood loss, operative time, additional surgery for complications, and postoperative deep infection were evaluated.The rate of postoperative deep infection was 3.2% (27/844 tumors. A pelvic tumor (odds ratio [OR]: 3.4, 95% confidence interval [CI]: 1.0-11.3 and use of an implant (OR: 9.3, 95% CI: 1.9-45.5 were associated with an increased risk of deep infection.This retrospective study showed that pelvic tumor and use of an implant were independent risk factors for deep infection. This information will help surgeons prepare an adequate surgical plan for patients with bone tumors.

  16. Brown Tumor Shown Flare Phenomenon On Bone Scan After Parathyroidectomy

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Kwang Ho; Park, Seol Hoon; Baek, So Ra; Chae, Sun Young; Koh, Jung Min; Kim, Jae Seung; Moon, Dae Hyuk; Ryu, Jin Sook [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)


    Brown tumor is the benign bone lesion consists of woven bone and fibrous tissue without matrix, which develop due to chronic excessive osteoclastic activity such as hyperparathyroidism. Usually they appear with normal uptake or occasionally focally increased uptake on bone scan. We present a case with brown tumor shown more increased uptake and more number of lesions on bone scan after parathyroidectomy, and lesser increased uptake on serial bone scans without any other treatment through several months. This finding is thought to be similar to 'flare phenomenon' which is occasionally seen after treatment of metastatic bone lesions of malignant cancer, and may represent curative process of brown tumor with rapid normal bone formation.

  17. Bone tumors of the spine and sacral bone; Primaere Tumoren der Wirbelsaeule und des Sakrums

    Energy Technology Data Exchange (ETDEWEB)

    Freyschmidt, Juergen [Klinikum Bremen-Mitte gGmbH, Bremen (Germany). Beratungsstelle und Referenzzentrum fuer Osteoradiologie


    Bone tumors and tumorlike lesions of the spine are rare entities and may harbour diagnostic problems. In this article we discuss the epidemiology, topographic aspects, clinical and radiologic features as well as the diagnostic management of vertebral bone tumors. Entities that should be more familiar to the radiologist (i.e. osteoid osteoma, osteoblastoma, hemangioma, giant cell tumor, chordoma, aneurysmal bone cyst) are considered in more detail. (orig.)

  18. Benign bone tumors and tumor-like lesions: value of cross-sectional imaging

    Energy Technology Data Exchange (ETDEWEB)

    Woertler, Klaus [Department of Radiology, Technische Universitaet Muenchen, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, Munich (Germany)


    This article reviews the role of CT and MR imaging in the diagnosis of benign bone tumors and tumor-like lesions of bone with with regard to differential diagnosis, the assessment of tumor-related complications, and the detection of postoperative recurrence. Indications for cross-sectional imaging of specific lesions, including osteoid osteoma, osteoblastoma, enchondroma, osteochondroma, intraosseous lipoma, hemangioma, giant cell tumor, aneurysmal bone cyst, simple bone cyst, and eosinophilic granuloma, are discussed, and advantages and disadvantages of the different imaging modalities are illustrated on the basis of pathologically confirmed cases. (orig.)

  19. Dissecting Tumor-Stromal Interactions in Breast Cancer Bone Metastasis

    Directory of Open Access Journals (Sweden)

    Yibin Kang


    Full Text Available Bone metastasis is a frequent occurrence in breast cancer, affecting more than 70% of late stage cancer patients with severe complications such as fracture, bone pain, and hypercalcemia. The pathogenesis of osteolytic bone metastasis depends on cross-communications between tumor cells and various stromal cells residing in the bone microenvironment. Several growth factor signaling pathways, secreted micro RNAs (miRNAs and exosomes are functional mediators of tumor-stromal interactions in bone metastasis. We developed a functional genomic approach to systemically identified molecular pathways utilized by breast cancer cells to engage the bone stroma in order to generate osteolytic bone metastasis. We showed that elevated expression of vascular cell adhesion molecule 1 (VCAM1 in disseminated breast tumor cells mediates the recruitment of pre-osteoclasts and promotes their differentiation to mature osteoclasts during the bone metastasis formation. Transforming growth factor β (TGF-β is released from bone matrix upon bone destruction, and signals to breast cancer to further enhance their malignancy in developing bone metastasis. We furthered identified Jagged1 as a TGF-β target genes in tumor cells that engaged bone stromal cells through the activation of Notch signaling to provide a positive feedback to promote tumor growth and to activate osteoclast differentiation. Substantially change in miRNA expression was observed in osteoclasts during their differentiation and maturation, which can be exploited as circulating biomarkers of emerging bone metastasis and therapeutic targets for the treatment of bone metastasis. Further research in this direction may lead to improved diagnosis and treatment strategies for bone metastasis.

  20. Fabrication of a two-level tumor bone repair biomaterial based on a rapid prototyping technique

    Energy Technology Data Exchange (ETDEWEB)

    Kai He; Yan Yongnian; Zhang Renji; Wang Xiaohong [Key Laboratory for Advanced Materials Processing Technology, Ministry of Education and Center of Organ Manufacturing, Department of Mechanical Engineering, Tsinghua University, Beijing 100084 (China); Wang Xinluan; Madhukar, Kumta Shekhar; Qin Ling [Department of Orthoapedics and Traumatology, The Chinese University of Hong Kong. Shatin, NT (Hong Kong)], E-mail:, E-mail:, E-mail:


    After the removal of the giant cell tumor (GCT) of bone, it is necessary to fill the defects with adequate biomaterials. A new functional bone repair material with both stimulating osteoblast growth and inhibiting osteoclast activity has been developed with phosphorylated chitosan (P-chitosan) and disodium (1 {yields} 4)-2-deoxy-2-sulfoamino-{beta}-D-glucopyranuronan (S-chitosan) as the additives of poly(lactic acid-co-glycolic acid) (PLGA)/calcium phosphate (TCP) scaffolds based on a double-nozzle low-temperature deposition manufacturing technique. A computer-assisted design model was used and the optimal fabrication parameters were determined through the manipulation of a pure PLGA/TCP system. The microscopic structures, water absorbability and mechanical properties of the samples with different P-chitosan and S-chitosan concentrations were characterized correspondingly. The results suggested that this unique composite porous scaffold material is a potential candidate for the repair of large bone defects after a surgical removal of GCT.

  1. Tumor-expressed adrenomedullin accelerates breast cancer bone metastasis. (United States)

    Siclari, Valerie A; Mohammad, Khalid S; Tompkins, Douglas R; Davis, Holly; McKenna, C Ryan; Peng, Xianghong; Wessner, Lisa L; Niewolna, Maria; Guise, Theresa A; Suvannasankha, Attaya; Chirgwin, John M


    Adrenomedullin (AM) is secreted by breast cancer cells and increased by hypoxia. It is a multifunctional peptide that stimulates angiogenesis and proliferation. The peptide is also a potent paracrine stimulator of osteoblasts and bone formation, suggesting a role in skeletal metastases-a major site of treatment-refractory tumor growth in patients with advanced disease. The role of adrenomedullin in bone metastases was tested by stable overexpression in MDA-MB-231 breast cancer cells, which cause osteolytic bone metastases in a standard animal model. Cells with fivefold increased expression of AM were characterized in vitro, inoculated into immunodeficient mice and compared for their ability to form bone metastases versus control subclones. Bone destruction was monitored by X-ray, and tumor burden and osteoclast numbers were determined by quantitative histomorphometry. The effects of AM overexpression on tumor growth and angiogenesis in the mammary fat pad were determined. The effects of AM peptide on osteoclast-like multinucleated cell formation were tested in vitro. A small-molecule AM antagonist was tested for its effects on AM-stimulated ex vivo bone cell cultures and co-cultures with tumor cells, where responses of tumor and bone were distinguished by species-specific real-time PCR. Overexpression of AM mRNA did not alter cell proliferation in vitro, expression of tumor-secreted factors or cell cycle progression. AM-overexpressing cells caused osteolytic bone metastases to develop more rapidly, which was accompanied by decreased survival. In the mammary fat pad, tumors grew more rapidly with unchanged blood vessel formation. Tumor growth in the bone was also more rapid, and osteoclasts were increased. AM peptide potently stimulated bone cultures ex vivo; responses that were blocked by small-molecule adrenomedullin antagonists in the absence of cellular toxicity. Antagonist treatment dramatically suppressed tumor growth in bone and decreased markers of

  2. Functional assessment of endoprosthesis in the treatment of bone tumors

    Directory of Open Access Journals (Sweden)

    Denis Kiyoshi Fukumothi

    Full Text Available ABSTRACT OBJECTIVES: Evaluate the functional grade of these patients and to identify the types of complications found that influenced the average life span of endoprostheses the functions of the operated limb. METHODS: We analyzed 14 post-operative cases of endoprosthesis, patients with malignant bone tumors and aggressive benign bone tumors submitted to surgery between 2004 and 2014. The evaluation system used was proposed by Enneking, recommended by the Musculoskeletal Tumor Society (MSTS, in addition to the radiologic evaluation. RESULTS: Endoprosthesis are excellent choices for the treatment of bone tumors with limb preservation in relation to pain, strength, and patient's emotional acceptance. Another factor for good results is the immediate weight-bearing capacity, generating a greater independence. CONCLUSION: The authors conclude that all patients classified the therapy as excellent/good, regardless of the type of prosthesis used, extent of injury, and/or type of tumor resection performed.

  3. Functional assessment of endoprosthesis in the treatment of bone tumors. (United States)

    Fukumothi, Denis Kiyoshi; Pupo, Hiran; Reganin, Luciano Augusto; Matte, Silvia Raquel Fricke; Lima, Bruno Spagnuolo de; Mattos, Carlos Augusto de


    Evaluate the functional grade of these patients and to identify the types of complications found that influenced the average life span of endoprostheses the functions of the operated limb. We analyzed 14 post-operative cases of endoprosthesis, patients with malignant bone tumors and aggressive benign bone tumors submitted to surgery between 2004 and 2014. The evaluation system used was proposed by Enneking, recommended by the Musculoskeletal Tumor Society (MSTS), in addition to the radiologic evaluation. Endoprosthesis are excellent choices for the treatment of bone tumors with limb preservation in relation to pain, strength, and patient's emotional acceptance. Another factor for good results is the immediate weight-bearing capacity, generating a greater independence. The authors conclude that all patients classified the therapy as excellent/good, regardless of the type of prosthesis used, extent of injury, and/or type of tumor resection performed.

  4. Imaging of primary bone tumors in veterinary medicine: which differences? (United States)

    Vanel, Maïa; Blond, Laurent; Vanel, Daniel


    Veterinary medicine is most often a mysterious world for the human doctors. However, animals are important for human medicine thanks to the numerous biological similarities. Primary bone tumors are not uncommon in veterinary medicine and especially in small domestic animals as dogs and cats. As in human medicine, osteosarcoma is the most common one and especially in the long bones extremities. In the malignant bone tumor family, chondrosarcoma, fibrosarcoma and hemangiosarcoma are following. Benign bone tumors as osteoma, osteochondroma and bone cysts do exist but are rare and of little clinical significance. Diagnostic modalities used depend widely on the owner willing to treat his animal. Radiographs and bone biopsy are the standard to make a diagnosis but CT, nuclear medicine and MRI are more an more used. As amputation is treatment number one in appendicular bone tumor in veterinary medicine, this explains on the one hand why more recent imaging modalities are not always necessary and on the other hand, that prognostic on large animals is so poor that it is not much studied. Chemotherapy is sometimes associated with the surgery procedure, depending on the aggressivity of the tumor. Although, the strakes differs a lot between veterinary and human medicine, biological behavior are almost the same and should led to a beneficial team work between all. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  5. Imaging of primary bone tumors in veterinary medicine: Which differences?

    Energy Technology Data Exchange (ETDEWEB)

    Vanel, Maïa, E-mail: [Diagnostic Imaging Department, Faculty of Veterinary Medicine, University of Montreal, 3200 Rue Sicotte, PO Box 5000, Saint-Hyacinthe, QC (Canada); Blond, Laurent [Diagnostic Imaging Department, Faculty of Veterinary Medicine, University of Montreal, 3200 Rue Sicotte, PO Box 5000, Saint-Hyacinthe, QC (Canada); Vanel, Daniel [The Rizzoli Institute, Via del Barbiano 1-10, 40136, Bologna (Italy)


    Veterinary medicine is most often a mysterious world for the human doctors. However, animals are important for human medicine thanks to the numerous biological similarities. Primary bone tumors are not uncommon in veterinary medicine and especially in small domestic animals as dogs and cats. As in human medicine, osteosarcoma is the most common one and especially in the long bones extremities. In the malignant bone tumor family, chondrosarcoma, fibrosarcoma and hemangiosarcoma are following. Benign bone tumors as osteoma, osteochondroma and bone cysts do exist but are rare and of little clinical significance. Diagnostic modalities used depend widely on the owner willing to treat his animal. Radiographs and bone biopsy are the standard to make a diagnosis but CT, nuclear medicine and MRI are more an more used. As amputation is treatment number one in appendicular bone tumor in veterinary medicine, this explains on the one hand why more recent imaging modalities are not always necessary and on the other hand, that pronostic on large animals is so poor that it is not much studied. Chemotherapy is sometimes associated with the surgery procedure, depending on the agressivity of the tumor. Although, the strakes differs a lot between veterinary and human medicine, biological behavior are almost the same and should led to a beneficial team work between all.

  6. Emergent Literacy Development and Computer Assisted Instruction (United States)

    Trotti, Judy; Hendricks, Randy; Bledsoe, Christie


    In this mixed-methods study, researchers examined the literacy development of prekindergarten students (N = 162) randomly placed in one of two treatment groups with each receiving 15 minutes of computer-assisted literacy instruction for four months. Literacy development of a control group of children not receiving computer-assisted instruction was…

  7. 43 Computer Assisted Programmed Instruction and Cognitive ...

    African Journals Online (AJOL)


    Computer Assisted Programmed Instruction and Cognitive Preference Style as. Determinant of Achievement of Secondary School Physics Students. Sotayo, M. A. O.. Federal College of Education, Osiele, Abeokuta, Nigeria. Abstract. The study probes into the effect of Computer Assisted Instruction and Cognitive preference.


    Oliveira, Marcelo Parente; Lima, Pablo Moura de Andrade; de Mello, Roberto José Vieira


    Objective: To study factors possibly associated with tumor contamination in the biopsy path of primary malignant bone tumors. Method: Thirty-five patients who underwent surgical treatment with diagnoses of osteosarcoma, Ewing's tumor and chondrosarcoma were studied retrospectively. The sample was analyzed to characterize the biopsy technique used, histological type of the tumor, neoadjuvant chemotherapy used, local recurrences and tumor contamination in the biopsy path. Results: Among the 35 patients studied, four cases of contamination occurred (11.43%): one from osteosarcoma, two from Ewing's tumor and one from chondrosarcoma. There was no association between the type of tumor and presence of tumor contamination in the biopsy path (p = 0.65). There was also no association between the presence of tumor contamination and the biopsy technique (p = 0.06). On the other hand, there were associations between the presence of tumor contamination and local recurrence (p = 0.01) and between tumor contamination and absence of neoadjuvant chemotherapy (p = 0.02). Conclusion: Tumor contamination in the biopsy path of primary malignant bone tumors was associated with local recurrence. On the other hand, the histological type of the tumor and the type of biopsy did not have an influence on tumor contamination. Neoadjuvant chemotherapy had a protective effect against this complication. Despite these findings, tumor contamination is a complication that should always be taken into consideration, and removal of the biopsy path is recommended in tumor resection surgery. PMID:27047877

  9. Skull bone tumor resection with intraoperative indocyanine green fluorescence imaging: A series of four surgical cases

    Directory of Open Access Journals (Sweden)

    Bunsho Asayama


    Conclusion: Our experience illustrates that intraoperative ICG fluorescence examination might be a useful supplemental method for skull bone tumor resection, especially for tumors extending under the bone surface or similar to normal bone in appearance.

  10. Giant cell tumor of bone and tenosynovial tissue : surgical outcome

    NARCIS (Netherlands)

    Heijden, Lizz van der


    Giant cell tumor of bone (GCTB) is an intermediate, locally aggressive but rarely metastasizing tumor. Radiologically, GCTB shows typical lytic lesions. MR imaging is required to evaluate extent of GCTB for surgical planning. Preferred treatment for GCTB is extended curettage with local adjuvants,

  11. Rheumatic manifestations of primary and metastatic bone tumors and paraneoplastic bone disease. (United States)

    Waimann, Christian A; Lu, Huifang; Suarez Almazor, Maria E


    Bone tumors can show a wide range of nonspecific rheumatic manifestations. The presence of unexplained or atypical chronic bone pain, an enlarging bone mass, neurovascular compression syndromes, or pathologic fractures should alert us to the possibility of a bone tumor causing these symptoms. These patients must undergo a complete physical examination; adequate imaging; and, if needed, a biopsy to confirm their diagnosis and offer them an opportune treatment. In addition, bone tumors and other malignancies can present remote clinical manifestations and unusual laboratory findings (eg, HOA, hypophosphatemia, hyperphosphaturia, and hypercalcemia) that may be the first and early manifestation of an occult cancer. These findings should motivate a cancer screening according to age, sex, and personal history. Cancer therapies also have a big impact on bone health, increasing the risk of osteoporosis, osteomalacia, and/or osteonecrosis. Rheumatologists should be aware of possible long-term adverse events of cancer treatment to avoid future complications. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. A metastatic glomus jugulare tumor. A temporal bone report

    Energy Technology Data Exchange (ETDEWEB)

    El Fiky, F.M.; Paparella, M.M.


    The clinicopathologic findings in the temporal bone of a patient with a highly malignant metastasizing glomus jugulare tumor are reported. The patient exhibited all the symptoms of primary malignant tumors of the ear, including facial paralysis, otorrhea, pain, hearing loss, tinnitus, dizziness, and vertigo. He was treated with cobalt irradiation followed by radium implant in the ear canal for a residual tumor; then a left-sided radical mastoidectomy was performed.

  13. A recurrent giant cell tumor of bone treated with denosumab

    Directory of Open Access Journals (Sweden)

    Nicola Stadler


    Full Text Available Although the giant cell tumor of bone is generally classified as a benign tumor it can rarely metastasize and has a potential risk of local recurrence. We want to report about a female patient who suffered from a recurrence of a giant cell tumor of bone after the implantation of a total endoprosthesis of the knee joint. We have treated her with denosumab, which is a receptor activator of nuclear factor kappa-B ligand inhibitor. In this case report we want to present a new option to treat this kind of neoplasm.

  14. Computer-assisted Orthopaedic Surgery. (United States)

    Hernandez, David; Garimella, Roja; Eltorai, Adam E M; Daniels, Alan H


    Nowadays, operating rooms can be inefficient and overcrowded. Patient data and images are at times not well integrated and displayed in a timely fashion. This lack of coordination may cause further reductions in efficiency, jeopardize patient safety, and increase costs. Fortunately, technology has much to offer the surgical disciplines and the ongoing and recent operating room innovations have advanced preoperative planning and surgical procedures by providing visual, navigational, and mechanical computerized assistance. The field of computer-assisted surgery (CAS) broadly refers to surgical interface between surgeons and machines. It is also part of the ongoing initiatives to move away from invasive to less invasive or even noninvasive procedures. CAS can be applied preoperatively, intraoperatively, and/or postoperatively to improve the outcome of orthopaedic surgical procedures as it has the potential for greater precision, control, and flexibility in carrying out surgical tasks, and enables much better visualization of the operating field than conventional methods have afforded. CAS is an active research discipline, which brings together orthopaedic practitioners with traditional technical disciplines such as engineering, computer science, and robotics. However, to achieve the best outcomes, teamwork, open communication, and willingness to adapt and adopt new skills and processes are critical. Because of the relatively short time period over which CAS has developed, long-term follow-up studies have not yet been possible. Consequently, this review aims to outline current CAS applications, limitations, and promising future developments that will continue to impact the operating room (OR) environment and the OR in the future, particularly within orthopedic and spine surgery. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

  15. Imaging of bone tumors for the musculoskeletal oncologic surgeon

    Energy Technology Data Exchange (ETDEWEB)

    Errani, C., E-mail: [Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna (Italy); Kreshak, J., E-mail: [Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna (Italy); Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Ruggieri, P., E-mail: [Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna (Italy); Alberghini, M., E-mail: [Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Picci, P., E-mail: [Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Department of Research, Istituto Ortopedico Rizzoli, Bologna (Italy); Vanel, D., E-mail: [Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Department of Research, Istituto Ortopedico Rizzoli, Bologna (Italy)


    The appropriate diagnosis and treatment of bone tumors requires close collaboration between different medical specialists. Imaging plays a key role throughout the process. Radiographic detection of a bone tumor is usually not challenging. Accurate diagnosis is often possible from physical examination, history, and standard radiographs. The location of the lesion in the bone and the skeleton, its size and margins, the presence and type of periosteal reaction, and any mineralization all help determine diagnosis. Other imaging modalities contribute to the formation of a diagnosis but are more critical for staging, evaluation of response to treatment, surgical planning, and follow-up.When necessary, biopsy is often radioguided, and should be performed in consultation with the surgeon performing the definitive operative procedure. CT is optimal for characterization of the bone involvement and for evaluation of pulmonary metastases. MRI is highly accurate in determining the intraosseous extent of tumor and for assessing soft tissue, joint, and vascular involvement. FDG-PET imaging is becoming increasingly useful for the staging of tumors, assessing response to neoadjuvant treatment, and detecting relapses.Refinement of these and other imaging modalities and the development of new technologies such as image fusion for computer-navigated bone tumor surgery will help surgeons produce a detailed and reliable preoperative plan, especially in challenging sites such as the pelvis and spine.

  16. Complications of massive allograft reconstruction for bone tumors

    Directory of Open Access Journals (Sweden)

    Abolhasan Borjian


    Full Text Available BACKGROUND: Since the evolution of multi-drug chemotherapy and radiotherapy and new sophisticated surgical techniques, limb salvage and reconstruction, rather than amputation, has become the preferred treatment for patients with bone tumors. One option is allograft replacement. Although allograft has several advantages, it is not without complications. This study was performed to observe these complications in a group of patients treated with allograft replacement for bone tumor resection. The purpose was to gain an overview of the factors predisposing to these complications to minimize their occurrence. METHODS: This retrospective study was performed on patients with benign aggressive and malignant bone tumors undergoing limb reconstruction with allograft between 1997 and 2005 in Al-Zahra and Kashani Hospitals in Isfahan, Iran. Data was collected from patient files, clinical notes, radiographs and a recent physical examination. Complications including local recurrence, fracture of allograft, fixation failure, nonunion, infection, skin necrosis and neurological damage were recorded. RESULTS: Sixty patients including 39 males and 21 females were studied. The mean age of patients was 23 ± 11.7 years. The mean follow-up interval was 28.1 ± 12.4 months (mean ± SD. Complications were allograft fracture in 20%, local recurrence in 16%, fixation failure in 11%, nonunion in 6%, infection in 6%, skin necrosis in 6%, and peroneal nerve palsy in 1% of cases. Most local recurrences (60% were those with a mal-performed biopsy. Most allograft fractures occurred when a short plate was used. CONCLUSIONS: Allograft replacement for bone tumors remains a valid option. To avoid complications, biopsy should be done by a trained surgeon in bone oncology. A long plate is recommended for fixation. Sterility and graft processing must be optimal. Autogenous bone graft must be added at host-allograft junction. KEY WORDS: Bone tumors, bone allograft, limb

  17. Soft Tissue Biomechanical Modeling for Computer Assisted Surgery

    CERN Document Server


      This volume focuses on the biomechanical modeling of biological tissues in the context of Computer Assisted Surgery (CAS). More specifically, deformable soft tissues are addressed since they are the subject of the most recent developments in this field. The pioneering works on this CAS topic date from the 1980's, with applications in orthopaedics and biomechanical models of bones. More recently, however, biomechanical models of soft tissues have been proposed since most of the human body is made of soft organs that can be deformed by the surgical gesture. Such models are much more complicated to handle since the tissues can be subject to large deformations (non-linear geometrical framework) as well as complex stress/strain relationships (non-linear mechanical framework). Part 1 of the volume presents biomechanical models that have been developed in a CAS context and used during surgery. This is particularly new since most of the soft tissues models already proposed concern Computer Assisted Planning, with ...

  18. Ankle arthrodesis with bone graft after distal tibia resection for bone tumors. (United States)

    Campanacci, Domenico Andrea; Scoccianti, Guido; Beltrami, Giovanni; Mugnaini, Marco; Capanna, Rodolfo


    Treatment of distal tibial tumors is challenging due to the scarce soft tissue coverage of this area. Ankle arthrodesis has proven to be an effective treatment in primary and post-traumatic joint arthritis, but few papers have addressed the feasibility and techniques of ankle arthrodesis in tumor surgery after long bone resections. Resection of the distal tibia and reconstruction by ankle fusion using non-vascularized structural bone grafts was performed in 8 patients affected by malignant (5 patients) or aggressive benign (3 patients) tumors. Resection length of the tibia ranged from 5 to 21 cm. Bone defects were reconstructed with cortical structural autografts (from contralateral tibia) or allografts or both, plus autologous bone chips. Fixation was accomplished by antegrade nailing (6 cases) or plating (2~cases). All the arthrodesis successfully healed. At followup ranging from 23 to 113 months (average 53.5), all patients were alive. One local recurrence was observed with concomitant deep infection (a below-knee amputation was performed). Mean functional MSTS score of the seven available patients was 80.4% (range, 53 to 93). Resection of the distal tibia and arthrodesis of the ankle with non-vascularized structural bone grafts, combined with autologous bone chips, can be an effective procedure in bone tumor surgery with durable and satisfactory functional results. In shorter resections, autologous cortical structural grafts can be used; in longer resections, allograft structural bone grafts are needed.

  19. Bone and soft tissue tumors of hip and pelvis

    Energy Technology Data Exchange (ETDEWEB)

    Bloem, Johan L., E-mail: [Leiden University Medical Center, Department of Radiology, PO Box 9600, 2300 RC Leiden (Netherlands); Reidsma, Inge I., E-mail: [Leiden University Medical Center, Department of Radiology, PO Box 9600, 2300 RC Leiden (Netherlands)


    Objective is to identify epidemiologic and radiologic criteria allowing specific diagnoses of tumors and tumor-like lesions in the hip region and pelvis, and to optimize pre-operative staging. Patients with pelvic tumors are usually older, and their tumors are larger relative to patients with tumors in extremities. The majority of tumors in the pelvis are malignant (metastases, myeloma, chondrosarcoma, Ewing-, osteo-, and MFH/fibrosarcoma), while those in the proximal femur are in majority benign (fibrous dysplasia, solitary bone cyst, and osteoid osteoma). Soft tissue masses in the thigh in the elderly are typically sarcomas without tumor specific signs. Common tumor-like lesions occurring in the hip and pelvis that can mimic neoplasm are: infections (including tuberculosis), insufficiency/avulsion fractures, cysts, fibrous dysplasia, aneurysmal bone cyst, Langerhans cell histiocytosis, and Paget's disease. Local MR staging is based on the compartmental anatomy. The psoas and gluteal muscles are easily invaded by sarcoma originating in the ileum. The pectineus muscle protects the neurovascular bundle at the level of the hip. The thigh is separated into three compartments, some structures (Sartorius muscle) cross borders between compartments. Immobile joints (SI-joints, osteoarthritic hip) are relatively easily crossed by sarcoma and giant cell tumor.

  20. Ex Vivo Behaviour of Human Bone Tumor Endothelial Cells

    Energy Technology Data Exchange (ETDEWEB)

    Infante, Teresa [SDN-Foundation, Institute of Diagnostic and Nuclear Development, IRCCS, 80143 Naples (Italy); Cesario, Elena [Department of Biochemistry and Biophysics, Second University of Naples, 80138 Naples (Italy); Gallo, Michele; Fazioli, Flavio [Division of Skeletal Muscles Oncology Surgery, National Cancer Institute, Pascale Foundation, 80131 Naples (Italy); De Chiara, Annarosaria [Anatomic Pathology Unit, National Cancer Institute, Pascale Foundation, 80131 Naples (Italy); Tutucci, Cristina; Apice, Gaetano [Medical Oncology of Bone and Soft Sarcoma tissues Unit, National Cancer Institute, Pascale Foundation, 80131 Naples (Italy); Nigris, Filomena de, E-mail: [Department of Biochemistry and Biophysics, Second University of Naples, 80138 Naples (Italy)


    Cooperation between endothelial cells and bone in bone remodelling is well established. In contrast, bone microvasculature supporting the growth of primary tumors and metastasis is poorly understood. Several antiangiogenic agents have recently been undergoing trials, although an extensive body of clinical data and experimental research have proved that angiogenic pathways differ in each tumor type and stage. Here, for the first time, we characterize at the molecular and functional level tumor endothelial cells from human bone sarcomas at different stages of disease and with different histotypes. We selected a CD31{sup +} subpopulation from biopsies that displayed the capability to grow as adherent cell lines without vascular endothelial growth factor (VEGF). Our findings show the existence in human primary bone sarcomas of highly proliferative endothelial cells expressing CD31, CD44, CD105, CD146 and CD90 markers. These cells are committed to develop capillary-like structures and colony formation units, and to produce nitric oxide. We believe that a better understanding of tumor vasculature could be a valid tool for the design of an efficacious antiangiogenic therapy as adjuvant treatment of sarcomas.

  1. Impact of primary metastatic bone disease in germ cell tumors

    DEFF Research Database (Denmark)

    Oing, C; Oechsle, K; Necchi, A


    Background: Bone metastases (BM) are rare in germ cell tumor (GCT) patients. Systematic data on risk factors, treatment and outcome are largely lacking. Patients and methods: A database created by an international consortium including 123 GCT patients with BM at primary diagnosis was retrospectiv......Background: Bone metastases (BM) are rare in germ cell tumor (GCT) patients. Systematic data on risk factors, treatment and outcome are largely lacking. Patients and methods: A database created by an international consortium including 123 GCT patients with BM at primary diagnosis...

  2. Utility of Fine Needle Aspiration Cytology in Diagnosing Bone Tumors

    Directory of Open Access Journals (Sweden)

    Sonal Mahajan


    Results: A total of 36 cases were studied, of which diagnostic material was adequately obtained in 32 cases (88.88%. The sensitivity (92.85% and specificity (94.44% of FNAC were high, with an accuracy of 93.75%, which is similar to findings in other studies. Conclusion: FNAC plays a vital role in diagnosing bone tumors. It is a rapid, easy, cheap, and minimum invasive outpatient department procedure. However histopathology is still important in diagnosing bone tumors that are unclear or undiagnosed on FNAC since histopathology gives a complete architectural pattern of tissue.

  3. Evaluation of bone scintigraphy in differential diagnosis of benign bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    Okuyama, Takeo; Suzuki, Hitoshi; Nakamoto, Kazuya; Suzuki, Soji (Tokyo Medical and Dental Univ. (Japan). School of Medicine)


    Bone scintigrachy with sup(99m)Tc-phosphate compounds was evaluated from the analysis of 71 consecutive cases of various benign bone tumors whether the scintigrams could be helpful in their differential diagnosis. The characteristics of the scintigraphic image at the site of bone lesions were noticed as being marked (++), moderate (+) and poor or minimal (-), according to the degree of accumulation of the radioactivity. Fibrous dysplasia (8 among 9 cases) as well as aneurysmal bone cyst (3 among 4 cases) had strong tendency of marked accumulation. Poor or minimal accumulation was observed in almost all of the lesions of nonossifying fibroma including fibrous cortical defect (6 all cases), solitary bone cyst (4 among 6 cases) and enchondroma (3 among 4 cases). Moderate accumulation was said to be non-specific, since it could be encountered in any type of benign bone tumors. But it was noticed that the majority of the bone lesions of eosinophilic granuloma (7 among 9 cases) showed moderate accumulation and the scintigraphic evidence of the skeletal disease appeared to be less extensive than the roentgenogram. These scintigraphic characteristics realized in some benign bone tumors occasionally played an important role in clinical diagnosis, especially in the cases atypical on roentgenographic findings. Several instructive cases whose final diagnosis was strongly linked to the scintigraphic information were demonstrated.

  4. Challenges of technology integration and computer-assisted surgery. (United States)

    Rivkin, Gurion; Liebergall, Meir


    The rapid progress of modern computerized capabilities has not been paralleled by a similar progress in the operating room setting and in operating techniques. The major advance in orthopaedic surgery during the past fifty years has been the introduction of intraoperative fluoroscopic imaging, while surgical techniques have remained mostly unchanged. Orthopaedic procedures dealing with bones--a nondeformable tissue--are suitable for computerized guidance based on preoperatively and intraoperatively obtained images. Computer-assisted surgery progressed from the first-generation systems of the 1990 s to the present third-generation systems, enabling surgeons to implant a knee or hip prosthesis with high precision. However, most orthopaedic surgeons avoid using computer-navigation surgical techniques. Why has the implementation of computer-assisted surgery procedures met so many hurdles and obstacles? The factors that make up the answer to this question can be grouped into three categories: human, technological, and financial. Computer-assisted surgery has the potential to revolutionize orthopaedic surgery just as fluoroscopy did a few decades ago; however, its widespread use has been hampered by a lack of sufficient clinical data on the one hand and by a reluctance to use the technique and thereby collect and share data on the other. The challenge is to overcome the human, technological, and financial hurdles. Once these obstacles are addressed, we believe that computer-assisted surgery will set a new standard of care. Until that time, some will be willing to lead the revolution and pay the price of progress, and others will be reluctant to take part in this endeavor.

  5. Late cardiotoxicity after treatment for a malignant bone tumor

    NARCIS (Netherlands)

    Postma, A; BinkBoelkens, MTE; BeaufortKrol, GCM; Kengen, RAM; Elzenga, NJ; SchasfoortvanLeeuwen, MJM; Kamps, WA; Schraffordt Koops, H.

    Cardiac function was assessed in longterm survivors of malignant bone tumors who were treated according to Rosen's T-5 or T-10 protocol, both including doxorubicin. Thirty-one patients, ages 10-45 years (median age 17.8 years) were evaluated 2.3-14.1 years (median 8.9 years) following completion of

  6. Calcium phosphate ceramics as bone graft substitutes in filling bone tumor defects

    Directory of Open Access Journals (Sweden)

    Saikia K


    Full Text Available Background: Synthetic bio-inert materials are currently used as an alternative to autogenous bone graft. Calcium hydroxyapatite (HA and Beta tri-calcium phosphate (β-TCP, which belong to the calcium phosphate ceramics group, are biocompatible and osteo-conductive. The purpose of this study is to analyse the use of HA and β-TCP in their ceramic forms as a bone graft substitute in filling bone voids after curettage of benign bone tumors. Materials and Methods: Twenty-four patients in the age range of 3.5-55 years (mean 14.3 years having benign bone tumors with bone defects were filled with bone graft substitute following curettage. In 20 patients bone defects were filled with block/granules of HA ceramic and in four with β-TCP. Fibular strut graft was packed with HA in four patients. The patients were followed up for an average of 18 months (range 12-36 months. Results: The functional status of the patients at follow-up was evaluated and compared with preoperative functional status. Early incorporation of graft substitutes became evident radiologically between 6 and 10 weeks (Stage I. Complete incorporation (Stage III was observed in an average of nine months (6-18 months. Clinical healing was observed before radiological healing. The average time taken to return to preoperative function was 14 weeks. There was no recurrence of lesion or growth retardation. Conclusion: Calcium hydroxyapatite and β-TCP are excellent bone graft substitutes for autogenous bone graft in filling voids after curettage of benign bone tumors.

  7. Computer assisted radiology and surgery. CARS 2010

    Energy Technology Data Exchange (ETDEWEB)



    The conference proceedings include contributions to the following topics: (1) CARS Clinical Day: minimally invasive spiral surgery, interventional radiology; (2) CARS - computer assisted radiology and surgery: ophthalmology, stimulation methods, new approaches to diagnosis and therapy; (3) Computer assisted radiology 24th International congress and exhibition: computer tomography and magnetic resonance, digital angiographic imaging, digital radiography, ultrasound, computer assisted radiation therapy, medical workstations, image processing and display; (4) 14th Annual conference of the International Society for computer aided surgery; ENT-CMF head and neck surgery computer-assisted neurosurgery, cardiovascular surgery, image guided liver surgery, abdominal and laparoscopic surgery, computer-assisted orthopedic surgery, image processing and visualization, surgical robotics and instrumentation, surgical modeling, simulation and education; (5) 28th International EuroPACS meeting: image distribution and integration strategies, planning and evaluation, telemedicine and standards, workflow and data flow in radiology; (6) 11th CARS/SPIE/EuroPACS joint workshop on surgical PACS and the digital operating, management and assessment of OR systems and integration; (7) 12th International workshop on computer-aided diagnosis: special session on breast CAD, special session on thoracic CAD, special session on abdominal brain, lumbar spine CAD; (8) 16th computed Maxillofacial imaging congress: computed maxillofacial imaging in dental implantology, orthodontics and dentofacial orthopedics; approaches to 3D maxillofacial imaging; surgical navigation; (9) 2nd EuroNOTES/CARS workshop on NOTES: an interdisciplinary challenge; (10) 2nd EPMA/CARS workshop on personalized medicine and ICT.; (11)poster sessions.

  8. Serous degeneration of bone marrow mimics spinal tumor. (United States)

    Sung, Chih-Wei; Hsieh, Kevin Li-Chun; Lin, Yun-Ho; Lin, Chun-Yi; Lee, Chian-Her; Tsuang, Yang-Hwei; Kuo, Yi-Jie


    To present a rare case of serous degeneration of bone marrow which resembles primary spinal tumor or bony metastasis to spine. Serous degeneration of bone marrow or gelatinous marrow transformation is a rare disease characterized by focal marrow hypoplasia, fat atrophy, and accumulation of extracellular mucopolysaccharides abundant in hyaluronic acid. Few literature was reviewed and few clinical case was presented. Two cases of serous marrow transformation were reported. In the first case, a 29-year-old man suffered from severe left buttock pain. Bone metastasis was impressed in radiology examinations. Percutaneous endoscopic lumbar discectomy was performed along with bone biopsy. In the second case, a 49-year-old man presented lower back pain with radiation to bilateral lower legs. Magnetic resonance imaging revealed a water-like signal lesion in sacrum. Serous marrow transformation was confirmed pathologically in both cases. To the best of our knowledge, a case of serous degeneration of bone marrow resembling malignancy has not been reported in the literature. In this report, two cases demonstrate serous transformation of bone marrow mimics spinal tumor.

  9. Quantification of radionuclide uptake levels for primary bone tumors

    Directory of Open Access Journals (Sweden)

    Hasford Francis


    Full Text Available The purpose of the study is to quantify the level of uptake of administered radionuclide in primary bone tumors for patients undergoing bone scintigraphy. Retrospective study on 48 patient's scintigrams to quantify the uptake levels of administered radiopharmaceuticals was performed in a nuclear medicine unit in Ghana. Patients were administered with activity ranging between 0.555 and 1.110 MBq (15–30 mCi, and scanned on Siemens SPECT system. Analyses on scintigrams were performed with Image J software by drawing regions of interest (ROIs over identified hot spots (pathologic sites. Nine skeletal parts namely cranium, neck, shoulder, sacrum, sternum, vertebra, femur, ribcage, and knee were considered in the study, which involved 96 identified primary tumors. Radionuclide uptakes were quantified in terms of the estimated counts of activity per patient for identified tumor sites. Average normalized counts of activity (nGMC per patient ranged from 5.2759 ± 0.6590 cts/mm2/MBq in the case of cranium tumors to 72.7569 ± 17.8786 cts/mm2/MBq in the case of ribcage tumors. The differences in uptake levels could be attributed to different mechanisms of Tc-99m MDP uptake in different types of bones, which is directly related to blood flow and degree of osteoblastic activity. The overall normalized count of activity for the 96 identified tumors was estimated to be 23.0350 ± 19.5424 cts/mm2/MBq. The study revealed highest uptake of activity in ribcage and least uptake in cranium. Quantification of radionuclide uptakes in tumors is important and recommended in assessing patient's response to therapy, doses to critical organs and in diagnosing tumors.

  10. Results of Diagnostic Review in Pediatric Bone Tumors and Tumorlike Lesions

    NARCIS (Netherlands)

    van den Berg, Hendrik; Slaar, Annelie; Kroon, Herman M.; Taminiau, Anthonie H. M.; Hogendoorn, Pancras


    Background: Histological examination of bone tumors is one of the most difficult subjects in pathology. In this manuscript, correctness of initial histological diagnosis in pediatric bone tumors and tumorlike lesions was investigated. Procedure: All 262 bone tumor specimens of children up to the age

  11. Future Prospects for Computer-Assisted Mathematics

    Energy Technology Data Exchange (ETDEWEB)

    Bailey, David H.; Borwein, Jonathan M.


    The recent rise of ''computer-assisted'' and ''experimental'' mathematics raises intriguing questions as to the future role of computation in mathematics. These results also draw into question the traditional distinctions that have been drawn between formal proof and computationally-assisted proof. This article explores these questions in the context of the growing consensus among computer technologists that Moore's Law is likely to continue unabated for quite some time into the future, producing hardware and software much more powerful than what is available today.

  12. Multilobular tumor of the zygomatic bone in a dog

    Directory of Open Access Journals (Sweden)

    L. Leonardi


    Full Text Available Multilobular tumor of bone (MTB (also known as Multilobular Osteochondrosarcoma is an uncommon bone tumor frequently located on the skull of dogs, rarely on the ribs or pelvis. These neoplasms are slow growing, locally invasive, and have the potential to compress and invade the brain. A 10-year-old mixed breed dog was presented with a history of approximately 4 months of progressive growth of a left zygomatic mass. Radiographic investigation revealed a finely granular or stippled non homogeneous radiopaque mass involving the zygomatic arch. After surgery, grossly the neoplasm consisted of multiple, variably sized, grayish-white to yellow nodules separated by collagenous septa of different thickness. Histologically, the tumor was characterized by the presence of multiple lobules containing osteoid and cartilage, separated by a net of fibrous septae. This neoplastic pattern was consistent with a typical multilobular tumor of bone and based on clinical, radiographical, gross and light microscopic findings the definitive diagnosis was made. While reviewing veterinary literature only few cases of MTB were found in dogs.

  13. Computer-assisted abdominal surgery: new technologies. (United States)

    Kenngott, H G; Wagner, M; Nickel, F; Wekerle, A L; Preukschas, A; Apitz, M; Schulte, T; Rempel, R; Mietkowski, P; Wagner, F; Termer, A; Müller-Stich, Beat P


    Computer-assisted surgery is a wide field of technologies with the potential to enable the surgeon to improve efficiency and efficacy of diagnosis, treatment, and clinical management. This review provides an overview of the most important new technologies and their applications. A MEDLINE database search was performed revealing a total of 1702 references. All references were considered for information on six main topics, namely image guidance and navigation, robot-assisted surgery, human-machine interface, surgical processes and clinical pathways, computer-assisted surgical training, and clinical decision support. Further references were obtained through cross-referencing the bibliography cited in each work. Based on their respective field of expertise, the authors chose 64 publications relevant for the purpose of this review. Computer-assisted systems are increasingly used not only in experimental studies but also in clinical studies. Although computer-assisted abdominal surgery is still in its infancy, the number of studies is constantly increasing, and clinical studies start showing the benefits of computers used not only as tools of documentation and accounting but also for directly assisting surgeons during diagnosis and treatment of patients. Further developments in the field of clinical decision support even have the potential of causing a paradigm shift in how patients are diagnosed and treated.

  14. Computer-Assisted Instruction on Study Skills. (United States)

    Gadzella, Bernadette M.


    A computer-assisted instruction study skills program was presented to 88 college students, while a control group did not have access to it. Scores for the experimental group on the Survey of Study Habits and Attitudes increased during the semester, while scores for the control group decreased. (Author/BW)

  15. Computer Assisted Language Learning (CALL) Software: Evaluation ...

    African Journals Online (AJOL)

    Evaluating the nature and extent of the influence of Computer Assisted Language Learning (CALL) on the quality of language learning is highly problematic. This is owing to the number and complexity of interacting variables involved in setting the items for teaching and learning languages. This paper identified and ...

  16. Computer Assisted Programmed Instruction and Cognitive ...

    African Journals Online (AJOL)

    The achievement of students of application learning mode was also significantly higher than those of recall and principle respectively. There was no significant interaction effect between Cognitive Preference Style and Computer Assisted Programmed Instruction. The implications of the result to the stakeholder were ...

  17. Computer-Assisted Discovery and Proof

    Energy Technology Data Exchange (ETDEWEB)

    Bailey, David H.; Borwein, Jonathan M.


    With the advent of powerful, widely-available mathematical software, combined with ever-faster computer hardware, we are approaching a day when both the discovery and proof of mathematical facts can be done in a computer-assisted manner. his article presents several specific examples of this new paradigm in action.

  18. Giraffe, a Computer Assisted Instruction Programme. (United States)

    Boekhorst, Albert K.; Groot, Tineke

    In 1989 a two year collaborative project, CAI (Computer Assisted Instruction) & Humanities, was initiated between the Faculty of Arts and IBM Netherlands during which General Information Retrieval All Faculties For Bibliographic Education (GIRAFFE), a program for the retrieval of information on general bibliographies, was developed. The…

  19. Local recurrence after curettage treatment of giant cell tumors in peripheral bones: retrospective study by the GSF-GETO (French Sarcoma and Bone Tumor Study Groups)

    National Research Council Canada - National Science Library

    Gouin, F; Dumaine, V


    .... The purpose of this retrospective study by the French Sarcoma and Bone Tumor Study Groups (GSF-GETO) was to analyze various tumor-specific and surgery-specific factors that could influence the rate of local recurrence...

  20. Fluid-fluid levels in bone and soft tissue tumors demonstrated by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Sone, Miyuki; Ehara, Shigeru; Sasaki, Makoto; Nakasato, Tatsuhiko; Tamakawa, Yoshiharu; Shiraishi, Hideo; Abe, Masataka (Iwate Medical Univ., Morioka (Japan). School of Medicine)


    Fluid-fluid levels in bone tumors have been described in aneurysmal bone cysts and other cystic tumors of bones and soft tissue tumors. We experienced three bone tumors (simple bone cyst, bone metastasis, and osteosarcoma) and three soft tissue tumors (fibrosarcoma, two cases of cavernous hemangioma) that showed fluid-fluid levels on MR, and investigated their cause. Causes included blood in the cystic spaces, hemorrhage in the tumor, the telangiectatic component of the osteosarcoma, and the cavernous component of the hemangioma. No specific diagnosis could be made based on the finding of fluid-fluid levels. We concluded that fluid-fluid levels on MR are rather nonspecific findings in bone and soft tissue tumors and that the diagnosis should be made on the basis of other radiological and clinical findings. (author).

  1. Solitary bone plasmacytoma of the pelvis: a rare tumor

    Directory of Open Access Journals (Sweden)

    Samir Karmali


    Full Text Available Solitary bone plasmacytomas are part of a wide range of monoclonal neoplasms that share a common progenitor in the B lymphocyte lineage. In their particular case, a single bone lesion is found, most frequently on the axial skeleton, having evidence of no other osteolytic lesions or systemic involvement. Diagnosis can sometimes prove to be difficult as they are rare tumors, occurring in 3 to 5% (up to 10% in some series of patients with plasma cell neoplasms, with important considerations regarding the differential diagnosis. We report a case of a solitary bone plasmacytoma, found on the ala of the left ilium of a patient during a routine consult due to hip pain.

  2. The Impact of Immune System in Regulating Bone Metastasis Formation by Osteotropic Tumors

    Directory of Open Access Journals (Sweden)

    Lucia D’Amico


    Full Text Available Bone metastases are frequent and debilitating consequence for many tumors, such as breast, lung, prostate, and kidney cancer. Many studies report the importance of the immune system in the pathogenesis of bone metastasis. Indeed, bone and immune system are strictly linked to each other because bone regulates the hematopoietic stem cells from which all cells of the immune system derive, and many immunoregulatory cytokines influence the fate of bone cells. Furthermore, both cytokines and factors produced by immune and bone cells promote the growth of tumor cells in bone, contributing to supporting the vicious cycle of bone metastasis. This review summarizes the current knowledge on the interactions among bone, immune, and tumor cells aiming to provide an overview of the osteoimmunology field in bone metastasis from solid tumors.

  3. Multicentric Giant Cell Tumor of Bone: Synchronous and Metachronous Presentation

    Directory of Open Access Journals (Sweden)

    Reiner Wirbel


    Full Text Available A 27-year-old man treated 2.5 years ago for synchronous multicentric giant cell tumor of bone located at the right proximal humerus and the right 5th finger presented now with complaints of pain in his right hip and wrist of two-month duration. Radiology and magnetic resonance revealed multicentric giant cell tumor lesions of the right proximal femur, the left ileum, the right distal radius, and the left distal tibia. The patient has an eighteen-year history of a healed osteosarcoma of the right tibia that was treated with chemotherapy, resection, and allograft reconstruction. A literature review establishes this as the first reported case of a patient with synchronous and metachronous multicentric giant cell tumor who also has a history of osteosarcoma.

  4. Typical tumors of the petrous bone; Typische Tumoren des Felsenbeins

    Energy Technology Data Exchange (ETDEWEB)

    Ahlhelm, F.; Mueller, U. [Kantonsspital Baden AG, Abteilung fuer Neuroradiologie, Institut fuer Radiologie, Baden (Switzerland); Ulmer, S. [Medizinisch-Radiologisches Institut, Zuerich (Switzerland)


    In the region of the petrous bone, inner acoustic canal and cerebellopontine angle, a variety of different tissues can be found, such as bony, epithelial, neural and vascular structures. Tumorous or tumor-like lesions, vascular or bony malformations or other pathologies can therefore be found in all of these areas. We discuss various frequently occurring tumorous or tumor-like pathologies including congential lesions, such as mucoceles, inflammatory disorders including osteomyelitis, pseudotumors and Wegener's granulomatosis. Benign non-neoplastic lesions, such as cholesteatoma, cholesterol granuloma, epidermoid and benign neoplastic tumors, such as the most commonly found vestibular schwannoma, meningeoma, paraganglioma, vascular pathologies and finally malignant lesions, such as metastasis, chordoma or chondrosarcoma and endolymphatic sac tumor (ELST) are also discussed. The emphasis of this article is on the appearance of these entities in computed tomography (CT) and more so magnetic resonance imaging (MRI), it provides key facts and typical images and discusses possibilities how to distinguish these pathologies. (orig.) [German] In der Region des Felsenbein, inneren Gehoerkanals und Kleinhirnbrueckenwinkels findet sich eine Vielzahl an unterschiedlichen Gewebearten inklusive knoechernes, epitheliales, nervales und vaskulaeres Gewebe. Tumoren oder tumoraehnliche Laesionen, ossaere oder vaskulaere Pathologien koennen entsprechend dort gefunden werden. Wir diskutieren verschiedene Tumoren oder tumoraehnliche Pathologien inklusive angeborene Laesionen wie Muko- und Meningozelen, entzuendliche Veraenderungen wie die Osteomyelitis, Pseudotumoren, die Wegener-Granulomatose, nichtneoplastische Tumoren wie das Epidermoid, Cholesteatom oder Cholesterolgranulom und gutartige neoplastische Tumoren wie das am haeufigsten zu findende Vestibularisschwannom, das Paragangliom und das Meningeom, Gefaessprozesse/-pathologien und schliesslich maligne Laesionen wie Metastasen

  5. Computer-Assisted Evaluation of Videokymographic Data

    Czech Academy of Sciences Publication Activity Database

    Novozámský, Adam; Sedlář, Jiří; Zita, A.; Švec, J. G.; Zitová, Barbara; Flusser, Jan; Hauzar, D.


    Roč. 1, č. 1 (2013), s. 49-49 ISSN 1805-8698. [EFMI STC Prague Data and Knowledge for Medical Decision Support. 17.04.2013-19.04.2013, Praha] Institutional support: RVO:67985556 Keywords : videokymography * image processing * computerassisted evaluation Subject RIV: JD - Computer Applications, Robotics evaluation of videokymographic data.pdf

  6. Significance of bone specific alkaline phosphatase as a tumor marker in malignant bone tumor

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sug Jun; Jeon, Dae Geun; Huh, Kwang [Korea Cancer Center Hospital, Seoul (Korea, Republic of)


    The relationship between total alkaline phosphatase activity and bone forming lesion is a well known fact. But alkaline phosphatase consist mainly of two portion (liver, bone). To clarify the exact activity of bone forming tissue, quantitative measurement of BALP is essential. Two finds of tests were performed for their feasibility as a laboratory test (wheat germ lectin vs electrophoresis). We analyzed 40 bony lesion and got 58 samples. Lectin method was simple, economic, with reliable resproducability. Owing to the small number of test sample, we could not identify the relationship between the disease activity and measured BALP level. Further collection of clinical sample and analysis the pattern of BALP on each clinical settings. (author). 8 refs.

  7. Computer-Assisted Exposure Treatment for Flight Phobia (United States)

    Tortella-Feliu, Miguel; Bornas, Xavier; Llabres, Jordi


    This review introduces the state of the art in computer-assisted treatment for behavioural disorders. The core of the paper is devoted to describe one of these interventions providing computer-assisted exposure for flight phobia treatment, the Computer-Assisted Fear of Flying Treatment (CAFFT). The rationale, contents and structure of the CAFFT…

  8. Bone marrow-derived cells and tumor growth : Contribution of bone marrow-derived cells to tumor micro-environments with special focus on mesenchymal stem cells

    NARCIS (Netherlands)

    Roorda, Berber D.; ter Elst, Arja; Kamps, Willem A.; de Bont, Eveline S. J. M.

    Research has provided evidence that tumor growth depends on the interaction of tumor cells with stromal cells, as already suggested in 1889 by Paget. Experimental and clinical studies have revealed that tumor stromal cells can be derived from bone marrow (BM)-derived progenitor cells, such as

  9. Computer-Assisted Technique for Surgical Tooth Extraction

    Directory of Open Access Journals (Sweden)

    Hosamuddin Hamza


    Full Text Available Introduction. Surgical tooth extraction is a common procedure in dentistry. However, numerous extraction cases show a high level of difficulty in practice. This difficulty is usually related to inadequate visualization, improper instrumentation, or other factors related to the targeted tooth (e.g., ankyloses or presence of bony undercut. Methods. In this work, the author presents a new technique for surgical tooth extraction based on 3D imaging, computer planning, and a new concept of computer-assisted manufacturing. Results. The outcome of this work is a surgical guide made by 3D printing of plastics and CNC of metals (hybrid outcome. In addition, the conventional surgical cutting tools (surgical burs are modified with a number of stoppers adjusted to avoid any excessive drilling that could harm bone or other vital structures. Conclusion. The present outcome could provide a minimally invasive technique to overcome the routine complications facing dental surgeons in surgical extraction procedures.

  10. Epiphyseal Sparing and Reconstruction by Frozen Bone Autograft after Malignant Bone Tumor Resection in Children

    Directory of Open Access Journals (Sweden)

    Ahmed Hamed Kassem Abdelaal


    Full Text Available Limb salvage surgery has become the standard treatment for malignant primary bone tumors in the extremities. Limb salvage represents a challenge in skeletally immature patients. Several treatment options are available for limb reconstruction after tumor resection in children. We report our results using the technique of epiphyseal sparing and reconstruction with frozen autograft bone in 18 children. The mean follow-up period for the all patients included in this study is 72 ± 26 m. Eight patients remained disease-free, seven patients lived with no evidence of disease, two were alive but with disease, and one patient died of the disease. Five- and ten-year rates of survival were 94.4%. Graft survival at 5 and 10 years was 94.4%. Functional outcome using the Enneking scale was excellent in 17 patients (94.4% and poor in one patient (5.5%. Complications include 2 nonunions, 2 fractures, 2 deep infections, 1 soft tissue recurrence, and leg length discrepancy in 7 cases. This technique is a good reconstructive choice in a child with a nonosteolytic primary or secondary bone tumor, responsive to chemotherapy, without involvement of the articular cartilage. It is a straight forward, effective, and biological technique, which affords immediate mobilization of joints and possible cryoimmune effects, with excellent long term functional outcome and less complication.

  11. Percutaneous treatment of bone tumors by radiofrequency thermal ablation

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Santiago, Fernando, E-mail: [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Mar Castellano Garcia, Maria del; Guzman Alvarez, Luis [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Martinez Montes, Jose Luis [Department of Traumatology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Ruiz Garcia, Manuel; Tristan Fernandez, Juan MIguel [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain)


    We present our experience of the treatment of bone tumors with radiofrequency thermal ablation (RFTA). Over the past 4 years, we have treated 26 cases (22 benign and 4 malignant) using CT-guided RFTA. RFTA was the sole treatment in 19 cases and was combined with percutaneous cementation during the same session in the remaining seven cases. Our approach to the tumors was simplified, using a single point of entrance for both RFTA and percutaneous osteoplasty. In the benign cases, clinical success was defined as resolution of pain within 1 month of the procedure and no recurrence during the follow-up period. It was achieved in 19 out of the 21 patients in which curative treatment was attempted. The two non-resolved cases were a patient with osteoid osteoma who developed a symptomatic bone infarct after a symptom-free period of 2 months and another with femoral diaphysis osteoblastoma who suffered a pathological fracture after 8 months without symptoms. The procedure was considered clinically successful in the five cases (4 malign and 1 benign) in which palliative treatment was attempted, because there was a mean ({+-}SD) reduction in visual analogue scale (VAS) pain score from 9.0 {+-} 0.4 before the procedure to <4 during the follow-up period.

  12. Rotationplasty for bone tumors: is there still a role? (United States)

    Agarwal, Manish; Puri, Ajay; Anchan, Chetan; Shah, Mandip; Jambhekar, Nirmala


    We evaluated the disease status and functional results in 30 patients (range, 6-25 years) who underwent rotationplasty for bone sarcomas from January 2000 to February 2004. Plating was used for fixation in all 27 distal femur resections. In the proximal femur tumor, the distal femur was contoured and fixed to the ilium with cancellous screws. In the two cases involving the entire femur, the upper end of the tibia was articulated with the acetabulum in one case and an Austin Moore prosthesis was inserted in the upper end of the tibia in the other. Two patients underwent an amputation after postoperative vascular compromise. Other complications included venous congestion in two patients, who recovered after exploration, partially recovered nerve palsy in one, wound infection in two, local recurrence in one, and nonunion with subsequent bone grafting in one. Functional evaluation was documented in 26 patients with a followup ranging from 24 to 60 months. Using the Musculoskeletal Tumor Society scoring system, the score was 25 or greater in 20 of 26 patients. In appropriately indicated cases, rotationplasty provides good local disease control and good function.


    Campanacci, D A; Dursky, S; Totti, F; Frenos, F; Scoccianti, G; Beltrami, G; Capanna, R


    Osteoarticular allografts represent a reconstructive option after bone tumor resection around the knee in growing children. The major advantage is the chance to preserve the growth plate of the remaining bone, but the disadvantage is the high failure rate eventually requiring definitive prosthetic replacement at skeletal maturity. We retrospectively reviewed 22 patients who underwent osteoarticular allograft reconstructions of the distal femur (16) or proximal tibia (6). There were 12 females and 10 males with an average age at surgery of 11 years (7-15). The diagnosis was osteosarcoma in 19 cases and Ewing sarcoma in 3. All patients underwent pre- and post-operative chemotherapy. At an average follow-up of 103 months (12-167), 18 patients (82%) were alive and 4 had died (18%). We observed 10 allograft failures requiring prosthetic replacement, 6 in distal femur and 4 in proximal tibia reconstructions. At last follow-up 8 allografts (36%) were still in place. Overall allograft survival was 79.6% at five and 45.8% at ten years. In distal femur, allograft survival was 86.2% at five and 59.1% at ten years. In proximal tibia, allograft survival was 62.5% at 5 years and 31.2% at 67 months. Average limb shortening was 3 cm (0- 5) in 8 patients with the allograft still in situ and 2 cm (0-4) in 10 patients after prosthetic replacement. Average MSTS functional score of the whole series was 25 (83.7%). The MSTS score of patients after revision with prosthetic replacement was 24 (80%) while patients who still had the allograft retained had an average MSTS scores of 26.8 (89.3%). In conclusion, osteoarticular allograft reconstruction of the knee after bone tumor resection in pediatric age can be considered a temporary solution with the aim to limit limb length discrepancy before definitive prosthetic replacement after skeletal maturity.

  14. Hydroxyapatite-coated collars reduce radiolucent line progression in cemented distal femoral bone tumor implants


    Coathup, M. J.; Sanghrajka, A.; Aston, W. J.; Gikas, P. D.; Pollock, R. C.; Cannon, S. R.; Skinner, J. A.; Briggs, T. W.; Blunn, G. W.


    BACKGROUND: Aseptic loosening of massive bone tumor implants is a major cause of prosthesis failure. Evidence suggests that an osteointegrated hydroxyapatite (HA)-coated collar would reduce the incidence of aseptic loosening around the cemented intramedullary stem in distal femoral bone tumor prostheses. Because these implants often are used in young patients with a tumor, such treatment might extend the longevity of tumor implants. Questions/purposes We asked whether (1) HA-coated collars we...

  15. Incidence of biopsy-proven bone tumors in children - A report based on the dutch pathology registration "PALGA"

    NARCIS (Netherlands)

    van den Berg, Hendrik; Kroon, Herman M.; Slaar, Annelie; Hogendoorn, Pancras


    Introduction: Data on childhood bone tumors are mainly confined to reports on malignant tumors or on institutional registries. Incidence figures on both benign and malignant bone tumors in childhood are lacking. Methods: From January 1999 to December 2003, 1474 newly diagnosed bone tumors in

  16. Late sarcoma development after curettage and bone grafting of benign bone tumors

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    Picci, Piero, E-mail: [Bone Tumor Center, Istituto Ortopedico Rizzoli, Bologna (Italy); Sieberova, Gabriela [Dept. of Pathology, National Cancer Institute, Bratislava (Slovakia); Alberghini, Marco; Balladelli, Alba; Vanel, Daniel [Bone Tumor Center, Istituto Ortopedico Rizzoli, Bologna (Italy); Hogendoorn, Pancras C.W. [Dept. of Pathology, Leiden University Medical Center, Leiden (Netherlands); Mercuri, Mario [Bone Tumor Center, Istituto Ortopedico Rizzoli, Bologna (Italy)


    Background and aim: Rarely sarcomas develop in previous benign lesions, after a long term disease free interval. We report the experience on these rare cases observed at a single Institution. Patients and methods: 12 cases curetted and grafted, without radiotherapy developed sarcomas, between 1970 and 2005, 6.5-28 years from curettage (median 18, average 19). Age ranged from 13 to 55 years (median 30, average 32) at first diagnosis; tumors were located in the extremities (9 GCT, benign fibrous histiocytoma, ABC, and solitary bone cyst). Radiographic and clinic documentation, for the benign and malignant lesions, were available. Histology was available for 7 benign and all malignant lesions. Results: To fill cavities, autogenous bone was used in 4 cases, allograft in 2, allograft and tricalcium-phosphate/hydroxyapatite in 1, autogenous/allograft in 1, heterogenous in 1. For 3 cases the origin was not reported. Secondary sarcomas, all high grade, were 8 osteosarcoma, 3 malignant fibrous histiocytoma, and 1 fibrosarcoma. Conclusions: Recurrences with progression from benign tumors are possible, but the very long intervals here reported suggest a different cancerogenesis for these sarcomas. This condition is extremely rare accounting for only 0.26% of all malignant bone sarcomas treated in the years 1970-2005 and represents only 8.76% of all secondary bone sarcomas treated in the same years. This incidence is the same as that of sarcomas arising on fibrous dysplasia, and is lower than those arising on bone infarcts or on Paget's disease. This possible event must be considered during follow-up of benign lesions.

  17. Computer Assisted Language Learning. Routledge Studies in Computer Assisted Language Learning (United States)

    Pennington, Martha


    Computer-assisted language learning (CALL) is an approach to language teaching and learning in which computer technology is used as an aid to the presentation, reinforcement and assessment of material to be learned, usually including a substantial interactive element. This books provides an up-to date and comprehensive overview of…

  18. Significance of image analysis in the diagnosis of bone tumors and tumor-like lesions (United States)

    Dreyer, Thomas; Gahm, Thomas; Delling, Guenter


    The distinction between different types of giant-cell containing lesions often represents a challenge for pathologists since wide ranges and overlappings of their morphological features are common. But despite of their similarities the treatment is very different and depends on an accurate morpological diagnostic. Our present study was undertaken to investigate the nuclear DNA content (NDC) of giant-cell containing lesions and its value for the diagnostic. Furthermore we studied the significance of NDC to predict the biological behavior of giant-cell tumors. 12 aneurysmal bone cysts 25 central osteosarcomas (biopsies) and 16 giant-cell tumors of the Hamburger Knochentumorregister were included in this study. In all cases fresh material was available. 20 imprintcytologies from each specimen of each case were prepared . 10 were used for Feulgen-staining to perform quantitative DNA-measurements. 10 were used for Pappenheim-staining for morphological examination. Conventionally prepared sections of each specimen of each patient radiological findings and clinical data served as control-system. The recently developed DNA measuring program CESAR based on image analysis (IBAS I Kontron Germany) was used for this study. The obtained DNA distributions were classified according to a new developed DNAgrading system for imprintcytologies (s. table 1). All investigated aneurysmal bone cysts were 0 I (euploid). 23 central osteosarcomas were G III (aneuploid). 2 central osteosarcomas (predominantly cartilage producing) were G II (only a small number of hypertetraploid cells). 9 giant-cell tumors were G II. 7 Giant

  19. CT assessment of the correlation between clinical examination and bone involvement in oral malignant tumors

    Energy Technology Data Exchange (ETDEWEB)

    Albuquerque, Marco Antonio Portela; Oliveira, Ilka Regina Souza; Cavalcanti, Marcelo Gusmao Paraiso [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Odontologia. Dept. de Radiologia], e-mail:; Kuruoshi, Marcia Etsuko [Universidade de Sao Paulo (USP), SP (Brazil). Hospital Universitario. Dept. de Radiologia


    Oral cancers have a tendency to invade the surrounding bone structures, and this has a direct influence on the treatment management and on outcomes. The objective of this study was to correlate the clinical parameters (location, clinical presentation and TNM staging) of oral malignant tumors that can be associated with a potential of bone invasion and determine the accuracy of clinical examination to predict bone involvement, using computed tomography (CT). Twenty five patients, with oral malignant tumors were submitted to clinical and CT examinations. CT was considered the standard parameter to evaluate the presence of bone involvement. Clinical assessment of location, presentation form and TNM staging of the tumors were then compared to the CT findings in predicting bone involvement. Bone involvement was observed in 68% of the cases. It was predicted that tumors located in the retromolar trigone and hard palate, with a clinical aspect of infiltrative ulcer or nodule and classified in stage IV had a high potential to cause bone involvement. The clinical examination assessment of these tumors showed to be a valuable tool to predict bone invasion, with high sensitivity (82%) and specificity (87.5%), based on the results found in the CT images. No statistical significance was found between the CT and clinical examinations regarding bone involvement. The identification of some clinical parameters such as location, clinical presentation, and TNM stage, associated with a detailed clinical examination, was considered a valuable tool for the assessment of bone destruction by oral malignant tumors. (author)

  20. High Prevalence of Vitamin D Deficiency in Patients with Bone Tumors. (United States)

    Horas, Konstantin; Maier, Gerrit; Jakob, Franz; Maus, Uwe; Kurth, Andreas; Jakuscheit, Axel; Rudert, Maximilian; Holzapfel, Boris Michael


    The aim of this study was to evaluate the prevalence of vitamin D deficiency in patients with different types of bone tumors and to elucidate whether or not there are differences in prediagnostic vitamin D levels in patients with malignant compared to benign bone tumors. Prediagnostic serum 25(OH)D levels of 105 consecutive patients that presented with bone tumors and tumor-like lesions to two Orthopedic Level I University Centers in Germany between 2011 and 2016 were measured on admission. We found an alarming and widespread rate of vitamin D deficiency in patients with bone tumors. Specifically, 83% of all patients had low vitamin D levels with a mean 25(OH)D level of 19.82 ng/ml. Notably, patients diagnosed with malignant bone tumors had significantly lower vitamin D levels compared to patients with benign bone lesions (p = 0.0008). In conclusion, it is essential to assess vitamin D levels in patients with tumors involving bone. In addition, there might be an association between vitamin D deficiency and the onset or course of primary malignant bone tumors.

  1. Histological Regression of Giant Cell Tumor of Bone Following RANK Ligand Inhibition

    Directory of Open Access Journals (Sweden)

    Martin F. Dietrich MD, PhD


    Full Text Available Lung metastases are a rare complication of giant cell tumors of bone. We herein describe an interesting case of histological regression and size reduction of lung metastases originating from a primary giant cell tumor of bone in response to the RANK ligand inhibitor denosumab.

  2. Computer assistance for the structural chemist (United States)

    Carhart, R. E.; Varkony, T. H.; Smith, D. H.


    A description is presented of the approaches used to modify the molecular structure generator program, CONGEN. The CONGEN program for constructing structures under constraints has been discussed by Carhart et al. (1975). The modifications reported are to lead to a more efficient structure generation on the basis of a translation of structural data input to the program. From an algorithmic standpoint, CONGEN is successful if it can, in a reasonable amount of time and without exhausting storage resources, produce a list of candidate structures satisfying the chemist's constraints. However, this list is often quite large, and it remains for the chemist to discriminate among the candidates, eventually reducing the possibilities to just one structure. Ways are studied for providing computer assistance in examining and further constraining lists of structural candidates.

  3. Computer-assisted qualitative data analysis software. (United States)

    Cope, Diane G


    Advances in technology have provided new approaches for data collection methods and analysis for researchers. Data collection is no longer limited to paper-and-pencil format, and numerous methods are now available through Internet and electronic resources. With these techniques, researchers are not burdened with entering data manually and data analysis is facilitated by software programs. Quantitative research is supported by the use of computer software and provides ease in the management of large data sets and rapid analysis of numeric statistical methods. New technologies are emerging to support qualitative research with the availability of computer-assisted qualitative data analysis software (CAQDAS).CAQDAS will be presented with a discussion of advantages, limitations, controversial issues, and recommendations for this type of software use.

  4. Biology teachers’ attitudes toward computer assisted learning

    Directory of Open Access Journals (Sweden)

    Županec Vera


    Full Text Available Based on the new technology initiative in Serbian education, we explored primary school teachers’ attitudes toward Computer Assisted Learning (CAL in biology teaching, as well as the relationships between the teachers’ attitudes and four independent variables: age, teaching experience, teachers’ competence to use modern teaching aids and their professional advanced training in the field of computer applied learning. Fifty-four elementary school biology teachers from Novi Sad participated in the study. The findings suggested that the teachers generally had positive attitudes toward CAL in biology teaching. Correlation analyses revealed significant relationships between age, teaching experience, teachers’ competence to use modern teaching aids in the teaching process, professional advanced training in the field of computer applied learning, and the teachers’ attitudes toward CAL. We offer suggestions for further research in this field. [Projekat Ministarstva nauke Republike Srbije, br. 179010

  5. Computer-assisted liver surgery: clinical applications and technological trends. (United States)

    Peterhans, Matthias; Oliveira, Thiago; Banz, Vanessa; Candinas, Daniel; Weber, Stefan


    Oncological liver surgery and interventions aim for removal of tumor tissue while preserving a sufficient amount of functional tissue to ensure organ regeneration. This requires detailed understanding of the patient-specific internal organ anatomy (blood vessel system, bile ducts, tumor location). The introduction of computer support in the surgical process enhances anatomical orientation through patient-specific 3D visualization and enables precise reproduction of planned surgical strategies though stereotactic navigation technology. This article provides clinical background information on indications and techniques for the treatment of liver tumors, reviews the technological contributions addressing the problem of organ motion during navigated surgery on a deforming organ, and finally presents an overview of the clinical experience in computer-assisted liver surgery and interventions. The review concludes that several clinically applicable solutions for computer aided liver surgery are available and small-scale clinical trials have been performed. Further developments will be required more accurate and faster handling of organ deformation and large clinical studies will be required for demonstrating the benefits of computer aided liver surgery.

  6. Hip fracture after radiofrequency ablation therapy for bone tumors : two case reports

    NARCIS (Netherlands)

    Dierselhuis, Edwin F.; Jutte, Paul C.; van der Eerden, Pepijn J. M.; Suurmeijer, Albert J. H.; Bulstra, Sjoerd K.


    Radiofrequency ablation (RFA) has become a valuable therapeutic modality in cancer treatment over the last decade. In orthopedic surgery, RFA is used for the treatment of benign bone tumors and bone metastases. Complications are rare and, to our knowledge, bone fracture as a complication due solely

  7. Parosteal osteoliposarcoma: A new bone tumor (from imaging to immunophenotype)

    Energy Technology Data Exchange (ETDEWEB)

    Larousserie, F. [Université Paris Descartes, Sorbonne Paris Cité, Paris (France); Department of Pathology, Rizzoli Institute, Bologna (Italy); Chen, X. [Department of Orthopaedic Oncology Surgery, Beijing Jishuitan hospital, Beijing (China); Ding, Y. [Department of pathology, Beijing Jishuitan hospital, Beijing (China); Kreshak, J.; Cocchi, S. [Department of Pathology, Rizzoli Institute, Bologna (Italy); Huang, Xiaoyuan [Department of pathology, Beijing Jishuitan hospital, Beijing (China); Niu, Xiaohui, E-mail: [Department of Orthopaedic Oncology Surgery, Beijing Jishuitan hospital, Beijing (China); Alberghini, M.; Vanel, D. [Department of Pathology, Rizzoli Institute, Bologna (Italy)


    Introduction: Parosteal osteosarcomas and well-differentiated liposarcomas (WDLPS) of soft tissue share several features: they are slowly progressive, locally aggressive tumors, tend to recur locally, and rarely or never metastasizes if not dedifferentiated. Their treatment is wide surgical resection. Microscopically, both are well differentiated tumors, very like their normal tissue counterpart. They share simple karyotypes with supernumerary ring chromosomes or giant marker chromosomes containing amplified 12q sequences including MDM2 and CDK4 genes, with subsequent overexpression of MDM2 and CDK4 proteins. We present the case of a parosteal osteoliposarcoma made of closely intermingled components of a low-grade osteosarcoma and a WDLPS. Case: In a 34 year-old woman with a slowly growing mass of the arm, imaging revealed a large well-defined heterogeneous parosteal mass of the upper humerus, with two main components: bone at the base and fat at the periphery. Microscopically, these two components were consistent respectively with low grade osteosarcoma and WDLPS. Cells of the two components were labeled with anti-CDK4 antibody. No labeling with anti-MDM2 antibody and no signal detected with MDM2 FISH analysis were likely due overdecalcification. No frozen tumor tissue was available for FISH analysis nor array-CGH. Discussion: Differential diagnoses of this new entity would be a well-differentiated liposarcoma with a low-grade osteosarcomatous component that originates from the soft tissues, ruled out on imaging, and an ossifying parosteal lipoma, ruled out on immunohistochemistry. Conclusion: This is the first description of a low-grade parosteal sarcoma with two components that morphologically and immunophenotypically demonstrate characteristics of a parosteal osteosarcoma and of a well-differentiated liposarcoma.

  8. Computer-assisted design/computer-assisted manufacturing systems: A revolution in restorative dentistry. (United States)

    Sajjad, Arbaz


    For the better part of the past 20 years, dentistry has seen the development of many new all-ceramic materials and restorative techniques fueled by the desire to capture the ever elusive esthetic perfection. This has resulted in the fusion of the latest in material science and the pen ultimate in computer-assisted design/computer-assisted manufacturing (CAD/CAM) technology. This case report describes the procedure for restoring the esthetic appearance of both the left and right maxillary peg-shaped lateral incisors with a metal-free sintered finely structured feldspar ceramic material using the latest laboratory CAD/CAM system. The use of CAD/CAM technology makes it possible to produce restorations faster with precision- fit and good esthetics overcoming the errors associated with traditional ceramo-metal technology. The incorporation of this treatment modality would mean that the dentist working procedures will have to be adapted in the methods of CAD/CAM technology.

  9. Effect of Irradiation on Tumor Microenvironment and Bone Marrow Cell Migration in a Preclinical Tumor Model

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    Kane, Jonathan L. [Department of Biological Sciences, Oakland University, Rochester, Michigan (United States); Department of Radiation Oncology, William Beaumont Health System, Royal Oak, Michigan (United States); Krueger, Sarah A.; Hanna, Alaa [Department of Radiation Oncology, William Beaumont Health System, Royal Oak, Michigan (United States); Raffel, Thomas R. [Department of Biological Sciences, Oakland University, Rochester, Michigan (United States); Wilson, George D. [Department of Radiation Oncology, William Beaumont Health System, Royal Oak, Michigan (United States); Madlambayan, Gerard J. [Department of Biological Sciences, Oakland University, Rochester, Michigan (United States); Marples, Brian, E-mail: [Department of Radiation Oncology, William Beaumont Health System, Royal Oak, Michigan (United States)


    Purpose: To characterize the tumor microenvironment after standard radiation therapy (SRT) and pulsed radiation therapy (PRT) in Lewis lung carcinoma (LLC) allografts. Methods and Materials: Subcutaneous LLC tumors were established in C57BL/6 mice. Standard RT or PRT was given at 2 Gy/d for a total dose of 20 Gy using a 5 days on, 2 days off schedule to mimic clinical delivery. Radiation-induced tumor microenvironment changes were examined after treatment using flow cytometry and antibody-specific histopathology. Normal tissue effects were measured using noninvasive {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography after naïve animals were given whole-lung irradiation to 40 Gy in 4 weeks using the same 2-Gy/d regimens. Results: Over the 2 weeks of therapy, PRT was more effective than SRT at reducing tumor growth rate (0.31 ± 0.02 mm{sup 3}/d and 0.55 ± 0.04 mm{sup 3}/d, respectively; P<.007). Histopathology showed a significant comparative reduction in the levels of Ki-67 (14.5% ± 3%), hypoxia (10% ± 3.5%), vascular endothelial growth factor (2.3% ± 1%), and stromal-derived factor-1α (2.5% ± 1.4%), as well as a concomitant decrease in CD45{sup +} bone marrow–derived cell (BMDC) migration (7.8% ± 2.2%) after PRT. The addition of AMD3100 also decreased CD45{sup +} BMDC migration in treated tumors (0.6% ± 0.1%). Higher vessel density was observed in treated tumors. No differences were observed in normal lung tissue after PRT or SRT. Conclusions: Pulsed RT–treated tumors exhibited slower growth and reduced hypoxia. Pulsed RT eliminated initiation of supportive mechanisms utilized by tumors in low oxygen microenvironments, including angiogenesis and recruitment of BMDCs.

  10. Huge aneurysmal bone cyst mimicking a kidney tumor: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Salah Termos


    Conclusion: ABC can mimic renal cell carcinoma and other malignant bone tumors. In huge tumors with a difficult location as in our case, we recommend a two stage procedure for huge tumors to ensure a complete resection and hence lower recurrence rate and better outcome.

  11. Computer assisted optical biopsy for colorectal polyps (United States)

    Navarro-Avila, Fernando J.; Saint-Hill-Febles, Yadira; Renner, Janis; Klare, Peter; von Delius, Stefan; Navab, Nassir; Mateus, Diana


    We propose a method for computer-assisted optical biopsy for colorectal polyps, with the final goal of assisting the medical expert during the colonoscopy. In particular, we target the problem of automatic classification of polyp images in two classes: adenomatous vs non-adenoma. Our approach is based on recent advancements in convolutional neural networks (CNN) for image representation. In the paper, we describe and compare four different methodologies to address the binary classification task: a baseline with classical features and a Random Forest classifier, two methods based on features obtained from a pre-trained network, and finally, the end-to-end training of a CNN. With the pre-trained network, we show the feasibility of transferring a feature extraction mechanism trained on millions of natural images, to the task of classifying adenomatous polyps. We then demonstrate further performance improvements when training the CNN for our specific classification task. In our study, 776 polyp images were acquired and histologically analyzed after polyp resection. We report a performance increase of the CNN-based approaches with respect to both, the conventional engineered features and to a state-of-the-art method based on videos and 3D shape features.

  12. Computer-assisted access to the kidney

    CERN Document Server

    Mozer, P; Payan, Yohan; Troccaz, J; Chartier-Kastler, E; Richard, F


    OBJECTIVES: The aim of this paper is to introduce the principles of computer-assisted access to the kidney. The system provides the surgeon with a pre-operative 3D planning on computed tomography (CT) images. After a rigid registration with space-localized ultrasound (US) data, preoperative planning can be transferred to the intra-operative conditions and an intuitive man-machine interface allows the user to perform a puncture. MATERIAL AND METHODS: Both CT and US images of informed normal volunteer were obtained to perform calculation on the accuracy of registration and punctures were carried out on a kidney phantom to measure the precision of the whole of the system. RESULTS: We carried out millimetric registrations on real data and guidance experiments on a kidney phantom showed encouraging results of 4.7 mm between planned and reached targets. We noticed that the most significant error was related to the needle deflection during the puncture. CONCLUSION: Preliminary results are encouraging. Further work w...

  13. Computer Assisted Language Learning” (CALL

    Directory of Open Access Journals (Sweden)

    Nazlı Gündüz


    Full Text Available This article will provide an overview of computers; an overview of the history of CALL, itspros and cons, the internet, World Wide Web, Multimedia, and research related to the uses of computers in the language classroom. Also, it also aims to provide some background for the beginnerson using the Internet in language classes today. It discusses some of the common types of Internetactivities that are being used today, what the minimum requirements are for using the Internet forlanguage learning, and some easy activities you can adapt for your classes. Some special terminology related to computers will also be used in this paper. For example, computer assisted language learning(CALL refers to the sets of instructions which need to be loaded into the computer for it to be able to work in the language classroom. It should be borne in mind that CALL does not refer to the use of acomputer by a teacher to type out a worksheet or a class list or preparing his/her own teaching alone.Hardware refers to any computer equipment used, including the computer itself, the keyboard, screen (or the monitor, the disc-drive, and the printer. Software (computer programs refers to the sets of instructions which need to be loaded into the computer for it to be able to work.

  14. Paget sarcoma of the spine: Scottish Bone Tumor Registry experience. (United States)

    Sharma, Himanshu; Mehdi, S A; MacDuff, E; Reece, A T; Jane, M J; Reid, R


    Retrospective case study of 13 cases of Paget sarcoma of the spine accrued from a prospectively collected Tumor Registry database. To analyze the clinical, radiologic, and histologic features of Paget sarcoma of the spine and to determine the factors influencing the prognosis. Paget disease of bone is a common disorder with the spine being involved in over 50% of patients. However, sarcomatous degeneration in the vertebral column is an extremely rare complication. There is very little in the literature with regard to clinical presentation and prognosis of patients with Paget sarcoma affecting the vertebral column. Between January 1944 and December 2003, 89 patients were registered with a diagnosis of Paget sarcoma in the Scottish Bone Tumor Registry. Thirteen patients with Paget sarcoma of the spine were analyzed with regard to their clinical, radiologic, and histopathologic features along with the prognostic predictors. The mean age was 66.9 years (range: 56-79 years). There were 10 males and three females. There were seven cases involving the sacral spine (63.6%), three cases involving lumbar vertebrae, two affecting the dorsal spine, and one with diffuse dorsolumbar involvement (D11-L3). The mode of presentation was progressively increasing low back pain (in all 13), unilateral sciatica (six; left-sided, five; right-sided, one), bilateral sciatica (two), lower limb weakness (eight), and autonomic dysfunction (four). Ten of 13 cases (76.9%) were osteosarcoma. The rest were chondrosarcoma (n = 1), fibrosarcoma (n = 1), and malignant fibrous histiocytoma (n = 1). Decompression laminectomy was performed in three patients with progressive neurologic deficit. Eight patients had received radiotherapy. The mean survival was 4.22 months. This series confirmed that Paget sarcoma of the spine has a very poor prognosis. We found a constellation of symptomatology in patients with sarcomatous Paget spine resulting from radiculomedullary compression, primarily lumbosacral

  15. Applications and Problems of Computer Assisted Education in Turkey (United States)

    Usun, Salih


    This paper focuses on the Computer Assisted Education (CAE) in Turkey; reviews of the related literature; examines the projects, applications and problems on the Computer Assisted Education (CAE) in Turkey compares with the World; exposes the positive and negative aspects of the projects; a number of the suggestion presents on the effective use of…

  16. Computer-Assisted Linguistic Analysis of the Peshitta

    NARCIS (Netherlands)

    Roorda, D.; Talstra, Eep; Dyk, Janet; van Keulen, Percy; Sikkel, Constantijn; Bosman, H.J.; Jenner, K.D.; Bakker, Dirk; Volkmer, J.A.; Gutman, Ariel; van Peursen, Wido Th.


    CALAP (Computer-Assisted Linguistic Analysis of the Peshitta), a joint research project of the Peshitta Institute Leiden and the Werkgroep Informatica at the Vrije Universiteit Amsterdam (1999-2005) CALAP concerned the computer-assisted analysis of the Peshitta to Kings (Janet Dyk and Percy van

  17. Guided bone regeneration following surgical treatment of a rare variant of Pindborg tumor: a case report. (United States)

    Mariano, Ronaldo C; Oliveira, Marina R; Silva, Amanda C; Ferreira, Delano H; Almeida, Oslei P


    Calcifying epithelial odontogenic tumor is a benign neoplasm, but its local destructive potential may lead to the formation of major bone defects. Microscopically, there are some histological variants. Among them, we highlight the clear cell variant due to its more aggressive behavior and a higher incidence of relapse. In this context, it is pertinent to describe the clear cell variant of calcifying epithelial odontogenic tumor. Despite the large bone defect formed in the posterior region of the mandible, conservative treatment associated with guided bone regeneration assured complete bone formation and the absence of recurrence in an 8-year follow-up period.

  18. Multilobular tumor of bone in an African wild dog (Lycaon pictus). (United States)

    McAloose, Denise; Raske, Matthew; Moore, Robert; Rodriguez, Carlos E


    A 13-mo-old, captive-born, female African wild dog (Lycaon pictus) was presented with a progressively enlarging, firm mass on the dorsum of the head. Due to rapid tumor growth and the development of neurologic signs, elective euthanasia and a complete postmortem were performed 2 months after initial presentation. Histologic findings were similar in both antemortem biopsy and postmortem samples from the tumor and consisted of nodules of cartilage and/or bone separated by thin interconnected trabeculae that contained spindle-shaped cells, consistent with multilobular tumor of bone. Very few reports of tumors in the endangered African wild dog have been published to date. To the authors' knowledge, this is the first report of an osseous tumor in an African wild dog and the first report of a multilobular tumor of bone in a nondomestic canid.

  19. How to read a pathology report of a bone tumor

    Energy Technology Data Exchange (ETDEWEB)

    Guinebretière, Jean-Marc, E-mail: [Department of Pathology, Hôpital René-Huguenin, Institut Curie, 35 rue Dailly, 92210 Saint Cloud (France); Kreshak, Jennifer [Department of Research, Istituto Ortopedico Rizzoli, Bologna (Italy); Suciu, Voichita [Department of Pathology, Hôpital René-Huguenin, Institut Curie, 35 rue Dailly, 92210 Saint Cloud (France); Maulmont, Charles De [Department of Radiology, Hôpital René-Huguenin, Institut Curie, 35 rue Dailly, 92210 Saint Cloud (France); Mascard, Eric; Missenard, Gilles [Institut Gustave-Roussy, 35 rue Camille Desmoulins, 94805 Villejuif (France); Larousserie, Frederique [Department of Research, Istituto Ortopedico Rizzoli, Bologna (Italy); Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris (France); Vanel, Daniel [Department of Research, Istituto Ortopedico Rizzoli, Bologna (Italy)


    The interpretation of a biopsy specimen involving bone is one of the most challenging feats for a pathologist, as it is often difficult to distinguish between benign or reactive lesions and malignant tumors on microscopic analysis. Therefore, correlation with the clinical data and imaging is essential and sometimes it is only the evolution of certain characteristics over time or information garnered from molecular analysis that can provide an accurate diagnosis. The pathology report is critical in that it will define subsequent patient management; its wording must precisely reflect those elements that are known with certainty and those that are diagnostic hypotheses. It must be systematic, thorough, and complete and should not be limited to a simple conclusion. The pathologist must first ensure the completeness and correct transcription of the information provided with the specimen, then describe and analyze the histology as well as the quality and representative nature of the sample (as they relate to the radiographic findings and preliminary/final diagnoses), and finally, compare what is seen under the microscope with the assessment made by the radiologist and/or surgeon. This analysis helps to identify difficult cases requiring further consultation between the radiologist and pathologist. There are multiple reasons for misinterpretation of a pathology report. An important and largely underestimated reason is varied interpretations of terms used by the pathologist. Standardized pathology reports with concise phrases as well as multidisciplinary meetings may limit errors and should be encouraged for optimal diagnostic accuracy.

  20. Vascular bone tumors: a proposal of a classification based on clinicopathological, radiographic and genetic features

    Energy Technology Data Exchange (ETDEWEB)

    Errani, Costantino [Istituto Ortopedico Rizzoli, Ortopedia Generale, Orthopaedic Service, Bagheria (Italy); Struttura Complessa Ortopedia Generale, Dipartimento Rizzoli-Sicilia, Bagheria, PA (Italy); Vanel, Daniel; Gambarotti, Marco; Alberghini, Marco [Istituto Ortopedico Rizzoli, Pathology Service, Bologna (Italy); Picci, Piero [Istituto Ortopedico Rizzoli, Laboratory for Cancer Research, Bologna (Italy); Faldini, Cesare [Istituto Ortopedico Rizzoli, Ortopedia Generale, Orthopaedic Service, Bagheria (Italy)


    The classification of vascular bone tumors remains challenging, with considerable morphological overlap spanning across benign to malignant categories. The vast majority of both benign and malignant vascular tumors are readily diagnosed based on their characteristic histological features, such as the formation of vascular spaces and the expression of endothelial markers. However, some vascular tumors have atypical histological features, such as a solid growth pattern, epithelioid change, or spindle cell morphology, which complicates their diagnosis. Pathologically, these tumors are remarkably similar, which makes differentiating them from each other very difficult. For this rare subset of vascular bone tumors, there remains considerable controversy with regard to the terminology and the classification that should be used. Moreover, one of the most confusing issues related to vascular bone tumors is the myriad of names that are used to describe them. Because the clinical behavior and, consequently, treatment and prognosis of vascular bone tumors can vary significantly, it is important to effectively and accurately distinguish them from each other. Upon review of the nomenclature and the characteristic clinicopathological, radiographic and genetic features of vascular bone tumors, we propose a classification scheme that includes hemangioma, hemangioendothelioma, angiosarcoma, and their epithelioid variants. (orig.)

  1. A case of recurrent giant cell tumor of bone with malignant transformation and benign pulmonary metastases

    Directory of Open Access Journals (Sweden)

    Gray Robert


    Full Text Available Abstract Giant cell tumor (GCT of bone is a locally destructive tumor that occurs predominantly in long bones of post-pubertal adolescents and young adults, where it occurs in the epiphysis. The majority are treated by aggressive curettage or resection. Vascular invasion outside the boundary of the tumor can be seen. Metastasis, with identical morphology to the primary tumor, occurs in a few percent of cases, usually to the lung. On occasion GCTs of bone undergo frank malignant transformation to undifferentiated sarcomas. Here we report a case of GCT of bone that at the time of recurrence was found to have undergone malignant transformation. Concurrent metastases were found in the lung, but these were non-transformed GCT.

  2. Targeting G-Protein Signaling for the Therapeutics of Prostate Tumor Bone Metastases and the Associated Chronic Bone Pain (United States)


    Cancer Bone Metastasis, heterotrimeric G protein  subunits, G protein -coupled receptors, signal transduction 16. SECURITY CLASSIFICATION OF: 17...comparable to that of Gαt-expressing cells (Fig.2A), indicating the involvement of G subunits released from Gi/o proteins . Interestingly, the growth...1 AWARD NUMBER: W81XWH-12-1-0213 TITLE: Targeting G- Protein Signaling for the Therapeutics of Prostate Tumor Bone Metastases and the

  3. CARS 2008: Computer Assisted Radiology and Surgery. Proceedings

    Energy Technology Data Exchange (ETDEWEB)



    The proceedings contain contributions to the following topics: digital imaging, computed tomography, magnetic resonance, cardiac and vascular imaging, computer assisted radiation therapy, image processing and display, minimal invasive spinal surgery, computer assisted treatment of the prostate, the interventional radiology suite of the future, interventional oncology, computer assisted neurosurgery, computer assisted head and neck and ENT surgery, cardiovascular surgery, computer assisted orthopedic surgery, image processing and visualization, surgical robotics, instrumentation and navigation, surgical modelling, simulation and education, endoscopy and related techniques, workflow and new concepts in surgery, research training group 1126: intelligent surgery, digital operating room, image distribution and integration strategies, regional PACS and telemedicine, PACS - beyond radiology and E-learning, workflow and standardization, breast CAD, thoracic CAD, abdominal CAD, brain CAD, orthodontics, dentofacial orthopedics and airways, imaging and treating temporomandibular joint conditions, maxillofacial cone beam CT, craniomaxillofacial image fusion and CBCT incidental findings, image guided craniomaxillofacial procedures, imaging as a biomarker for therapy response, computer aided diagnosis. The Poster sessions cover the topics computer aided surgery, Euro PACS meeting, computer assisted radiology, computer aided diagnosis and computer assisted radiology and surgery.

  4. Computer-assisted design/computer-assisted manufacturing systems: A revolution in restorative dentistry

    Directory of Open Access Journals (Sweden)

    Arbaz Sajjad


    Full Text Available For the better part of the past 20 years, dentistry has seen the development of many new all-ceramic materials and restorative techniques fueled by the desire to capture the ever elusive esthetic perfection. This has resulted in the fusion of the latest in material science and the pen ultimate in computer-assisted design/computer-assisted manufacturing (CAD/CAM technology. This case report describes the procedure for restoring the esthetic appearance of both the left and right maxillary peg-shaped lateral incisors with a metal-free sintered finely structured feldspar ceramic material using the latest laboratory CAD/CAM system. The use of CAD/CAM technology makes it possible to produce restorations faster with precision- fit and good esthetics overcoming the errors associated with traditional ceramo-metal technology. The incorporation of this treatment modality would mean that the dentist working procedures will have to be adapted in the methods of CAD/CAM technology.

  5. Differentiating benign from malignant bone tumors using fluid-fluid level features on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Hong; Cui, Jian Ling; Cui, Sheng Jie; Sun, Ying Cal; Cui, Feng Zhen [Dept. of Radiology, The Third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laborary of Orthopedics, Shijiazhuang, Hebei (China)


    To analyze different fluid-fluid level features between benign and malignant bone tumors on magnetic resonance imaging (MRI). This study was approved by the hospital ethics committee. We retrospectively analyzed 47 patients diagnosed with benign (n = 29) or malignant (n = 18) bone tumors demonstrated by biopsy/surgical resection and who showed the intratumoral fluid-fluid level on pre-surgical MRI. The maximum length of the largest fluid-fluid level and the ratio of the maximum length of the largest fluid-fluid level to the maximum length of a bone tumor in the sagittal plane were investigated for use in distinguishing benign from malignant tumors using the Mann-Whitney U-test and a receiver operating characteristic (ROC) analysis. Fluid-fluid level was categorized by quantity (multiple vs. single fluid-fluid level) and by T1-weighted image signal pattern (high/low, low/high, and undifferentiated), and the findings were compared between the benign and malignant groups using the chi2 test. The ratio of the maximum length of the largest fluid-fluid level to the maximum length of bone tumors in the sagittal plane that allowed statistically significant differentiation between benign and malignant bone tumors had an area under the ROC curve of 0.758 (95% confidence interval, 0.616-0.899). A cutoff value of 41.5% (higher value suggests a benign tumor) had sensitivity of 73% and specificity of 83%. The ratio of the maximum length of the largest fluid-fluid level to the maximum length of a bone tumor in the sagittal plane may be useful to differentiate benign from malignant bone tumors.

  6. [Application values of computer-assisted preoperative planning of hilar cholangiocarcinoma]. (United States)

    Li, Huixing; Shi, Xianjie; Liang, Yurong; He, Lei; Chen, Mingyi; Wang, Hongguang; Lü, Shaocheng; Wang, Xuedong; Meng, Xiangfei


    To explore the application value of computer-assisted preoperative planning of hilar cholangiocarcinoma. Retrospective analyses were conducted for the clinical data of 47 patients with hilar cholangiocarcinoma undergoing radical resection plus hemihepatectomy from January to December 2013. According to whether computer-assisted preoperative planning was used, they were divided two groups of computer-assisted surgical planning (CASP) and without computer-assisted surgical planning (WCASP). Then we analyzed the data including preoperative examinations, preoperative planning, intraoperative findings and postoperative complications. There were 31 cases of hilar vascular invasion by tumor. Among 29 cases of CASP, left hepatic artery originated from left gastric artery (n = 6), right posterior bile duct drained into left hepatic bile duct (n = 1) and right posterior bile duct run into common hepatic bile duct (n = 2). The mean operative duration of CASP was (6.5 ± 1.3) h and the mean volume of intraoperative bleeding (672.0 ± 214.3) ml; while the mean operative duration of WCASP was (7.9 ± 2.9) h and the mean volume of intraoperative bleeding (870.0 ± 330.1) ml. By statistical analysis, the inter-group differences of mean operative duration had statistical difference (P = 0.028) and the inter-group differences of mean volume of intraoperative bleeding had statistical difference (P = 0.016). The ratio of first negative test in group CASP was higher than that of group WCASP and the inter-group differences had statistical significance (P = 0.043). But the inter-group rate of postoperative complications had no significant difference (P = 0.419). The computer-assisted surgical planning system provides accurate information so that an optimal surgical protocol may be designed by surgeons. And it has great application values in preoperative surgical planning for hilar cholangiocarcinoma and enjoys wide prospects in precise liver surgery.

  7. Cathepsin K is the principal protease in giant cell tumor of bone

    NARCIS (Netherlands)

    Lindeman, J.H.N.; Hanemaaijer, R.; Mulder, A.; Dijkstra, P.D.S.; Szuhai, K.; Bromme, D.; Verheijen, J.H.; Hogendoorn, P.C.W.


    Giant cell tumor (GCT) of bone is a neoplasm of bone characterized by a localized osteolytic lesion. The nature of GCT is an enigma and the cell type(s) and protease(s) responsible for the extensive localized clinicoradiological osteolysis remain unresolved. We evaluated protease expression and

  8. [Computer-assisted total knee arthroplasty: 12 years experience in Grenoble]. (United States)

    Saragaglia, Dominique


    Computer-assisted total knee arthroplasty was developed in Grenoble in the mid-1990s. The first human implantation was performed on 21 January 1997, with no particular problems. Since this date more than 200,000 patients have been implanted with our device all over the world. The device is passive (not active like a robot), and requires no pre- or perioperative imaging. It is based on kinematics and palpation, the surgeon remaining in charge at all times. The computer helps to identify the lower leg axis, to accurately fix the bone cutting guides, and to check the ligament balance. These steps are not easy to perform with conventional ancillaries. The effectiveness of computer-assisted total knee replacement is well documented, although it is too early to claim that a "well-aligned" prothesis will have a better survival rate. Long-term follow-up studies are needed, with modern prostheses, to confirm the results of historical studies.

  9. Analysis of the results of replacement of large bone defects in the patients who underwent segmental bone resection for tumor (United States)

    Anastasieva, E. A.; Voropaeva, A. A.; Sadovoy, M. A.; Kirilova, I. A.


    The problem of large bone defects replacement, formed after segmental bone resections, remains an actual issue of modern orthopedics. It is known that the autograft is the most acceptable material for the replacement of bone tissue; however, due to its small volume and physical properties, it has limited usage. Our goal is to analyze the results of the experiments and studies on replacement of large bone defects after resection of the bone tumor. The problem is justified by the complicated osteoconduction and osteointegration; because it is proved that the reconstruction of the microcirculatory bloodstream is difficult in the presence of damage more than 4 cm2. It was revealed that using of allograft in combination with additional components is comparable in effectiveness, including long-term period, with autograft usage. It is promising to combine plastic allogenous material, capable of reconstructing defects of various configuration intraoperatively, with the necessary chemotherapy with controlled desorption to maintain effective concentration of drug.

  10. Override of the osteoclast defect in osteopontin-deficient mice by metastatic tumor growth in the bone. (United States)

    Natasha, Tajneen; Kuhn, Misty; Kelly, Owen; Rittling, Susan R


    Osteopontin (OPN) is a major noncollagenous protein of bone that is frequently up-regulated in tumors, where it enhances tumor growth. OPN-deficient mice are resistant to stimulated bone resorption, including that occurring after ovariectomy. Using a new syngeneic model of bone metastasis (r3T), we examined whether OPN-deficient mice are similarly resistant to bone loss resulting from osteolytic tumor growth. Transformed mammary epithelial cells, r3T, which express parathyroid hormone-related protein but not receptor activator of nuclear factor-kappaB ligand, were injected via the intracardiac route into both wild-type and OPN-/- mice. We measured tumor burden in the bone by quantitative polymerase chain reaction assay and evaluated bone loss by X-ray and microCT. Unexpectedly, bone loss was similar in OPN-/- and wild-type mice bearing similar-sized tumors. Osteoclast number was comparable in both genotypes, and the expression of bone sialoprotein was similar in tumor-bearing bones of both genotypes, excluding two potential mechanisms of overriding the defect. Taken together, these results indicate that in the absence of OPN, the bone loss associated with tumor growth at the bone site proceeds rapidly despite the osteoclast defects documented in OPN-/- mice, suggesting that the mechanism of bone loss due to tumor growth differs from that occurring in other pathologies.

  11. Ethics and Computer-Assisted Assessment: Three Case Studies. (United States)

    Jacob, Susan; Brantley, John C.


    Three ethical-legal case incidents involving computer-assisted psychodiagnostic assessment in the schools are presented. Each case is analyzed in terms of applicable laws, ethical codes, and standards for professional practice. (Author)

  12. Center for Advanced Energy Studies: Computer Assisted Virtual Environment (CAVE) (United States)

    Federal Laboratory Consortium — The laboratory contains a four-walled 3D computer assisted virtual environment - or CAVE TM — that allows scientists and engineers to literally walk into their data...

  13. Autoclaved Tumor Bone for Skeletal Reconstruction in Paediatric Patients: A Low Cost Alternative in Developing Countries

    Directory of Open Access Journals (Sweden)

    Masood Umer


    Full Text Available We reviewed in this series forty patients of pediatric age who underwent resection for malignant tumors of musculoskeletal system followed by biological reconstruction. Our surgical procedure for reconstruction included (1 wide en bloc resection of the tumor; (2 curettage of tumor from the resected bone; (3 autoclaving for 8 minutes (4 bone grafting from the fibula (both vascularized and nonvascularized fibular grafts used; (5 reimplantation of the autoclaved bone into the host bone defect and fixation with plates. Functional evaluation was done using MSTS scoring system. At final followup of at least 18 months (mean 29.2 months, 31 patients had recovered without any complications. Thirty-eight patients successfully achieved a solid bony union between the graft and recipient bone. Three patients had surgical site infection. They were managed with wound debridement and flap coverage of the defect. Local recurrence and nonunion occurred in two patients each. One patient underwent disarticulation at hip due to extensive local disease and one died of metastasis. For patients with non-union, revision procedure with bone graft and compression plates was successfully used. The use of autoclaved tumor grafts provides a limb salvage option that is inexpensive and independent of external resources and is a viable option for musculoskeletal tumor management in developing countries.

  14. Giant cell tumor of bone: current review of morphological, clinical, radiological, and therapeutic characteristics

    Directory of Open Access Journals (Sweden)

    Georgi P. Georgiev


    Full Text Available Giant cell tumor of bone accounts for about 5% of all primary bone tumors in adults and is still one of the most obscure and intensively examined tumors of bone. This largely results from the lack of uniform clinical, radiographic, histological or morphological aspects that allow prediction of recurrence. Classified by the World Health Organization as “an aggressive, potentially malignant lesion”, the giant cell tumor of bone could give lung metastases, could undergo malignant degeneration or could have multicentric localization. It usually develops in long bones but can also occur in unusual locations. The common presenting symptom is increasing pain at the tumor site. Standard treatment ranges from curettage to wide resection, with reports of varying oncological and functional results. The recurrence rate is high during the first 2-3 years after surgery regardless of pre-operative tumor stage. Herein, we discuss the morphological, clinical, radiological, and therapeutic characteristics of this pathologic entity as well as its differential diagnosis. J Clin Exp Invest 2014; 5 (3: 475-485


    Directory of Open Access Journals (Sweden)

    E. A. Anastasieva


    Full Text Available The problem of replacement of large bone defects resulting from segmental bone resections in patients with bone tumors is still actual in modern orthopedics. Segmental defects cause the main difficulty especially in cases of disturbance of normal biomechanics while the “gold standard” of reconstruction with bone autograft is not always possible. The reason is that the defect can be so extensive that would make it impossible to harvest necessary autobone stock. Therefore, allografts based on demineralized bone with optimal properties for osteoregeneration are used as an alternative for autograft. For certain composite materials it is possible to program the properties of future graft by changing its compound. Literature analysis revealed that the effectiveness of the allograft in combination with additional components is comparable to autograft effectiveness. Mesenchymal stem cells of both bone marrow and adipose tissue can be used as an additional component to improve osteoregeneration. It is noteworthy that the analyzed studies did not reveal the influence of stem cells on the tumor recurrence. Nevertheless, the authors support the need of further researches in this area to confirm gained results. Some authors still prefer traditional methods of bone traction despite obtaining own satisfactory results of defects reconstruction with allografts. Such opinion is based on proven effectiveness of the method, structural stability of construction during treatment period and ability to adjust the process of bone regeneration at any stage. The authors goal was to analyze publications over the recent 5 years with the results of experiments and clinical studies on the replacement of large bone defects after bone tumor resection with autoand allografts. Based on the literature analysis the authors propose a general algorithm for graft selection in replacement of large bone defects after segmental bone resections. 

  16. Tumoral calcinoses in bone scanning: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Cook, P. [Royal Prince Alfred Hospital, Sydney, NSW (Australia). Department of Nuclear Medicine


    Full text: Tumoral calcinosis (TC) is a rare disorder characterised by hyperphosphateamia, normocalceamia and calcified para-articular masses as seen on X-ray. At present, an inborn error of phosphorous metabolism is accepted as the primary cause. Symptoms include pain, swelling, infection and single- or multi-focal lesions. Radionuclide imaging was recently described as the most reliable and simplest method for detection, localisation and assessment of the calcific masses. Bone scintigraphy may demonstrate unsuspected masses even when clinical examination is negative. It is also useful in assessing the effects of surgery and therapy. A 55-year-old male with an 18-year history of TC presented to our department on two occasions. He was first referred to assess the extent of his calcinosis. He had known involvement of the hands, shoulders and pelvis, with little restriction of movement. He had a 6-8 year history of polio which was currently stable. Seven years later he again presented to our department, this time for the evaluation of a suspected fractured hip. On both occasions 800 MBq of {sup 99}mTc-MDP was injected IV and whole body and planar images were obtained at three hours. In the second study, additional dynamic and blood pool images were obtained over the anterior aspect of both hips. Both scans were grossly abnormal and typical of the appearance of widespread TC or calcinosis universalis. Multiple areas of extra osseous uptake involving subcutaneous tissue and muscle of the hands, para-articular regions of both elbows, shoulders and hips were seen and confirmed by X-ray. Localised abnormalities were noted involving left lower neck, left forearm and left foot. Marked progression of the disease was seen in the region of the left shoulder on the second scan. No abnormalities were noted within the skeleton itself. Neither the dynamic nor blood pool phase of the study demonstrated significant hyperaemia in the region of the left proximal femur. Although the

  17. Autologous bone marrow infusion following high dose chemotherapy of the canine transmissible venereal tumor (TVT). (United States)

    Epstein, R B; Sarpel, S C


    The present study was undertaken to evaluate infusion of cryopreserved autologous bone marrow following supralethal chemotherapy in canines bearing a solid tumor thought to be moderately sensitive to cytotoxic agents. Initial studies in 5 dogs established a combination of busulfan (Bu) 3 mg/kg X 2 days and cyclophosphamide (Cy) 50 mg/kg on day 3 to produce bone marrow lethality within 14 days (high dose regime). Bu 1 mg/kg, Cy 20 mg/kg produced tolerable toxicity (low dose regime). Eight pairs of dogs were challenged with 3 X 10(8) transmissible venereal tumor cells. Measurable progressive tumor growth occurred in all instances. Marrow aspirated from the femoral shafts of the animals was cryopreserved in 10% DMSO. One dog of each pair received the high dose Bu + Cy regime followed in 30 h by marrow infusion and his partner received the low dose regime without marrow. Tumors were measured serially for at least 2 months. Infusion of marrow resulted in evidence of hematologic recovery within 2 weeks following the high dose regime. Tumor responses occurred in both groups when compared to 8 untreated tumor challenged controls. High dose animals had greater initial responses than low dosed dogs but long term responses were not significantly different. Eight dogs rechallenged with tumor cells after initial successful therapy failed to develop tumors. It was concluded that: a) cryopreserved autologous bone marrow infusion was effective in protecting tumor bearing canines from otherwise lethal chemotherapy; b) the transmissible venereal tumor of canines responded to both high and low dose regimes; c) the rescue of dogs by stored autologous marrow did not offer additional benefits in tumor control over a standard regime; d) chemotherapy treated dogs resisted tumor rechallenge. This model may offer a large animal system to study the autologous marrow rescue concept during controlled periods of tumor evolution.

  18. Computer-assisted virtual planning and surgical template fabrication for frontoorbital advancement. (United States)

    Soleman, Jehuda; Thieringer, Florian; Beinemann, Joerg; Kunz, Christoph; Guzman, Raphael


    OBJECT The authors describe a novel technique using computer-assisted design (CAD) and computed-assisted manufacturing (CAM) for the fabrication of individualized 3D printed surgical templates for frontoorbital advancement surgery. METHODS Two patients underwent frontoorbital advancement surgery for unilateral coronal synostosis. Virtual surgical planning (SurgiCase-CMF, version 5.0, Materialise) was done by virtual mirroring techniques and superposition of an age-matched normative 3D pediatric skull model. Based on these measurements, surgical templates were fabricated using a 3D printer. Bifrontal craniotomy and the osteotomies for the orbital bandeau were performed based on the sterilized 3D templates. The remodeling was then done placing the bone plates within the negative 3D templates and fixing them using absorbable poly-dl-lactic acid plates and screws. RESULTS Both patients exhibited a satisfying head shape postoperatively and at follow-up. No surgery-related complications occurred. The cutting and positioning of the 3D surgical templates proved to be very accurate and easy to use as well as reproducible and efficient. CONCLUSIONS Computer-assisted virtual planning and 3D template fabrication for frontoorbital advancement surgery leads to reconstructions based on standardizedmeasurements, precludes subjective remodeling, and seems to be overall safe and feasible. A larger series of patients with long-term follow-up is needed for further evaluation of this novel technique.

  19. [Rotationplasty in the surgical treatment plan of primary malignant bone tumors. Possibilities and limits]. (United States)

    Hardes, J; Gebert, C; Hillmann, A; Winkelmann, W; Gosheger, G


    Long-term survival of patients with a malignant bone tumor increased with a combined therapeutic approach using chemotherapy and possibly radiation therapy. Today up to 80% of patients with an osteosarcoma or Ewing's sarcoma survive. Therefore, it is important that the functional outcome and the quality of life are good after resection of the tumor. Before the era of endoprosthetic devices, rotationplasty, which was introduced in 1974 by Salzer for surgery of malignant bone tumors and modified by Winkelmann, protected many patients from an amputation. Although many authors favor limb-saving procedures today, rotationplasty obtained excellent functional and psychosocial results. Rotationplasty can be recommended in tumors with a large soft tissue component, in tumors located in the proximal femur and proximal tibia, and in children under 10 years of age. Furthermore, rotationplasty can be used in patients in whom a limb-salvage procedure failed because of infection or repeated changes of the endoprosthesis.

  20. Granulocyte colony-stimulating factor enhances bone tumor growth in mice in an osteoclast-dependent manner


    Hirbe, Angela C.; Uluçkan, Özge; Morgan, Elizabeth A.; Eagleton, Mark C.; Prior, Julie L.; Piwnica-Worms, David; Trinkaus, Kathryn; Apicelli, Anthony; Weilbaecher, Katherine


    Inhibition of osteoclast (OC) activity has been associated with decreased tumor growth in bone in animal models. Increased recognition of factors that promote osteoclastic bone resorption in cancer patients led us to investigate whether increased OC activation could enhance tumor growth in bone. Granulocyte colony-stimulating factor (G-CSF) is used to treat chemotherapy-induced neutropenia, but is also associated with increased markers of OC activity and decreased bone mineral density (BMD). ...

  1. High Birth Weight Increases the Risk for Bone Tumor: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Songfeng Chen


    Full Text Available There have been several epidemiologic studies on the relationship between high birth weight and the risk for bone tumor in the past decades. However, due to the rarity of bone tumors, the sample size of individual studies was generally too small for reliable conclusions. Therefore, we have performed a meta-analysis to pool all published data on electronic databases with the purpose to clarify the potential relationship. According to the inclusion and exclusion criteria, 18 independent studies with more than 2796 cases were included. As a result, high birth weight was found to increase the risk for bone tumor with an Odds Ratio (OR of 1.13, with the 95% confidence interval (95% CI ranging from 1.01 to 1.27. The OR of bone tumor for an increase of 500 gram of birth weight was 1.01 (95% CI 1.00–1.02; p = 0.048 for linear trend. Interestingly, individuals with high birth weight had a greater risk for osteosarcoma (OR = 1.22, 95% CI 1.06–1.40, p = 0.006 than those with normal birth weight. In addition, in the subgroup analysis by geographical region, elevated risk was detected among Europeans (OR = 1.14, 95% CI 1.00–1.29, p = 0.049. The present meta-analysis supported a positive association between high birth weight and bone tumor risk.

  2. [Mandibular aneurysmal bone cyst mimicking a malignant tumor]. (United States)

    Jeblaoui, Y; Ben Neji, N; Haddad, S; Zribi, A; Néji, R; Boussafa, H; Sahtout, S; Hchicha, S


    We report the case of a 24-year-old woman presenting with a rapidly growing mass in the right masseteric region. MRI suggested a diagnosis of a rhabdomyosarcoma but CT-scan evoked a benign lesion such as chondroblastoma or aneurismal bone cyst. The biopsy specimen proved the diagnosis of aneurismal bone cyst and the patient was treated by surgical curettage. There was no recurrence after 4 years of follow-up. The aneurismal bone cyst of the jaw is a rare pseudocystic lesion, characterized by replacement of the normal bone with fibro-osseous tissue containing blood-filled sinusoidal or cavernous spaces. The lesion generally affects young persons under 20 years of age. The molar region, the angle, and the ascending ramus of the mandible are the predominantly affected sites. The lesion does not have any clinical or radiological specificity and surgical curettage is the standard treatment. Recurrence is rare and occurs within 30 months after surgery.

  3. Local recurrence after curettage treatment of giant cell tumors in peripheral bones: retrospective study by the GSF-GETO (French Sarcoma and Bone Tumor Study Groups). (United States)

    Gouin, F; Dumaine, V


    Curettage is a well-established treatment modality for giant cell tumors of bone. The purpose of this retrospective study by the French Sarcoma and Bone Tumor Study Groups (GSF-GETO) was to analyze various tumor-specific and surgery-specific factors that could influence the rate of local recurrence. Data was collected from patients with giant cells tumors of the appendicular skeletal who were treated by intralesional curettage. The hazard ratio for tumor recurrence was calculated for the different variables collected and a multifactorial analysis carried out. One hundred and ninety-three surgical procedures were included from nine centers. One hundred and seventy-one (89%) were primary tumors and 22 had been referred after one or more recurrences. The mean follow-up was 6 years and 11 months. The distal femur and proximal tibia were the most common locations: 42.5 and 34.2% of cases, respectively. The bone defect after curettage was filled in 176 cases (91.2%) and left empty in 16 cases. Local adjuvant treatment (phenol, alcohol, cryotherapy or combination treatment) was used in 39 cases (20.2%) and systemic adjuvant treatment used in 24 cases (calcitonin 11 and zoledronic acid 13). Local recurrence occurred in 71 cases (36.8%). Risk factors for local recurrence were an empty defect, a defect filled with autograft, and patients treated before 2005. Multivariate analysis showed that the only risk factors for local recurrence were a surgical procedure before 2005 (odds ratio 3.6 (95% CI: 1.2, 7.9) P=0.017) and a bone defect filled with autograft (odds ratio 3.9 [95% CI: 1.3, 11.6] P=0.013) CONCLUSION: Neither tumor-specific nor surgery-specific factors such as adjuvant treatment were found to be as risk factors for local recurrence after curettage of giant cell tumors in the appendicular skeleton. As recently reported, high-quality local curettage is probably the most effective technique to prevent local recurrence. The current study suggests that two factors

  4. Whole body MRI for detecting metastatic bone tumor: comparison with bone scintigrams.

    NARCIS (Netherlands)

    Nakanishi, K.; Kobayashi, M.; Takahashi, S.; Nakata, S.; Kyakuno, M.; Nakaguchi, K.; Nakamura, H.


    PURPOSE: To compare the effectiveness of whole body MRI (WB-MRI [magnetic resonance imaging]) and bone scintigram (BS) at detecting bone metastasis. MATERIALS AND METHODS: WB-MRI was performed on 16 patients for detecting bone metastasis (6 breast carcinoma, 7 prostatic carcinoma, 1 renal cell

  5. Giant cell tumor of the metatarsal bone: case report and review of the literature; Tumor de celulas gigantes do metatarso: relato de caso e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Benites Filho, Paulo R.; Escuissato, Dante L. [Hospital de Clinicas da Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Servico de Radiologia]. E-mail:; Urban, Linei A.B.D. [DAPI - Diagnostico Avancado por Imagem, Curitiba, PR (Brazil); Gasparetto, Taisa P. Davaus [Hospital Universitario Antonio Pedro (HUAP), Niteroi, RJ (Brazil). Dept. de Radiologia; Sakamoto, Danielle; Ioshii, Sergio [Hospital de Clinicas da Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Servico de Anatomia Patologica; Marchiori, Edson [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia


    Giant cell tumor of bone is a rare neoplasm and account for 5% of all primary bone tumors. It is common in the knee and wrist, but rare in the small bones of the foot. The authors report a 32-year old male patient presented with a four-month history of right foot pain. Plain radiographs showed an expansive lytic lesion involving the first right metatarsal bone. Computed tomography scan demonstrated a radiolucent lesion with well-defined borders. Biopsy was performed and the histological diagnostic was giant cell tumor. The authors emphasize the correlation between the imaging and histological findings. (author)

  6. A novel 3-D mineralized tumor model to study breast cancer bone metastasis.

    Directory of Open Access Journals (Sweden)

    Siddharth P Pathi


    Full Text Available Metastatic bone disease is a frequent cause of morbidity in patients with advanced breast cancer, but the role of the bone mineral hydroxyapatite (HA in this process remains unclear. We have developed a novel mineralized 3-D tumor model and have employed this culture system to systematically investigate the pro-metastatic role of HA under physiologically relevant conditions in vitro.MDA-MB231 breast cancer cells were cultured within non-mineralized or mineralized polymeric scaffolds fabricated by a gas foaming-particulate leaching technique. Tumor cell adhesion, proliferation, and secretion of pro-osteoclastic interleukin-8 (IL-8 was increased in mineralized tumor models as compared to non-mineralized tumor models, and IL-8 secretion was more pronounced for bone-specific MDA-MB231 subpopulations relative to lung-specific breast cancer cells. These differences were pathologically significant as conditioned media collected from mineralized tumor models promoted osteoclastogenesis in an IL-8 dependent manner. Finally, drug testing and signaling studies with transforming growth factor beta (TGFbeta confirmed the clinical relevance of our culture system and revealed that breast cancer cell behavior is broadly affected by HA.Our results indicate that HA promotes features associated with the neoplastic and metastatic growth of breast carcinoma cells in bone and that IL-8 may play an important role in this process. The developed mineralized tumor models may help to reveal the underlying cellular and molecular mechanisms that may ultimately enable more efficacious therapy of patients with advanced breast cancer.

  7. Prevalence, extension and characteristics of fluid-fluid levels in bone and soft tissue tumors

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    Dyck, P. van; Venstermans, C.; Gielen, J.; Parizel, P.M. [University Hospital Antwerp, Department of Radiology, Edegem (Belgium); Vanhoenacker, F.M. [University Hospital Antwerp, Department of Radiology, Edegem (Belgium); AZ St-Maarten, Department of Radiology, Duffel/Mechelen (Belgium); Vogel, J. [Leiden University Medical Centre, Department of Orthopedics, Leiden (Netherlands); Kroon, H.M.; Bloem, J.L. [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Schepper, A.M.A. de [University Hospital Antwerp, Department of Radiology, Edegem (Belgium); Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands)


    The purpose of this study was to determine the prevalence, extension and signal characteristics of fluid-fluid levels in a large series of 700 bone and 700 soft tissue tumors. Out of a multi-institutional database, MRI of 700 consecutive patients with a bone tumor and MRI of 700 consecutive patients with a soft tissue neoplasm were retrospectively reviewed for the presence of fluid-fluid levels. Extension (single, multiple and proportion of the lesion occupied by fluid-fluid levels) and signal characteristics on magnetic resonance imaging of fluid-fluid levels were determined. In all patients, pathologic correlation was available. Of 700 patients with a bone tumor, 19 (10 male and 9 female; mean age, 29 years) presented with a fluid-fluid level (prevalence 2.7%). Multiple fluid-fluid levels occupying at least one half of the total volume of the lesion were found in the majority of patients. Diagnoses included aneurysmal bone cyst (ten cases), fibrous dysplasia (two cases), osteoblastoma (one case), simple bone cyst (one case), telangiectatic osteosarcoma (one case), ''brown tumor'' (one case), chondroblastoma (one case) and giant cell tumor (two cases). Of 700 patients with a soft tissue tumor, 20 (9 males and 11 females; mean age, 34 years) presented with a fluid-fluid level (prevalence 2.9%). Multiple fluid-fluid levels occupying at least one half of the total volume of the lesion were found in the majority of patients. Diagnoses included cavernous hemangioma (12 cases), synovial sarcoma (3 cases), angiosarcoma (1 case), aneurysmal bone cyst of soft tissue (1 case), myxofibrosarcoma (1 case) and high-grade sarcoma ''not otherwise specified'' (2 cases). In our series, the largest reported in the literature to the best of our knowledge, the presence of fluid-fluid levels is a rare finding with a prevalence of 2.7 and 2.9% in bone and soft tissue tumors, respectively. Fluid-fluid levels remain a non-specific finding and can

  8. Computer-assisted local resection for exostosis osteochondroma of the mandibular condyle. (United States)

    Huang, Dong; He, Dong-Mei; Yang, Chi; Chen, Min-Jie; Zhou, Qin; Dong, Min-Jun


    The purpose of this study was to evaluate the guiding effect of computer-assisted design technique in local resection of exostosis osteochondroma (EOC) from the mandibular condyle. Eight patients diagnosed with EOC through computed tomographic scan were selected from January 2011 to March 2012. SurgiCase CMF software was used for preoperative design. The osteotomy angle, depth, and tumor shape were measured to guide the surgery. The tumors were resected from the stalk 2 mm within the normal tissue to restore the unaffected condyle as much as possible. Postoperative computed tomographic scans showed that the tumors had been resected completely in all patients. The mean (SD) error between the design and the result was 1.82 (1.25) mm. Five patients had more than 1-year follow-up without recurrence. Computer-assisted design is a good way to help local resection of EOC. It can improve the accuracy of tumor resection and keep the unaffected condyle as much as possible for function.

  9. Local bone pain and osseous scintigraphic findings in patients with metastatic bone tumor

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    Imaeda, Takeyoshi; Iinuma, Gen; Hirota, Keiichi; Inoue, Akemi; Sone, Yasuhiro; Seki, Matsuzo; Suzuki, Masao; Doi, Hidetaka


    Local bone pain and osseous scintigraphic findings were evaluated in patients with cancer of the lung, breast or prostate. (1) In 77-92% out of the patients with local pain, metastatic bone lesions were detected. (2) The sacrum and scapulae were the frequent sites of pain as estimated from the metastatic bone lesions. On the other hand, the incidence of pain was low in the ribs, cervical vertebrae, skull and femurs. (3) When calculated by the weight of red bone marrow, the most likely sites for bone metastases consisted of the scapulae, clavicles, sternum, humeri, ribs and cervical vertebrae, somewhat different from previous reports. Those bones involved were all proximate to the heart. (4) Extensive bone metastases were already detected in more than 50% of patients who complain of pain in the metastatic bone lesion. On the other hand, extensive bone metastases occurred in less than 6% of patients who didn't complain of pain. (5) The appearance of pain in the metastatic bone lesion was earlier in only 3% and was later in 71% than the detection of abnormal radioisotope accumulation on scintigram. (6) Majority of the patients with pain in the metastatic bone lesion showed a high degree of abnormal radioisotope accumulation which measured more than 5 cm in diameter on scintigram. On the other hand, the abnormal radioisotope accumulation in most of patients without pain was mild and mostly measured less than 5 cm in diameter. (7) The positive rate of bone metastasis amounted to 29% by plain X-ray and 41% by local bone pain as compaired to positive bone scintigram.

  10. Critical evaluation of fine needle aspiration cytology as a diagnostic technique in bone tumors and tumor-like lesions. (United States)

    Chakrabarti, Sudipta; Datta, Alok Sobhan; Hira, Michael


    Though open surgical biopsy is the procedure of choice for the diagnosis of bone tumors, many disadvantages are associated with this approach. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of bony tumors and tumor-like lesions which may be conducted in centers where facilities for surgical biopsies are inadequate. The study population consisted of 51 cases presenting with a skeletal mass. After clinical evaluation, radiological correlation was done to assess the nature and extent of each lesion. Fine needle aspiration was performed aseptically and smears were prepared. Patients subsequently underwent open surgical biopsy and tissue samples were obtained for histopathological examination. Standard statistical methods were applied for analysis of data. Adequate material was not obtained even after repeated aspiration in seven cases, six of which were benign. Among the remaining 44 cases, diagnosis of malignancy was correctly provided in 28 (93.3%) out of 30 cases and categorical diagnosis in 20 (66.67%). Interpretation of cytology was more difficult in cases of benign and tumor-like lesions, with a categorical opinion only possible in seven (50%) cases. Statistical analysis showed FNAC with malignant tumors to have high sensitivity (93.3%), specificity (92.9%) and positive predictive value of 96.6%, whereas the negative predictive value was 86.7%. FNAC should be included in the diagnostic workup of a skeletal tumor because of its simplicity and reliability. However, a definitive pathologic diagnosis heavily depends on compatible clinical and radiologic features which can only be accomplished by teamwork. The cytological technique applied in this study could detect many bone tumors and tumor-like conditions and appears particularly suitable as a diagnostic technique for rural regions of India as other developing countries.

  11. Malignant Phyllodes Tumor Presenting in Bone, Brain, Lungs, and Lymph Nodes

    Directory of Open Access Journals (Sweden)

    Eric D. Johnson


    Full Text Available Introduction: Phyllodes tumors (PTs are rare fibroepithelial tumors of the breast which are classified as benign, borderline, or malignant. Malignant PTs account for <1% of malignant breast tumors, and borderline tumors have potential to progress to malignant tumors. Metastatic recurrences are most commonly documented in bone and lungs. We report an extremely rare presentation of recurrent malignant PTs involving the brain, lung, lymph nodes, and bone. Case: A 66-year-old female presented with a large breast mass. Biopsy identified malignant PT, treated by mastectomy. One year later she presented with acute back pain; imaging showed pathological L4 spinal compression fracture. Core biopsy confirmed PT. Staging identified additional metastases in the lymph nodes, brain, and lung. Discussion: PTs are rare and fast-growing tumors that originate from periductal stromal tissues and are composed of both epithelial and stromal components. Histologically, they are classified as benign, borderline, or malignant. The prognosis of the malignant type is poorly defined, with local recurrence occurring in 10–40% and metastases in 10%. Chemotherapy and radiotherapy are generally ineffective in this tumor type. The most common metastatic sites for malignant cases are the lung and bones, but in rare instances, PTs may metastasize elsewhere. Conclusion: We report a rare presentation of recurrent malignant PT presenting as pathological fracture of the lumbar spine with impingement on the spinal column, along with cerebellar, nodal, and pulmonary metastases. Only 1 similar case has been previously reported.

  12. Tumor Tissue-Derived Formaldehyde and Acidic Microenvironment Synergistically Induce Bone Cancer Pain (United States)

    Yang, Fei; Han, Ying; Li, Hui; Luo, Hongjun; Duan, Bo; Xu, Tianle; Maoying, Qiliang; Tan, Huangying; Wang, Jun; Zhao, Hongmei; Liu, Fengyu; Wan, You


    Background There is current interest in understanding the molecular mechanisms of tumor-induced bone pain. Accumulated evidence shows that endogenous formaldehyde concentrations are elevated in the blood or urine of patients with breast, prostate or bladder cancer. These cancers are frequently associated with cancer pain especially after bone metastasis. It is well known that transient receptor potential vanilloid receptor 1 (TRPV1) participates in cancer pain. The present study aims to demonstrate that the tumor tissue-derived endogenous formaldehyde induces bone cancer pain via TRPV1 activation under tumor acidic environment. Methodology/Principal Findings Endogenous formaldehyde concentration increased significantly in the cultured breast cancer cell lines in vitro, in the bone marrow of breast MRMT-1 bone cancer pain model in rats and in tissues from breast cancer and lung cancer patients in vivo. Low concentrations (1∼5 mM) of formaldehyde induced pain responses in rat via TRPV1 and this pain response could be significantly enhanced by pH 6.0 (mimicking the acidic tumor microenvironment). Formaldehyde at low concentrations (1 mM to 100 mM) induced a concentration-dependent increase of [Ca2+]i in the freshly isolated rat dorsal root ganglion neurons and TRPV1-transfected CHO cells. Furthermore, electrophysiological experiments showed that low concentration formaldehyde-elicited TRPV1 currents could be significantly potentiated by low pH (6.0). TRPV1 antagonists and formaldehyde scavengers attenuated bone cancer pain responses. Conclusions/Significance Our data suggest that cancer tissues directly secrete endogenous formaldehyde, and this formaldehyde at low concentration induces metastatic bone cancer pain through TRPV1 activation especially under tumor acidic environment. PMID:20422007

  13. Receptor-Activator of Nuclear KappaB Ligand Expression as a New Therapeutic Target in Primary Bone Tumors.

    Directory of Open Access Journals (Sweden)

    Tetsuro Yamagishi

    Full Text Available The receptor-activator of nuclear kappaB ligand (RANKL signaling pathway plays an important role in the regulation of bone growth and mediates the formation and activation of osteoclasts. Osteoclasts are involved in significant bone resorption and destruction. Denosumab is a fully human monoclonal antibody against RANKL that specifically inhibits osteoclast differentiation and bone resorption. It has been approved for use for multiple myeloma and bone metastases, as well as for giant cell tumor of bone. However, there is no previous report quantitatively, comparing RANKL expression in histologically varied bone tumors. Therefore, we analyzed the mRNA level of various bone tumors and investigated the possibility of these tumors as a new therapeutic target for denosumab. We examined RANKL mRNA expression in 135 clinical specimens of primary and metastatic bone tumors using real-time PCR. The relative quantification of mRNA expression levels was performed via normalization with RPMI8226, a human multiple myeloma cell line that is recognized to express RANKL. Of 135 cases, 64 were also evaluated for RANKL expression by using immunohistochemistry. Among all of the tumors investigated, RANKL expression and the RANKL/osteoprotegerin ratio were highest in giant cell tumor of bone. High RANKL mRNA expression was observed in cases of aneurysmal bone cyst, fibrous dysplasia, osteosarcoma, chondrosarcoma, and enchondroma, as compared to cases of multiple myeloma and bone lesions from metastatic carcinoma. RANKL-positive stromal cells were detected in six cases: five cases of GCTB and one case of fibrous dysplasia. The current study findings indicate that some primary bone tumors present new therapeutic targets for denosumab, particularly those tumors expressing RANKL and those involving bone resorption by osteoclasts.

  14. [The history and development of computer assisted orthopaedic surgery]. (United States)

    Jenny, J-Y


    Computer assisted orthopaedic surgery (CAOS) was developed to improve the accuracy of surgical procedures. It has improved dramatically over the last years, being transformed from an experimental, laboratory procedure into a routine procedure theoretically available to every orthopaedic surgeon. The first field of application of computer assistance was neurosurgery. After the application of computer guided spinal surgery, the navigation of total hip and knee joints became available. Currently, several applications for computer assisted surgery are available. At the beginning of navigation, a preoperative CT-scan or several fluoroscopic images were necessary. The imageless systems allow the surgeon to digitize patient anatomy at the beginning of surgery without any preoperative imaging. The future of CAOS remains unknown, but there is no doubt that its importance will grow in the next 10 years, and that this technology will probably modify the conventional practice of orthopaedic surgery.

  15. RI plethysmography in the early evaluation of preoperative treatment for malignant bone tumors

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    Yamamoto, Seiichi; Kawaguchi, Tomoyoshi; Manabe, Jun; Kuroda, Hiroshi; Oyamada, Hiyoshimaru; Yamada, Yasuhiko (Japanese Foundation for Cancer Research, Tokyo (Japan). Hospital); Furuya, Kotaro; Isobe, Yasushi


    RI plethysmography with Tc-99m human serum albumin was performed to determine the effectiveness of preoperative chemotherapy performed in 14 patients with malignant bone tumor. It failed to detect blood changes before and after chemotherapy in 2 patients with bone tumor of telangiectatic type. In the other 12 patients, changes in blood flow during the process of treatment were depicted on plethysmograms. It preceded the other techniques for chemotherapeutic evaluation in 2 patients. It was considered useful in the early evaluation of chemotherapy, if combined with other imaging examinations to detect morphological changes. (N.K.).

  16. The importance of radiographic imaging in the microscopic assessment of bone tumors

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    Larousserie, F., E-mail: [Université Paris Descartes, Sorbonne Paris Cité, Paris (France); Department of pathology, Rizzoli Institute, Bologna (Italy); Kreshak, J.; Gambarotti, M.; Alberghini, M.; Vanel, D. [Department of pathology, Rizzoli Institute, Bologna (Italy)


    Introduction: Primary bone tumors are rare and require a multidisciplinary approach. Diagnosis involves primarily the radiologist and the pathologist. Bone lesions are often heterogeneous and the microscopic diagnostic component(s) may be in the minority, especially on core needle biopsies. Reactive processes, benign, and malignant tumors may have similar microscopic aspects. For these challenging cases, the correlation of microscopic and radiologic information is critical, or diagnostic mistakes may be made with severe clinical consequences for the patient. The purpose of this article is to explain how pathologists can best use imaging studies to improve the diagnostic accuracy of bone lesions. Diagnosis: Many bone lesions are microscopically and/or radiographically heterogeneous, especially those with both lytic and matrix components. Final diagnosis may require specific microscopic diagnostic features that may be present in the lesion, but not the biopsy specimen. A review of the imaging helps assess if sampling was adequate. The existence of a pre-existing bone lesion, syndrome (such as Ollier disease or multiple hereditary exostosis), or oncologic history may be of crucial importance. Finally, imaging information is very useful for the pathologist to perform accurate local and regional staging during gross examination. Conclusion: Close teamwork between pathologists, radiologists, and clinicians is of utmost importance in the evaluation and management of bone tumors. These lesions can be very difficult to interpret microscopically; imaging studies therefore play a crucial role in their accurate diagnosis.

  17. Hydroxyapatite-coated collars reduce radiolucent line progression in cemented distal femoral bone tumor implants. (United States)

    Coathup, Melanie J; Sanghrajka, Anish; Aston, William J; Gikas, Panagiotis D; Pollock, Robin C; Cannon, Stephen R; Skinner, John A; Briggs, Timothy W R; Blunn, Gordon W


    Aseptic loosening of massive bone tumor implants is a major cause of prosthesis failure. Evidence suggests that an osteointegrated hydroxyapatite (HA)-coated collar would reduce the incidence of aseptic loosening around the cemented intramedullary stem in distal femoral bone tumor prostheses. Because these implants often are used in young patients with a tumor, such treatment might extend the longevity of tumor implants. Questions/purposes We asked whether (1) HA-coated collars were more likely to osteointegrate; (2) HA collars were associated with fewer progressive radiolucent lines around the stem-cement interface; and (3) HA-coated collars were associated with less bone loss at the bone-shoulder implant junction? Twenty-two patients were pair-matched to one of two groups--either (1) implants with a HA-coated ingrowth collar (HA Collar Group); or (2) implants without an ingrowth collar (Noncollar Group). Age, sex, and length of followup were similar in both groups. HA-coated collars were developed and used at our institution from 1992 to address the high failure rate attributable to aseptic loosening in patients with massive bone tumor implants. Before this, smooth titanium shafts were used routinely adjacent to bone at the transection site. The minimum followup was 2 years (mean, 7 years; range, 2-12 years). Radiographs obtained throughout the followup period were analyzed and osteointegration at the shaft of the implant quantified. Radiolucent line progression around the cemented stem was semi-quantitatively assessed and cortical bone loss at the bone-shoulder implant junction was measured during the followup period. Comparison of the most recent radiographs showed nine of 11 patients had osteointegrated HA collars, whereas only one patient in the Noncollar Group had osteointegration (p > 0.001). The radiolucent line score quantified around the cemented stem was lower in the HA Collar Group when compared with the Noncollar Group (p = 0.001). Results showed an

  18. Disseminated mast cell tumor infiltrating the sphenoid bone and causing blindness in a dog. (United States)

    Beltran, Elsa; de Stefani, Alberta; Stewart, Jennifer; De Risio, Luisa; Johnson, Victoria


    Mast cell tumors are found in most organs and tissues with variable biologic behavior in dogs. This case illustrates the clinical and magnetic resonance imaging (MRI) findings in a dog with disseminated mast cell tumor infiltrating the sphenoid bones. A 6-year-old male neutered Greyhound presented with a 3-day history of acute onset of blindness. General physical examination was normal. Neurological examination revealed mildly disorientated mental status, absent menace response in both eyes, bilaterally decreased vestibulo-oculocephalic reflexes and absent direct and consensual pupillary light reflex in both eyes. An electroretinogram indicated normal retinal function in both eyes. A lesion involving the middle and rostral cranial fossa was suspected. Hematology and serum biochemistry were normal except decreased urea (1.2 mmol/L). MRI of the head revealed heterogeneous signal intensity of the sphenoid bones on T2-weighted images and loss of their normal internal architecture. Cerebrospinal fluid analysis was normal. Abdominal ultrasound revealed hepatosplenomegaly and mesenteric lymphadenopathy. Fine needle aspirates were taken from the jejunal lymph nodes and the spleen. Results were consistent with disseminated mast cell tumor. The owner declined any treatment and the dog was euthanatized. Postmortem examination confirmed disseminated mast cell tumor affecting multiple organs, including the sphenoid bones. To our knowledge, this is the first case describing MRI features of disseminated mast cell tumor affecting the sphenoid bones and causing acute onset of blindness in a dog.

  19. The role of imaging for the surgeon in primary malignant bone tumors of the chest wall

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    Rocca, M., E-mail: [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy); Salone, M. [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy); Galletti, S. [Ultrasound Unit, The Rizzoli Orthopaedic Institute, Bologna (Italy); Balladelli, A. [Laboratory of Experimental Oncology, The Rizzoli Orthopaedic Institute, Bologna (Italy); Vanel, D. [Research in Imaging Musculo Skeletal Tumors, The Rizzoli Orthopaedic Institute, Bologna (Italy); Briccoli, A. [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy)


    Primary malignant chest wall tumors are rare. The most frequent primary malignant tumor of the chest wall is chondrosarcoma, less common are primary bone tumors belonging to the Ewing Family Bone Tumors (EFBT), or even rarer are osteosarcomas. They represent a challenging clinical entities for surgeons as the treatment of choice for these neoplasms is surgical resection, excluding EFBT which are normally treated by a multidisciplinary approach. Positive margins after surgical procedure are the principal risk factor of local recurrence, therefore to perform adequate surgery a correct preoperative staging is mandatory. Imaging techniques are used for diagnosis, to determine anatomic site and extension, to perform a guided biopsy, for local and general staging, to evaluate chemotherapy response, to detect the presence of a recurrence. This article will focus on the role of imaging in guiding this often difficult surgery and the different technical possibilities adopted in our department to restore the mechanics of the thoracic cage after wide resections.

  20. Analysis of limb function after various reconstruction methods according to tumor location following resection of pediatric malignant bone tumors

    Directory of Open Access Journals (Sweden)

    Tokuhashi Yasuaki


    Full Text Available Abstract Background In the reconstruction of the affected limb in pediatric malignant bone tumors, since the loss of joint function affects limb-length discrepancy expected in the future, reconstruction methods that not only maximally preserve the joint function but also maintain good limb function are necessary. We analysis limb function of reconstruction methods by tumor location following resection of pediatric malignant bone tumors. Patients and methods We classified the tumors according to their location into 3 types by preoperative MRI, and evaluated reconstruction methods after wide resection, paying attention to whether the joint function could be preserved. The mean age of the patients was 10.6 years, Osteosarcoma was observed in 26 patients, Ewing's sarcoma in 3, and PNET(primitive neuroectodermal tumor and chondrosarcoma (grade 1 in 1 each. Results Type I were those located in the diaphysis, and reconstruction was performed using a vascularized fibular graft(vascularized fibular graft. Type 2 were those located in contact with the epiphyseal line or within 1 cm from this line, and VFG was performed in 1, and distraction osteogenesis in 1. Type III were those extending from the diaphysis to the epiphysis beyond the epiphyseal line, and a Growing Kotz was mainly used in 10 patients. The mean functional assessment score was the highest for Type I (96%: n = 4 according to the type and for VFG (99% according to the reconstruction method. Conclusion The final functional results were the most satisfactory for Types I and II according to tumor location. Biological reconstruction such as VFG and distraction osteogenesis without a prosthesis are so high score in the MSTS rating system. Therefore, considering the function of the affected limb, a limb reconstruction method allowing the maximal preservation of joint function should be selected after careful evaluation of the effects of chemotherapy and the location of the tumor.

  1. The value of recognizing suspect diagnoses in the triple diagnosis of giant cell tumor of bone

    Directory of Open Access Journals (Sweden)

    Kotru Mrinalini


    Full Text Available Giant cell tumor (GCT of bone is the most frequently over-diagnosed neoplasm in orthopedic pathology because giant cells are a common component of many neoplastic and nonneoplastic conditions of bone. Triple diagnosis, requiring substantial individual and collective inputs by orthopedic surgeons, radiologists and pathologists, is the preferred method for the workup of patients with suspected bone neoplasms. At each stage in triple diagnosis, deviations from the typical must be regarded as clues to alternate diagnoses: the greater the deviation, the more a diagnosis of GCT must be considered suspect. A suspect diagnosis must trigger renewed analysis of the available data and a diligent search to exclude alternate diagnoses.

  2. Tumor-Host Interaction in Breast Cancer Bone Metastasis (United States)


    Kallioniemi, O.-P., and Ethier, S. P. Molecular cytogenetic analysis of 11 new breast cancer cell lines. Br J Cancer, 81: 1328-1334, 1999. 26. Harris, A...1.318480186 NM_000546 TP53 Tumor protein p53 (Li-Fraumeni syndrome ) 0.875703301 NM_006670 TPBG Trophoblast glycoprotein 1.130637565 NM_003379 VIL2 Villin...primary tumors was determined according to the Richardson– Bloom grading system [17]. BM assessment BM (10 cc) was aspirated from the sternum and both

  3. Anxiety, Drive Theory, and Computer-Assisted Learning. (United States)

    Spielberger, Charles D.; And Others

    Hypotheses about the effects of anxiety on performance in computer-assisted instruction (CAI) were formulated and then tested. High school students and college students were used in the experiments. Learning materials used were in the subjects of science, mathematics, psychology, physics, and educational research. Two settings were compared: a…

  4. Computer-Assisted Instruction: What the Research Shows. (United States)

    Bracey, Gerald W.


    Briefly reviews current research on the effectiveness of computer-assisted instruction (CAI) and microcomputers. The Hawthorne Effect and research results for elementary, secondary, and college level students are discussed, courseware requirements are described, and research studies showing positive and negative effects of CAI are listed. (LRW)


    Directory of Open Access Journals (Sweden)

    Georgiana, MÎNDRECI


    Full Text Available In a world in which IT is developing faster than ever, providing reliable solutions to all problems, regardless the field of interest, the issue of computer-assisted translation systems is more and more complex, offering both advantages and disadvantages. The field of translating legal texts from Romanian into English is deprived of a large number of specialists and this is one of the main reasons why more and more people resort to computer-assisted translations, especially Google translations when dealing with translating various texts (from Romanian into English or vice-versa, in this particular case legal texts. Yet, although this field has immensely thrived recently, and is quite reliable for simple and very easy translations, the average English speaker runs huge risks of falling into traps that can lead to errors and misinterpretations. Thus, this article aims to identify the main theoretical approaches to computer-assisted theories and the major risks and threats that occur in this type of translation, focusing particularly on legal texts. There are important differences, not only of words, but also differences in the legal systems themselves, both theoretical and practical ones, which must be correctly dealt with -something which computer-assisted translation cannot do (yet.

  6. Computer-Assisted Dieting: Effects of a Randomized Nutrition Intervention (United States)

    Schroder, Kerstin E. E.


    Objectives: To compare the effects of a computer-assisted dieting intervention (CAD) with and without self-management training on dieting among 55 overweight and obese adults. Methods: Random assignment to a single-session nutrition intervention (CAD-only) or a combined CAD plus self-management group intervention (CADG). Dependent variables were…

  7. The Impact of Computer-Assisted Instruction on Secondary School ...

    African Journals Online (AJOL)

    This research, carried out in Manicaland Province in Zimbabwe, aimed to investigate the impact of computer-assisted instruction on students' performance in Geography. The equivalent group research design which included a pre-test post-test control group design was used. Respondents to interviews and pre-test and ...

  8. The use of Computer Assisted Language Learning (CALL) Devices ...

    African Journals Online (AJOL)

    Computer-Assisted Language Learning (CALL) is a relatively new and rapidly evolving academic field that explores the role of information and communication technologies in language learning and teaching. It has rapidly developed over the last forty years. This development can be categorized into three distinct phases: ...

  9. Incorporating computer-assisted assessment to Bachelor of Science ...

    African Journals Online (AJOL)

    The use of computers in education has already been established for decades. Computers have been used from lesson preparations, presentations, and student assessments. Many authors have studied the design, implementation, and impact of computer-assisted assessment (CAA) (also called computer-based testing, ...

  10. Computer-Assisted Learning in British Sign Language (United States)

    Mertzani, Maria


    The fact that language teaching can be operationalized through computer-assisted language learning (CALL) has directed researchers' attention to the learning task, which, in this case, is considered to be the unit that demands analysis of the communicative processes in which the learner is involved while working with CALL. Research focuses on…

  11. Some Measurement and Instruction Related Considerations Regarding Computer Assisted Testing. (United States)

    Oosterhof, Albert C.; Salisbury, David F.

    The Assessment Resource Center (ARC) at Florida State University provides computer assisted testing (CAT) for approximately 4,000 students each term. Computer capabilities permit a small proctoring staff to administer tests simultaneously to large numbers of students. Programs provide immediate feedback for students and generate a variety of…

  12. Computer Assisted Drafting (CNC) Drawings. Drafting Module 6. Instructor's Guide. (United States)

    Missouri Univ., Columbia. Instructional Materials Lab.

    This Missouri Vocational Instruction Management System instructor's drafting guide has been keyed to the drafting competency profile developed by state industry and education professionals. This unit contains information on computer-assisted drafting drawings. The guide contains a cross-reference table of instructional materials and 20 worksheets.…

  13. Teaching Reading through Computer-Assisted Language Learning (United States)

    Bhatti, Tariq Muhammad


    To study the role of reading in secondary schools and how it may be improved through computers, a year-long study was conducted to examine which of two methods of teaching reading skills, an instructor-led class vs. computer-assisted language learning (CALL), aided secondary students in improving the literal, inferential, and evaluative levels of…

  14. User Interface Improvements in Computer-Assisted Instruction, the Challenge. (United States)

    Chalmers, P. A.


    Identifies user interface problems as they relate to computer-assisted instruction (CAI); reviews the learning theories and instructional theories related to CAI user interface; and presents potential CAI user interface improvements for research and development based on learning and instructional theory. Focuses on screen design improvements.…

  15. Ethical and Professional Issues in Computer-Assisted Therapy. (United States)

    Ford, B. Douglas


    Discusses ethical and professional issues in psychology regarding computer-assisted therapy (CAT). Topics addressed include an explanation of CAT; whether CAT is psychotherapy; software, including independent use, validation of effectiveness, and restricted access; clinician resistance; client acceptance; the impact on ethical standards; and a…

  16. General Purpose Cost Distribution Model for Computer Assisted Instruction. (United States)

    Voeller, Rick

    To compare the unit cost of computer-assisted instruction (CAI) programs, there must be a standard model for calculating the cost of computer services. Such cost can be classified into direct costs--expenditures made directly by the group in charge of CAI programs, and indirect costs--expenditures made by other groups in support of CAI services.…

  17. Implementation of Computer Assisted Assessment: Lessons from the Literature (United States)

    Sim, Gavin; Holifield, Phil; Brown, Martin


    This paper draws attention to literature surrounding the subject of computer-assisted assessment (CAA). A brief overview of traditional methods of assessment is presented, highlighting areas of concern in existing techniques. CAA is then defined, and instances of its introduction in various educational spheres are identified, with the main focus…

  18. Conversation Analysis in Computer-Assisted Language Learning (United States)

    González-Lloret, Marta


    The use of Conversation Analysis (CA) in the study of technology-mediated interactions is a recent methodological addition to qualitative research in the field of Computer-assisted Language Learning (CALL). The expansion of CA in Second Language Acquisition research, coupled with the need for qualitative techniques to explore how people interact…

  19. System/360 Computer Assisted Network Scheduling (CANS) System (United States)

    Brewer, A. C.


    Computer assisted scheduling techniques that produce conflict-free and efficient schedules have been developed and implemented to meet needs of the Manned Space Flight Network. CANS system provides effective management of resources in complex scheduling environment. System is automated resource scheduling, controlling, planning, information storage and retrieval tool.

  20. A Model for Intelligent Computer Assisted Language Instruction (MICALI). (United States)

    Farghaly, Ali


    States that Computer Assisted Language Instruction (CALI) software should be developed as an interactive natural language processing system. Describes artificial intelligence and proposes a model for intelligent CALI software (MICALI). Discusses MICALI's potential and current limitations due to the present state of the art. (Author/LS)

  1. Integrating Computer-Assisted Translation Tools into Language Learning (United States)

    Fernández-Parra, María


    Although Computer-Assisted Translation (CAT) tools play an important role in the curriculum in many university translator training programmes, they are seldom used in the context of learning a language, as a good command of a language is needed before starting to translate. Since many institutions often have translator-training programmes as well…

  2. Audible Computer-Assisted Instruction: Toward the Compleat CAI. (United States)

    Hertzler, Emanuel C.


    Presents the technical details of the hardware and software used with two kinds of computers, the Radio Shack TRS-80 and the Apple II, in developing personalized computer-assisted instruction with the addition of the instructor's voice interfaced with the computer. Programing controls for this interface are listed. (RAO)

  3. Medical Image Computing and Computer-Assisted Intervention - MICCAI 2006

    DEFF Research Database (Denmark)

    Nielsen, Mads; Sporring, Jon

    The two-volume set LNCS 4190 and LNCS 4191 constitute the refereed proceedings of the 9th International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2006, held in Copenhagen, Denmark in October 2006. The program committee carefully selected 39 revised full papers...

  4. Computer Assisted Assessment and The Role it Plays in ...

    African Journals Online (AJOL)

    Although the use of computers in data-driven decision making in education was initially focused on education's core business i.e. computer aided learning (CAL), educational leaders are now using this approach to transform other aspects of their operations e.g. computer-assisted assessment (CAA). The full potential of ...

  5. Computer-Assisted Language Learning: Diversity in Research and Practice (United States)

    Stockwell, Glenn, Ed.


    Computer-assisted language learning (CALL) is an approach to teaching and learning languages that uses computers and other technologies to present, reinforce, and assess material to be learned, or to create environments where teachers and learners can interact with one another and the outside world. This book provides a much-needed overview of the…

  6. Renal Diet Therapy--A Computer-Assisted Instruction Model. (United States)

    Schroeder, Lois; Thiele, Victoria F.


    A computer-assisted instruction (CAI) unit was designed to teach renal diet therapy. Utilizing this unit, differences in performance and attitudes between traditionally taught and CAI taught students (N=34), and differences in achievement between students in two nutrition fields were assessed. (DS)

  7. Computer-Assisted Foreign Language Teaching and Learning: Technological Advances (United States)

    Zou, Bin; Xing, Minjie; Wang, Yuping; Sun, Mingyu; Xiang, Catherine H.


    Computer-Assisted Foreign Language Teaching and Learning: Technological Advances highlights new research and an original framework that brings together foreign language teaching, experiments and testing practices that utilize the most recent and widely used e-learning resources. This comprehensive collection of research will offer linguistic…

  8. Computer-assisted Elementary Chinese Learning for American Students (United States)

    Hong-yan, Zhang


    Despite hopes and claims about benefits of computer-assisted language learning, few studies have documented actual cases about how American students learn elementary Chinese in a computer-equipped classroom. This paper deals with how to use computer as an educational tool to develop American students' Chinese language skills. The theoretical…

  9. Bone single photon emission computed tomography (SPECT in a patient with Pancoast tumor: a case report

    Directory of Open Access Journals (Sweden)

    Hamid Javadi

    Full Text Available CONTEXT: Non-small cell lung carcinomas (NSCLCs of the superior sulcus are considered to be the most challenging type of malignant thoracic disease. In this disease, neoplasms originating mostly from the extreme apex of the lung expand to the chest wall and thoracic inlet structures. Multiple imaging procedures have been applied to identify tumors and to stage and predict tumor resectability in surgical operations. Clinical examinations to localize pain complaints in shoulders and down the arms, and to screen for Horner's syndrome and abnormalities seen in paraclinical assessments, have been applied extensively for differential diagnosis of superior sulcus tumors. Although several types of imaging have been utilized for diagnosing and staging Pancoast tumors, there have been almost no reports on the efficiency of whole-body bone scans (WBBS for detecting the level of abnormality in cases of superior sulcus tumors. CASE REPORT: We describe a case of Pancoast tumor in which technetium-99m methylene diphosphonate (Tc-99m MDP bone single-photon emission-computed tomography (SPECT was able to accurately detect multiple areas of abnormality in the vertebrae and ribs. In describing this case, we stress the clinical and diagnostic points, in the hope of stimulating a higher degree of suspicion and thereby facilitating appropriate diagnosis and treatment. From the results of this study, further clinical trials to evaluate the potential of SPECT as an efficient imaging tool for the work-up on cases of Pancoast tumor are recommended.


    Directory of Open Access Journals (Sweden)

    V. M. Merabishvili


    Full Text Available Introduction. Standardized (world standard incidence of malignant tumors of bones (S40,41 does not have has significant fluctuations. According to IARC among male population the most common incidence rates range from 1 to 2 cases per 100.000 and among female population – from 0.5 to 1.0 among women.  Purpose of study. To study dynamics of morbidity and mortality from malignant tumors of bones, the quality of estimation, observed and relative survival of patients according to histological forms. The work of this level is held in Russia for the first time. Material and methods of study. There were used an open world and domestic sources to estimate the prevalence of malignant tumors of bones, databases of population-based cancer registers, classical methods of population-based estimation of the prevalence of malignant tumors of bones. results of study. The basis of this work is data from the Population-based Cancer Registry of St. Petersburg and special studies being held before its establishing in 1993. Annually in St. Petersburg there are registered 40–60 primary cases of malignant tumors of bones (S40, 41. The level of morphological verification of these malignancies in Russia is 82.1 %, in St. Petersburg – 84.9 %. There is a high rate of undefined stage: in Russia – 19.7 %, in St. Petersburg – 24.5 %, in Moscow – 23.5 %. During the first year of observation 27.3 % of patients die in Russia, 21.7 % in St. Petersburg, and 11.1 % in Moscow. In comparison with the average data (Eurocare program the relative survival of patients in St. Petersburg is significantly lower: in men (St. Petersburg – 42.2–48.2 %, (Eurocare-3,4 – 55–58 %, in women (St. Petersburg – 32.2–54.6 % (Eurocare – 59–63 %. conclusion. Thus, in this work for the first time in Russia it is showed dynamics of absolute and relative incidence rates of malignant tumors of bones since 1980 by sex and age-specific indicators. It is presented a set of

  11. Experimental ex-vivo validation of PMMA-based bone cements loaded with magnetic nanoparticles enabling hyperthermia of metastatic bone tumors (United States)

    Harabech, Mariem; Kiselovs, Normunds Rungevics; Maenhoudt, Wim; Crevecoeur, Guillaume; Van Roost, Dirk; Dupré, Luc


    Percutaneous vertebroplasty comprises the injection of Polymethylmethacrylate (PMMA) bone cement into vertebrae and can be used for the treatment of compression fractures of vertebrae. Metastatic bone tumors can cause such compression fractures but are not treated when injecting PMMA-based bone cement. Hyperthermia of tumors can on the other hand be attained by placing magnetic nanoparticles (MNPs) in an alternating magnetic field (AMF). Loading the PMMA-based bone cement with MNPs could both serve vertebra stabilization and metastatic bone tumor hyperthermia when subjecting this PMMA-MNP to an AMF. A dedicated pancake coil is designed with a self-inductance of 10 μH in series with a capacitance of 0.1 μF that acts as resonant inductor-capacitor circuit to generate the AMF. The thermal rise is appraised in beef vertebra placed at 10 cm from the AMF generating circuit using optical temperatures sensors, i.e. in the center of the PMMA-MNP bone cement, which is located in the vicinity of metastatic bone tumors in clinical applications; and in the spine, which needs to be safeguarded to high temperature exposures. Results show a temperature rise of about 7 °C in PMMA-MNP whereas the temperature rise in the spine remains limited to 1 °C. Moreover, multicycles heating of PMMA-MNP is experimentally verified, validating the technical feasibility of having PMMA-MNP as basic component for percutaneous vertebroplasty combined with hyperthermia treatment of metastatic bone tumors.

  12. Myelopotentiating effect of curcumin in tumor-bearing host: Role of bone marrow resident macrophages

    Energy Technology Data Exchange (ETDEWEB)

    Vishvakarma, Naveen Kumar; Kumar, Anjani; Kumar, Ajay; Kant, Shiva [School of Biotechnology, Banaras Hindu University, Varanasi-221 005, U.P. (India); Bharti, Alok Chandra [Division of Molecular Oncology, Institute of Cytology and Preventive Oncology, Noida, UP (India); Singh, Sukh Mahendra, E-mail: [School of Biotechnology, Banaras Hindu University, Varanasi-221 005, U.P. (India)


    The present investigation was undertaken to study if curcumin, which is recognized for its potential as an antineoplastic and immunopotentiating agent, can also influence the process of myelopoiesis in a tumor-bearing host. Administration of curcumin to tumor-bearing host augmented count of bone marrow cell (BMC) accompanied by an up-regulated BMC survival and a declined induction of apoptosis. Curcumin administration modulated expression of cell survival regulatory molecules: Bcl2, p53, caspase-activated DNase (CAD) and p53-upregulated modulator of apoptosis (PUMA) along with enhanced expression of genes of receptors for M-CSF and GM-CSF in BMC. The BMC harvested from curcumin-administered hosts showed an up-regulated colony forming ability with predominant differentiation into bone marrow-derived macrophages (BMDM), responsive for activation to tumoricidal state. The number of F4/80 positive bone marrow resident macrophages (BMM), showing an augmented expression of M-CSF, was also augmented in the bone marrow of curcumin-administered host. In vitro reconstitution experiments indicated that only BMM of curcumin-administered hosts, but not in vitro curcumin-exposed BMM, augmented BMC survival. It suggests that curcumin-dependent modulation of BMM is of indirect nature. Such prosurvival action of curcumin is associated with altered T{sub H1}/T{sub H2} cytokine balance in serum. Augmented level of serum-borne IFN-γ was found to mediate modulation of BMM to produce enhanced amount of monokines (IL-1, IL-6, TNF-α), which are suggested to augment the BMC survival. Taken together the present investigation indicates that curcumin can potentiate myelopoiesis in a tumor-bearing host, which may have implications in its therapeutic utility. Highlights: ► Curcumin augments myelopoiesis in tumor-bearing host. ► Bone marrow resident macrophages mediate curcumin-dependent augmented myelopoiesis. ► Serum borne cytokine are implicated in modulation of bone marrow resident

  13. Bone metastasis from malignant phyllodes breast tumor: report of two cases. (United States)

    El Ochi, Mohamed Reda; Toreis, Mehdi; Benchekroun, Mohamed; Benkerroum, Zineb; Allaoui, Mohamed; Ichou, Mohamed; El Khannoussi, Basma; Albouzidi, Abderrahman; Oukabli, Mohamed


    Phyllodes tumors are rare fibroepithelial tumors accounting for less than 1 % of all breast neoplasms. They are malignant in 20 % of cases. Only a few cases of malignant phyllodes tumors metastatic to bone have been reported. Case 1: A 40 year-old white woman presented with three-week history of pain and functional impairment of the left lower limb. Her clinical past was remarkable for previous left mastectomy and radiotherapy for malignant phyllodes tumor performed one year ago. Computed tomography revealed a moth-eaten appearance of the left femoral head. The patient underwent computed guided femoral head biopsy. Pathological findings were consistent with metastatic malignant phyllodes tumor. The patient received ifosfamide and adriamycin chemotherapy. She is doing well without any evidence of progression on her imaging follow- up after 8 months. Case 2: A 48 year-old white woman, with history of bilateral mastectomy and radiotherapy for malignant phyllodes tumor performed one and two year ago, presented with four-week left lower quadrant abdominal pain. Computed tomography and magnetic resonance imaging revealed a solid aggressive osteolytic mass of the left iliac bone with extensive soft tissue invasion. Biopsy of the tumor was performed and showed a sarcomatous proliferation consistent with metastatic malignant phyllodes tumor. The patient received the same chemotherapy regimen as in the first case but without any response on her imaging follow up after 6 months. Malignant phyllodes tumor is a rare and aggressive fibroepithelial neoplasm. An accurate diagnosis of metastases should be based on clinicopathological correlation allowing exclusion of differential diagnoses. The goal of successful managing this tumor is early detection and complete resection prior to dissemination.

  14. Computer-Assisted Assessment -- Research into E-Assessment. Proceedings of the 17th International Conference on Computer Assisted Assessment

    NARCIS (Netherlands)

    Kalz, Marco; Ras, Eric


    This book constitutes the refereed proceedings of the International Conference on Computer Assisted Assessment, CAA 2014, held in Zeist, The Netherlands, in June/July 2014. The 16 revised full papers presented were carefully reviewed and selected from numerous submissions. The papers address issues

  15. Errors and Intelligence in Computer-Assisted Language Learning: Parsers and Pedagogues. Routledge Studies in Computer Assisted Language Learning (United States)

    Heift, Trude; Schulze, Mathias


    This book provides the first comprehensive overview of theoretical issues, historical developments and current trends in ICALL (Intelligent Computer-Assisted Language Learning). It assumes a basic familiarity with Second Language Acquisition (SLA) theory and teaching, CALL and linguistics. It is of interest to upper undergraduate and/or graduate…

  16. Bone and cementum as stromal features in Pindborg tumor. (United States)

    Slootweg, P J


    A case of calcifying epithelial odontogenic tumor (CEOT) occurring in the left mandible of a 50-yr-old man was characterized by the presence of large masses of calcified collagen. Calcified amyloid acted as the nucleus for the deposition of this material. Because of the close association between both types of calcified material, it is presumed that the calcified amyloid is an inductive stimulus for the stromal cells to differentiate towards production of a collagenous matrix destined to calcify and resembling cementum. The stromal component of CEOT thus seems to be just as odontogenic as the epithelium is.

  17. Tumor-targeting Salmonella typhimurium A1-R prevents experimental human breast cancer bone metastasis in nude mice


    Miwa, Shinji; Yano, Shuya; Zhang, Yong; Matsumoto,Yasunori; Uehara, Fuminari; Yamamoto, Mako; Hiroshima, Yukihiko; Kimura, Hiroaki; Hayashi, Katsuhiro; Yamamoto, Norio; Bouvet, Michael; Tsuchiya, Hiroyuki; Hoffman, Robert M.; Zhao, Ming


    Bone metastasis is a lethal and morbid late stage of breast cancer that is currently treatment resistant. More effective mouse models and treatment are necessary. High bone-metastatic variants of human breast cancer cells were selected in nude mice by cardiac injection. After cardiac injection of a high bone-metastatic variant of breast cancer, all untreated mice had bone metastases compared to only 20% with parental cells. Treatment with tumor-targeting Salmonella typhimurium A1-R completely...

  18. Computer Assisted Surgery and Current Trends in Orthopaedics Research and Total Joint Replacements (United States)

    Amirouche, Farid


    Musculoskeletal research has brought about revolutionary changes in our ability to perform high precision surgery in joint replacement procedures. Recent advances in computer assisted surgery as well better materials have lead to reduced wear and greatly enhanced the quality of life of patients. The new surgical techniques to reduce the size of the incision and damage to underlying structures have been the primary advance toward this goal. These new techniques are known as MIS or Minimally Invasive Surgery. Total hip and knee Arthoplasties are at all time high reaching 1.2 million surgeries per year in the USA. Primary joint failures are usually due to osteoarthristis, rheumatoid arthritis, osteocronis and other inflammatory arthritis conditions. The methods for THR and TKA are critical to initial stability and longevity of the prostheses. This research aims at understanding the fundamental mechanics of the joint Arthoplasty and providing an insight into current challenges in patient specific fitting, fixing, and stability. Both experimental and analytical work will be presented. We will examine Cementless total hip arthroplasty success in the last 10 years and how computer assisted navigation is playing in the follow up studies. Cementless total hip arthroplasty attains permanent fixation by the ingrowth of bone into a porous coated surface. Loosening of an ingrown total hip arthroplasty occurs as a result of osteolysis of the periprosthetic bone and degradation of the bone prosthetic interface. The osteolytic process occurs as a result of polyethylene wear particles produced by the metal polyethylene articulation of the prosthesis. The total hip arthroplasty is a congruent joint and the submicron wear particles produced are phagocytized by macrophages initiating an inflammatory cascade. This cascade produces cytokines ultimately implicated in osteolysis. Resulting bone loss both on the acetabular and femoral sides eventually leads to component instability. As

  19. Evaluation of Clinical Results and Complications of Structural Allograft Reconstruction after Bone Tumor Surgery

    Directory of Open Access Journals (Sweden)

    Mohammad Gharedaghi


    Full Text Available Background: Massive bone allograft is an option in cases of limb preservation and reconstruction after massive benign and malignant bone tumor resection. The purpose of this study was to analyze the outcome of these procedures at Imam Reza Hospital, Mashhad University of Medical Sciences. Methods: In this study, 113 cases have been presented. Eleven cases were excluded (patients has a traumatic defect or they passed away before the completion of the study’s two-year follow up period. Each patient completed a questionnaire, went through a physical examination and, if indicated, X-ray information was collected. The patients were divided into three groups: chemotherapy, chemotherapy plus radiation therapy, and no-adjuvant-therapy. Results: Fifty-four cases were male and the mean age was 24.5±5.39. The number of cases and indications for surgery were: 33 cases of aggressive benign tumors or low grade malignant bone tumors (large bone defects including 16 germ cell tumors, eight aneurysmal bone cysts, five low grade osteosarcomas, and four chondrosarcomas. Another 69 cases were high-grade malignant bone tumors including 42 osteosarcomas, 21 Ewing’s sarcoma, and six other high grade osteosarcomas. Patients were divided into three groups: the first group received no adjuvant therapy, the second group received chemotherapy, and the third group received chemotherapy plus radiotherapy. The location of tumors were as follows: eight cases in the pelvic bone, 12 in the proximal femur, 18 in the femoral shaft, 36 in the distal femur, 12 in the proximal tibia, and 16 in the humeral bone. The 12 cases of proximal femoral defects were reconstructed by allograft composite prosthesis, 18 diaphyseal defects with intercalary allograft, and 36 distal femoral defects were reconstructed using osteoarticular allograft. The rate of deep infection was 7:8% (eight patients and in this regard, we found a significant difference among the three groups, such that most

  20. Biological Reconstruction Following the Resection of Malignant Bone Tumors of the Pelvis

    Directory of Open Access Journals (Sweden)

    Frank Traub


    Full Text Available Background. Surgical treatment of malignant pelvic bone tumors can be very challenging. The objective of this retrospective study was to evaluate the oncological as well as the clinical and functional outcome after limb salvage surgery and biological reconstruction. Methods. The files of 27 patients with malignant pelvic bone tumors, who underwent surgical resection at our department between 2000 and 2011, were retrospectively analyzed (9 Ewing's sarcoma, 8 chondrosarcoma, 4 osteosarcoma, 1 synovial sarcoma, 1 malignant fibrous histiocytoma, and 4 carcinoma metastases. Results. After internal hemipelvectomy reconstruction was performed by hip transposition (, using autologous nonvascularised fibular graft ( or autologous iliac crest bone graft (. In one patient a proximal femor prothetis and in three patients a total hip prosthesis was implanted at the time of resection. The median follow-up was 33 months. Two- and five-year disease-specific survival rates of all patients were 86.1% and 57.7%, respectively. The mean functional MSTS score was 16.5 (~55% for all patients. Conclusion. On the basis of the oncological as well as the clinical and functional outcome, biological reconstruction after internal hemipelvectomy seems to be a reliable technique for treating patients with a malignant pelvic bone tumor.

  1. Tumor-specific expression of αvβ3 integrin promotes spontaneous metastasis of breast cancer to bone (United States)

    Sloan, Erica K; Pouliot, Normand; Stanley, Kym L; Chia, Jenny; Moseley, Jane M; Hards, Daphne K; Anderson, Robin L


    Introduction Studies in xenograft models and experimental models of metastasis have implicated several β3 integrin-expressing cell populations, including endothelium, platelets and osteoclasts, in breast tumor progression. Since orthotopic human xenograft models of breast cancer are poorly metastatic to bone and experimental models bypass the formation of a primary tumor, however, the precise contribution of tumor-specific αvβ3 to the spontaneous metastasis of breast tumors from the mammary gland to bone remains unclear. Methods We used a syngeneic orthotopic model of spontaneous breast cancer metastasis to test whether exogenous expression of αvβ3 in a mammary carcinoma line (66cl4) that metastasizes to the lung, but not to bone, was sufficient to promote its spontaneous metastasis to bone from the mammary gland. The tumor burden in the spine and the lung following inoculation of αvβ3-expressing 66cl4 (66cl4beta3) tumor cells or control 66cl4pBabe into the mammary gland was analyzed by real-time quantitative PCR. The ability of these cells to grow and form osteolytic lesions in bone was determined by histology and tartrate-resistant acid phosphatase staining of bone sections following intratibial injection of tumor cells. The adhesive, migratory and invasive properties of 66cl4pBabe and 66cl4beta3 cells were evaluated in standard in vitro assays. Results The 66cl4beta3 tumors showed a 20-fold increase in metastatic burden in the spine compared with 66cl4pBabe. A similar trend in lung metastasis was observed. αvβ3 did not increase the proliferation of 66cl4 cells in vitro or in the mammary gland in vivo. Similarly, αvβ3 is not required for the proliferation of 66cl4 cells in bone as both 66cl4pBabe and 66cl4beta3 proliferated to the same extent when injected directly into the tibia. 66cl4beta3 tumor growth in the tibia, however, increased osteoclast recruitment and bone resorption compared with 66cl4 tumors. Moreover, αvβ3 increased 66cl4 tumor cell

  2. Frontal bone hemangioma in an 8-year-old female: A common tumor in a rare location

    Directory of Open Access Journals (Sweden)

    Abhimanyu Sharma


    Full Text Available Intraosseous hemangioma is a rare bone tumor accounting for 0.7%–1.0% of all bone tumors. In the skull, frontal bone is the commonly involved bone. An 8-year-old female presented to our outpatient department with complaints of pain and swelling over forehead for 4 months. X-ray revealed a lytic expansile lesion involving frontal bone with sunburst pattern of bony spicules radiating to periphery of the lesion. Magnetic resonance imaging revealed the presence of a well-circumscribed lesion with both intra as well as extracranial components. Histopathology revealed a vascular tumor consisting of both small (capillary and large (cavernous sized vessels. A diagnosis of mixed type of hemangioma of the frontal bone was given. Recognition of hemangioma on radiology and confirmation by histopathology is essential for proper management as it might be confused clinically with other locally aggressive/malignant lesions.

  3. Three cases of bone metastases in patients with gastrointestinal stromal tumors

    Directory of Open Access Journals (Sweden)

    Maurizio Zompatori


    Full Text Available Gastrointestinal stromal tumors (GISTs are rare, but represent the most common mesenchymal neoplasms of the gastrointestinal tract. Tumor resection is the treatment of choice for localized disease. Tyrosine kinase inhibitors (imatinib, sunitinib are the standard therapy for metastatic or unresectable GISTs. GISTs usually metastasize to the liver and peritoneum. Bone metastases are uncommon. We describe three cases of bone metastases in patients with advanced GISTs: two women (82 and 54 years of age, and one man (62 years of age. Bones metastases involved the spine, pelvis and ribs in one patient, multiple vertebral bodies and pelvis in one, and the spine and iliac wings in the third case. The lesions presented a lytic pattern in all cases. Two patients presented with multiple bone metastases at the time of initial diagnosis and one patient after seven years during the follow-up period. This report describes the diagnosis and treatment of the lesions and may help clinicians to manage bones metastases in GIST patients.

  4. Insufficiency Fracture in the Para-Acetabulum, with Features Mimicking Those of a Malignant Bone Tumor (United States)

    Sakamoto, Akio; Yamamoto, Takuaki; Tanaka, Kazuhiro; Matsuda, Shuichi; Yoshida, Tatsuya; Iwamoto, Yukihide


    Para-acetabular insufficiency fractures are rare and exceedingly difficult to diagnose without a high index of suspicion, since the images mimic those of bone tumors. We herein present the case of a 55-year-old woman who suffered from hip pain with subacute onset. She had undergone a hysterectomy-ovariectomy due to endometriosis when she was 41 years old. Her bone mineral density was normal due to supplemental treatment with female hormones. About 3 months after onset, she was referred to our institute with a diagnosis of pelvic bone tumor. Plain radiographs and computed tomography showed irregular osteosclerosis in the para-acetabulum. Bone scintigraphy demonstrated uptake in the para-acetabulum. Magnetic resonance imaging showed abnormal signal with low-signal intensity on T1-weighted images and high-signal intensity on T2-weighted images throughout the entire hemipelvic bone. Since the pain continued for more than 3 months, open biopsy was undertaken and the lesion was found to be non-neoplastic. Six months after onset, the pain disappeared. The clinical course suggested a diagnosis of insufficiency fracture in the para-acetabulum. Para-acetabular insufficiency fractures should always be considered in cases of hip pain, even in patients with prolonged symptoms. PMID:24179350

  5. ABL kinases promote breast cancer osteolytic metastasis by modulating tumor-bone interactions through TAZ and STAT5 signaling. (United States)

    Wang, Jun; Rouse, Clay; Jasper, Jeff S; Pendergast, Ann Marie


    Bone metastases occur in up to 70% of advanced breast cancer. For most patients with breast cancer, bone metastases are predominantly osteolytic. Interactions between tumor cells and stromal cells in the bone microenvironment drive osteolytic bone metastasis, a process that requires the activation of osteoclasts, cells that break down bone. We report that ABL kinases promoted metastasis of breast cancer cells to bone by regulating the crosstalk between tumor cells and the bone microenvironment. ABL kinases protected tumor cells from apoptosis induced by TRAIL (TNF-related apoptosis-inducing ligand), activated the transcription factor STAT5, and promoted osteolysis through the STAT5-dependent expression of genes encoding the osteoclast-activating factors interleukin-6 (IL-6) and matrix metalloproteinase 1 (MMP1). Furthermore, in breast cancer cells, ABL kinases increased the abundance of the Hippo pathway mediator TAZ and the expression of TAZ-dependent target genes that promote bone metastasis. Knockdown of ABL kinases or treatment with ABL-specific allosteric inhibitor impaired osteolytic metastasis of breast cancer cells in mice. These findings revealed a role for ABL kinases in regulating tumor-bone interactions and provide a rationale for using ABL-specific inhibitors to limit breast cancer metastasis to bone. Copyright © 2016, American Association for the Advancement of Science.

  6. A review of computer assisted learning in medical undergraduates. (United States)

    John, Lisha J


    Laboratory based practical classes, have been the corner stone of undergraduate pharmacology learning. Ethical issues with the use of animals and rapid development of information technology has led to newer trends in teaching and learning such as computer assisted learning. Computer assisted learning (CAL) software includes computer based packages, focusing on interactive instruction in a specific subject area, collection of animal experiments that encourage students to understand concepts in pharmacology. CAL offers a number of advantages to both students and teachers; most important being meeting the learning objectives. Few disadvantages and pitfalls to implementation in medical schools are also associated with CAL sessions. This article reviews the trend of CAL in pharmacology, advantages, disadvantages and pitfalls to the implementation of CAL.

  7. Computer-assisted cognitive-behavior therapy for depression. (United States)

    Eells, Tracy D; Barrett, Marna S; Wright, Jesse H; Thase, Michael


    This article reviews the use of computer technology in treating depression as a substitute or adjunct for standard therapy. It discusses advantages and disadvantages of introducing computer technology as a treatment option, problems and barriers to expanded use, the varieties of computer-assisted psychotherapy for major depression, and relevant research. Three specific Internet-based programs are described, assessed and compared: Good Days Ahead, Beating the Blues, and MoodGYM. The authors conclude that these and similar programs are promising. Preliminary outcome studies suggest that these programs produce outcome similar to standard therapy, although methodological shortcomings limit confidence in these findings. Suggestions are offered for practitioners considering the addition of computer assistance to their treatment of depression. (c) 2014 APA, all rights reserved.

  8. Detection of Tumor Cells in Bone Marrow, Peripheral Blood and Lymph Nodes by Automated Imaging Devices

    Directory of Open Access Journals (Sweden)

    Wilma E. Mesker


    Full Text Available The presence of tumor cells in bone marrow, peripheral blood and lymph nodes has proven its clinical and prognostic value. Since the frequency of these cells in bone marrow and blood is sometimes as low as 1 per million and due to the fact that for the analysis of lymph nodes many sectioning levels have to be analyzed, automated imaging devices have been suggested as an useful alternative to conventional manual screening of specimens. The aim of this paper is to review the performance of current equipment that is commercially available, based on literature published so far. Requirements for introducing this equipment for routine clinical practice are discussed.

  9. Toward computer-assisted diagnosis and telemedicine in ophthalmology

    Czech Academy of Sciences Publication Activity Database

    Marrugo, A.; Millán, M. S.; Cristóbal, G.; Gabarda, S.; Šorel, Michal; Šroubek, Filip


    Roč. 2012, č. 6 (2012), s. 1-3 ISSN 1818-2259 R&D Projects: GA MŠk 1M0572 Institutional research plan: CEZ:AV0Z10750506 Institutional support: RVO:67985556 Keywords : computer-aided diagnosis * medical and retinal image * deconvolution * telemedicine Subject RIV: JD - Computer Applications, Robotics computer-assisted diagnosis and telemedicine in ophthalmology .pdf

  10. Implementation of computer assisted assessment: lessons from the literature


    Sim, Gavin; Holifield, Phil; Brown, Martin


    This paper draws attention to literature surrounding the subject of computer-assisted assessment (CAA). A brief overview of traditional methods of assessment is presented, highlighting areas of concern in existing techniques. CAA is then defined, and instances of its introduction in various educational spheres are identified, with the main focus of the paper concerning the implementation of CAA. Through referenced articles, evidence is offered to inform practitioners, and direct further resea...

  11. On Modeling the Instructional Content in Computer Assisted Education

    Directory of Open Access Journals (Sweden)

    Emilia PECHEANU


    Full Text Available This paper presents a solution for conceptually modeling the instructionalcontent in computer-assisted education. The different cognitive style of learnersimposes different modalities of presenting and structuring the information (thepedagogical knowledge to be taught. Conceptual organization of the training domainknowledge, with learning stages phasing, can constitute a better solution to the problemof adapting the instructional system interaction to users with different cognitive styleand needs.

  12. Computer-Assisted Orthopedic Surgery: Current State and Future Perspective


    Zheng, Guoyan; Nolte, Lutz P.


    Introduced about two decades ago, computer-assisted orthopedic surgery (CAOS) has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual repre...

  13. Learning Priniciples Essential for effective computer assisted instruction (cai)


    Havlicek, Larry L.; Ghandour, Mahmoud M.


    Guidelines and recommendations for effective computer assisted instruction are presented based on a review of the current theories and research relating to cognitive conceptions of learning and instructional design which are documented by meta-analytic techniques. The main focus is on how meta-cognitive processes are conceptualized and integrated for the most effective development of any interactive technology for learning. These concepts are then integrated into sequencing and synthesizin...

  14. Translation project adaptation for MT-enhanced computer assisted translation


    Cettolo, Mauro; Bertoldi, Nicola; Federico, Marcello; Schwenk, Holger; Barrault, loïc; Servan, Christophe


    International audience; The effective integration of MT technology into computer-assisted translation tools is a challenging topic both for academic research and the translation industry. Particularly, professional translators feel crucial the ability of MT systems to adapt to their feedback. In this paper, we propose an adaptation scheme to tune a statistical MT system to a translation project using small amounts of post-edited texts, like those generated by a single user in even just one da...


    Directory of Open Access Journals (Sweden)

    PINTILIE Anca-Aurelia


    Full Text Available The art of tapestry has its basics back in time, probably in the decorations of tent, the house of the nomad. Tapestry in its beginnings is the first wall of the nomad’s home and the decorative wall and canopy in the ancient Greek houses as architect Gottfried Semper stated in the nineteen century. The architectural approach is not unusual even in the next centuries. Tapestry becomes popular as a form of monumental art during the Middle Ages when it is used as decorative architectural element, coating the walls of medieval castles. During the next centuries dominated by decadent styles of baroque, rococo, the tapestry will lose its monumental spirit and architectural quality but at the middle of the XXth century a new approach will sustain the revival of the tapestry as monumental art. Later, in the XXIst century, renowned multimedia artists will approach this medium and will use computer assisted looms in ambitious tapestry projects. This technique will allow them to realize complex and exquisite tapestries, sustaining in this way the revival of the tapestry in the contemporary art world. The paper presents the importance of the architectural side of tapestry and the great achievement that computer assisted loom represents for this form of art. The research activity is willing to inform Romanian textile designers about the possibilities to create tapestries on computer assisted looms. The research was made during the initial stage of a doctoral thesis consisting in a documentary study on monumental aspects of contemporary tapestry.

  16. Giant Cell Tumor Of The Long Bones: Results With Combination Of Cryosurgery, Curettage, And Cementation

    Directory of Open Access Journals (Sweden)

    Mortazavi S.M.J


    Full Text Available Background: In this study we evaluated the treatment of giant cell tumor (GCT of long bones using cryosurgery combined with curettage and polymethylmetacrylate (PMMA cementing. Material and methods: From January 1999 to December 2004, twenty patients (mean age at the time of surgery 29.2 years; 13 females and 7 males; were included in the study. Cortical disruption were presented in 7 patients; 4 with soft tissue extension, but none of them had intra-articular extension of tumor, 3 patients presented with pathologic fracture of distal femoral lesions. These tumors were located in distal femur in 6 patients, proximal tibia in 7, distal radius in 3, proximal femur in 2, and each of proximal humerus and distal ulna in one patient. In each case diagnostic biopsy was done and surgical procedure performed including curettage, power burr of the wall, cryosurgery with liquid nitrogen and finally filling the space with PMMA cementing. The mean follow-up was 34 months (7 to 61 . Results: During follow-up, we observed one recurrence of GCT of proximal tibia. Secondary Aneurysmal bone cyst was reported at the site of one primary distal femoral lesion, without any finding in favor of a recurrence. Neurapraxia of the proneal nerve was occurred in one patient with proximal tibia tumor improved after 8 months. Conclusion: Cryosurgery combined with power burr and PMMA cementing in the treatment of GCT could be an effective approach in tumor eradication. This method obviates the need for extensive resections and reconstructive procedure.

  17. [Guided and computer-assisted implant surgery and prosthetic: The continuous digital workflow]. (United States)

    Pascual, D; Vaysse, J


    New continuous digital workflow protocols of guided and computer-assisted implant surgery improve accuracy of implant positioning. The design of the future prosthesis is based on the available prosthetic space, gingival height and occlusal relationship with the opposing and adjacent teeth. The implant position and length depend on volume, density and bone quality, gingival height, tooth-implant and implant-implant distances, implant parallelism, axis and type of the future prosthesis. The crown modeled on the software will therefore serve as a guide to the future implant axis and not the reverse. The guide is made by 3D printing. The software determines surgical protocol with the drilling sequences. The unitary or plural prosthesis, modeled on the software and built before surgery, is loaded directly after implant placing, if needed. These protocols allow for a full continuity of the digital workflow. The software provides the surgeon and the dental technician a total freedom for the prosthetic-surgery guide design and the position of the implants. The prosthetic project, occlusal and aesthetic, taking the bony and surgical constraints into account, is optimized. The implant surgery is simplified and becomes less "stressful" for the patient and the surgeon. Guided and computer-assisted surgery with continuous digital workflow is becoming the technique of choice to improve the accuracy and quality of implant rehabilitation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Use of irradiated autologous bone in joint sparing endoprosthetic femoral replacement tumor surgery

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    Sridhar Vijayan


    Full Text Available Background: Joint preservation is usually attempted in cases of bone tumors, though insufficient bone following tumour resection may prevent fixation of conventional joint sparing prosthesis. To preserve the hip joint in skeletally immature patients, we have combined autologous proximal femoral irradiation and intercalary re-implantation with custom made distal femoral replacements. Materials and Methods: A retrospective cohort study of four patients (aged 4-12 years; in whom irradiated autologous bone was combined with an extendable distal femoral endoprostheses was performed. There were three cases of osteosarcoma and one case of Ewing′s sarcoma. Results: At a mean follow-up of 70.5 months (range 26-185 months, all four patients were alive without evidence of local recurrence. There was no evidence of metastatic disease in three patients while one patient showed chest metastatic disease at presentation. In all cases, the irradiated segment of bone united with the proximal femur and demonstrated bone ongrowth at the prosthetic collar. There were no cases of loosening or peri-prosthetic fracture. One implant was revised after 14 years following fracture of the extending component of the endoprosthesis. Conclusions: We report encouraging results utilizing irradiated autologous proximal femoral bone combined with distal femoral replacement in skeletally immature patients.

  19. A Rare Tumor with a Very Rare Initial Presentation: Thymic Carcinoma as Bone Marrow Metastasis

    Directory of Open Access Journals (Sweden)

    Sonam Sharma


    Full Text Available Tumors of thymus gland are rare and account for 0.2% to 1.5% of all the neoplasms. They constitute a heterogeneous group that has an unknown etiology and a complex as well as varied biology. This has led to difficulty in their histological classification and in predicting their prognostic and survival markers. Among them, thymic carcinoma is the most aggressive thymic epithelial tumor exhibiting cytological malignant features and a diversity of clinicopathological characteristics that can cause diagnostic dilemmas, misdiagnosis, and therapeutic challenge. We herein describe a case of a 60-year-old man who while undergoing evaluation for the cause of pancytopenia was discovered having bone marrow metastasis from an asymptomatic thymic carcinoma. Bone marrow metastasis is an extremely rare initial presentation of thymic carcinoma with only few cases reported in the literature.

  20. Avulsion Fracture of the Anterior Inferior Iliac Spine Mimicking a Bone Tumor: A Case Report

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    Mehmet Incedayi


    Full Text Available This is a case of a 17-year-old boy who was admitted to the clinic suffering from right hip-inguinal region pain which began after a soccer match. He had an avulsion fracture in the anterior inferior iliac spine and CT/MR images showed similarities to a bone tumor. These fractures are especially seen in the apophyses which are within the ossification process. The radiological appearance of these fractures during the healing period may be involved with bone tumors. In the control MRI of the patient after one year, the fracture was almost healed completely. Treatment is generally conservative. Good results have been reported with rest, analgesic and anti-inflammatory drugs. Familiarity with radiological findings of these avulsion fractures in this region not only protects the patient from invasive procedures but also avoids the involvement of the practitioner in legal consequences resulting from a misdiagnosis of sarcoma.

  1. Primary hyperparathyroidism diagnosed after surgical ablation of a costal mass mistaken for giant-cell bone tumor: a case report

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    Vera Lara


    Full Text Available Abstract Introduction Primary hyperparathyroidism is a common endocrine disorder characterized by elevated parathyroid hormone levels, which cause continuous osteoclastic bone resorption. Giant cell tumor of bone is an expansile osteolytic tumor that contains numerous osteoclast-like giant cells. There are many similarities in the radiological and histological features of giant cell tumor of bone and brown tumor. This is a rare benign focal osteolytic process most commonly caused by hyperparathyroidism. Case presentation We report the unusual case of a 40-year-old Caucasian woman in which primary hyperparathyroidism was diagnosed after surgical ablation of a costal mass. The mass was suspected of being neoplastic and histopathology was compatible with a giant cell tumor of bone. On the basis of the biochemical results (including serum calcium, phosphorous and intact parathyroid hormone levels primary hyperparathyroidism was suspected and a brown tumor secondary to refractory hyperparathyroidism was diagnosed. Conclusions Since giant cell tumor is a bone neoplasm that has major implications for the patient, the standard laboratory tests in patients with bone lesions are important for a correct diagnosis.

  2. Laryngeal Chondrosarcoma: An Exceptional Localisation of a Not Unfrequent Bone Tumor

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    Mieke Moerman


    Full Text Available After osteosarcoma, chondrosarcoma is the second most common primary bone tumor accounting for 26% of all malignancies. In the laryngeal region however, chondrosarcomas are rather rare. Only 300 cases are reported in literature. Considering laryngeal chondrosarcoma, about 75% occur in the cricoid cartilage, whereas 20% occur in the thyroid cartilage. In this paper we report a case of thyroidal chondrosarcoma, and based on a thorough literature search we suggest some practical guidelines concerning diagnosis and therapy.

  3. Morphologic Alteration of Metastatic Neuroblastic Tumor in Bone Marrow after Chemotherapy


    Bae, Go Eun; Suh, Yeon-Lim; Sung, Ki Woong; Kim, Jung-Sun


    Background The aim of this study is to evaluate the histologic features of metastatic neuroblastic tumors (NTs) in bone marrow (BM) before and after chemotherapy in comparison with those of primary NTs. Methods A total of 294 biopsies from 48 children diagnosed with NTs with BM metastasis were examined. There were 48 primary neoplasm biopsies, 48 BM biopsies before chemotherapy, 36 primary neoplasm excisional biopsies after chemotherapy, and 162 BM biopsies after chemotherapy. Results Metasta...

  4. Inhibition of mammary tumor growth and metastases to bone and liver by dietary grape polyphenols. (United States)

    Castillo-Pichardo, Linette; Martínez-Montemayor, Michelle M; Martínez, Joel E; Wall, Kristin M; Cubano, Luis A; Dharmawardhane, Suranganie


    The cancer preventive properties of grape products such as red wine have been attributed to polyphenols enriched in red wine. However, much of the studies on cancer preventive mechanisms of grape polyphenols have been conducted with individual compounds at concentrations too high to be achieved via dietary consumption. We recently reported that combined grape polyphenols at physiologically relevant concentrations are more effective than individual compounds at inhibition of ERalpha(-), ERbeta(+) MDA-MB-231 breast cancer cell proliferation, cell cycle progression, and primary mammary tumor growth (Schlachterman et al., Transl Oncol 1:19-27, 2008). Herein, we show that combined grape polyphenols induce apoptosis and are more effective than individual resveratrol, quercetin, or catechin at inhibition of cell proliferation, cell cycle progression, and cell migration in the highly metastatic ER (-) MDA-MB-435 cell line. The combined effect of dietary grape polyphenols (5 mg/kg each resveratrol, quercetin, and catechin) was tested on progression of mammary tumors in nude mice created from green fluorescent protein-tagged MDA-MB-435 bone metastatic variant. Fluorescence image analysis of primary tumor growth demonstrated a statistically significant decrease in tumor area by dietary grape polyphenols. Molecular analysis of excised tumors demonstrated that reduced mammary tumor growth may be due to upregulation of FOXO1 (forkhead box O1) and NFKBIA (IkappaBalpha), thus activating apoptosis and potentially inhibiting NfkappaB (nuclear factor kappaB) activity. Image analysis of distant organs for metastases demonstrated that grape polyphenols reduced metastasis especially to liver and bone. Overall, these results indicate that combined dietary grape polyphenols are effective at inhibition of mammary tumor growth and site-specific metastasis.

  5. [Application of computer-assisted navigation in oral and maxillofacial surgery: retrospective analysis of 104 consecutive cases]. (United States)

    Yu, Hong-bo; Zhang, Shi-lei; Wang, Xu-dong; Lin, Yan-ping; Wang, Cheng-tao; Shen, Guo-fang


    To evaluate the application of computer-assisted navigation system (CANS) in Oral and Maxillofacial Surgery. One hundred and four patients were included in this study, including 34 with zygomatic-orbital-maxillary fracture, 27 with unilateral TMJ ankylosis, 29 with fibrous dysplasia, 9 with mandibular angle hypertropia, 3 with cartilage and bone tumors and 2 with facial foreign bodies. CT scan was performed and the data was saved as Dicom (digital imaging and communications in medicine) format. With preoperative planning and 3-dimensional simulation, normal anatomic structures of the affected side were created by superimposing and mirroring the unaffected side. The osteotomy lines, amount and range of resection, the reduction position of bony segments and the reconstruction morphology was determined and displayed. All surgeries were performed under the guidance of navigation system. The accuracy of navigation was evaluated by comparing the postoperative CT three-dimensional model with preoperative surgical planning. Through registration, an accurate match between the intra-operative anatomy and the CT images was achieved. With the guidance of navigation, anatomic structures and the position of surgical instruments were shown real-time on the screen. No complications occurred in all patients and the systematic error was within 1 mm. Good coincidence with preoperative planning was achieved for osteotomy lines, the amount of resection and reduction of fractures. The mean error between virtual and real results was (1.46±0.24) mm. All patients healed uneventfully and facial symmetry was improved. With the ability of preoperative planning, surgical simulation and postoperative prediction, CANS shows its great value in improving the accuracy of oral and maxillofacial surgery, reducing trauma and restoring facial symmetry. It is regarded as a valuable and safe technique in this potentially complicated procedure.

  6. Inflammation and tumors of the temporal bone; Entzuendungen und Tumoren des Schlaefenbeins

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    Burian, M. [Universitaetsklinik fuer Hals-, Nasen- und Ohrenkrankheiten, Allgemeines Krankenhaus, Wien (Austria)


    The term `inflammation of the middle ear` covers a couple of deseases which range from the acute otitis media to the middle ear cholesteatoma. However, a clear characterization of a certain pathology is essential for any further treatment. Therefore this article presents a short overview about the different types of infections and their clinical manifestation. The tumors of the temporal bone show a great variety in their incidence. Even if tumors like the acoustic neurinoma or the paraganglioma are compareable common, the chondroblastoma of the temporal bone is absolutely rare. In spite of these differences the individual temporal bone neoplasias are shortly mentioned herein. (orig.) [Deutsch] Der Begriff Mittelohrentzuendung umfasst ein weites Spektrum von Krankheiten welches von der akuten Mittelohrentzuendung bis hin zum Cholesteatom reicht. Es soll in diesem Artikel eine kurze Uebersicht ueber die verschiedenen Entzuendungen gegeben werden, wobei vor allem auf eine klare Begriffsdefinition der einzelnen Entzuendungsformen und deren klinisches Erscheinungsbild geachtet wurde. Bei den Tumoren des Schlaefenbeins ist ein grosser Unterschied in der Inzidenz der einzelnen Tumoren gegeben. Waehrend Neubildungen wie das Akustikusneurinom oder das Paragangliom vergleichsweise haeufig im klinischen Alltag zu sehen sind, stellen Veraenderungen wie das Chondroblastom eine Raritaet dar. Trotz dieses Unterschieds im Vorkommen der verschiedenen Tumoren, wurde versucht, einen kurzen Gesamtueberblick ueber die Tumore des Mittel- und Innenohres zu geben. (orig.)

  7. Use of percutaneous core needle biopsy for diagnosing acral bone tumors

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    Zhichao Tong


    Full Text Available This study aims to evaluate the diagnostic value of percutaneous core needle biopsy (PCNB in diagnosing acral bone tumors. The clinical PCNB data of 341 patients with bone tumors were retrospectively analyzed. The diagnostic accuracy was calculated according to the lesion components (sclerotic, parenchymatous, or cystic, benign or malignant character, and whether a soft tissue mass was present. The chi-square test was performed to assess diagnostic accuracy. The accuracy rate for sclerotic and substantive lesions was high (87.5% and 90.1%, respectively, while that for cystic lesions was the lowest. The accuracy difference in diagnosing benign and malignant lesions was significant (P<0.001. The existence of an extraskeletal soft tissue mass significantly affected the diagnostic accuracy (P=0.007. PCNB is a safe, accurate, rapid, and effective screening method in diagnosing bone tumors; however, the diagnostic accuracy for cystic lesions was poorest. The lesions without a diagnostic biopsy result were most likely to be benign, and the existence of an extraskeletal soft tissue mass significantly affected diagnostic accuracy; therefore, the correct diagnosis of skeletal system lesions still relies on the coordinated efforts of clinics, pathology, and imaging.

  8. Osteomyelitis of the femur mimicking bone tumors: a review of 10 cases (United States)


    Background The clinical symptoms and radiographic appearance of osteomyelitis can mimic those of bone tumors. Methods We reviewed 10 patients with osteomyelitis of the femur who were initially diagnosed as having bone tumors and were subsequently transferred to our institution. Results Nocturnal pain of moderate intensity occurred in seven patients, and all 10 patients had elevated C-reactive protein levels. The radiographic findings included the following: a permeative, moth-eaten osteolytic lesion in six patients, an osteolytic lesion with sclerotic borders in three patients, and cortical destruction with pathological fracture in one patient. Magnetic resonance imaging was performed for eight patients, and only one had a positive penumbra sign. All patients underwent a surgical biopsy to confirm the final diagnosis for histological analysis and cultures. Klebsiella pneumoniae was detected in six patients and Staphylococcus aureus, the most common organism in osteomyelitis, was detected in three. Recurrence of infection occurred in five patients following debridement surgery; of these three had a Klebsiella pneumoniae infection. All patients received antibiotic treatment for an average of 20.4 weeks (range, 4 to 44) and surgical treatment an average of 1.8 times (range, 1 to 4). At the final follow-up, all patients were fully recovered with no signs of infection. Conclusions When used in combination, clinical examinations, laboratory data, and radiographic findings can reliably distinguishing osteomyelitis from bone tumors. PMID:24148903

  9. MicroRNA function and dysregulation in bone tumors: the evidence to date.

    LENUS (Irish Health Repository)

    Nugent, Mary


    Micro ribonucleic acids (miRNAs) are small non-coding RNA segments that have a role in the regulation of normal cellular development and proliferation including normal osteogenesis. They exert their effects through inhibition of specific target genes at the post-transcriptional level. Many miRNAs have altered expression levels in cancer (either increased or decreased depending on the specific miRNA). Altered miRNA expression profiles have been identified in several malignancies including primary bone tumors such as osteosarcoma and Ewing\\'s sarcoma. It is thought that they may function as tumor suppressor genes or oncogenes and hence when dysregulated contribute to the initiation and progression of malignancy. miRNAs are also thought to have a role in the development of bone metastases in other malignancies. In addition, evidence increasingly suggests that miRNAs may play a part in determining the response to chemotherapy in the treatment of osteosarcoma. These molecules are readily detectable in tissues, both fresh and formalin fixed paraffin embedded and, more recently, in blood. Although there are fewer published studies regarding circulating miRNA profiles, they appear to reflect changes in tissue expression. Thus miRNAs may serve as potential indicators of disease presence but more importantly, may have a role in disease characterization or as potential therapeutic targets. This review gives a brief overview of miRNA biochemistry and explores the evidence to date implicating these small molecules in the pathogenesis of bone tumors.

  10. Use of extended curettage with osteotomy and fenestration followed by reconstruction with conservation of muscle insertion in the treatment of Enneking stage II locally aggressive bone tumor of the proximal extremities: resection and treatment of bone tumors (United States)


    Background The purpose of this study was to investigate the clinical efficacy of extended resection with osteotomy, fenestration and conservation of muscle (tendon) insertion in the treatment of bone tumors. Methods A total of 15 patients with locally aggressive bone tumors (Enneking stage II) in the adjacent muscle (tendon) insertion of the proximal extremity were enrolled in the present study (mean age of 29 years). Extended curettage of lesions with osteotomy, fenestration and/or conservation of muscle (tendon) insertion and internal fixation with a bone graft or bone cement was performed at stage I. Postsurgical brace protection was used for 4 to 12 weeks and the patients were periodically followed-up by X-ray and functional assessment. Recurrence, postsurgical Enneking score and outcome rating were assessed. Results Treated cases included 15 patients aged 29 ±7.75 years (range, 18 to 42) with a male to female ratio of 8:7. Six had a femoral tumor and nine had a humeral tumor. These tumors comprised three chondroblastomas, five giant-cell tumors and seven aneurysmal bone cysts. Follow-up for 48 ±12.95 months (range, 25 to 72) revealed that 13 of 15 (87%) patients exhibited no recurrence. Local recurrence was observed in a patient with an aneurysmal bone cyst (nine months) and one with a giant-cell tumor (12 months). Mean Enneking scores were 27 ±4.07 (range, 18 to 29). Except for the patient with the recurrent giant-cell tumor, all patients reported good (13%, 2 out of 15) or very good (80%, 12 out of 15) outcomes. Very good outcomes were reported in 92% of patients (12 out of 13) without recurrence. Conclusions The procedures used in this study achieved high clinical efficacy, complete lesion removal, reduced recurrence and good restoration of joint function in patients with primary locally aggressive Enneking stage II bone tumors of the proximal extremities. PMID:23497479

  11. A blocking antibody to nerve growth factor attenuates skeletal pain induced by prostate tumor cells growing in bone. (United States)

    Halvorson, Kyle G; Kubota, Kazufumi; Sevcik, Molly A; Lindsay, Theodore H; Sotillo, Julio E; Ghilardi, Joseph R; Rosol, Thomas J; Boustany, Leila; Shelton, David L; Mantyh, Patrick W


    Prostate cancer is unique in that bone is often the only clinically detectable site of metastasis. Prostate tumors that have metastasized to bone frequently induce bone pain which can be difficult to fully control as it seems to be driven simultaneously by inflammatory, neuropathic, and tumorigenic mechanisms. As nerve growth factor (NGF) has been shown to modulate inflammatory and some neuropathic pain states in animal models, an NGF-sequestering antibody was administered in a prostate model of bone cancer where significant bone formation and bone destruction occur simultaneously in the mouse femur. Administration of a blocking antibody to NGF produced a significant reduction in both early and late stage bone cancer pain-related behaviors that was greater than or equivalent to that achieved with acute administration of 10 or 30 mg/kg of morphine sulfate. In contrast, this therapy did not influence tumor-induced bone remodeling, osteoblast proliferation, osteoclastogenesis, tumor growth, or markers of sensory or sympathetic innervation in the skin or bone. One rather unique aspect of the sensory innervation of bone, that may partially explain the analgesic efficacy of anti-NGF therapy in relieving prostate cancer-induced bone pain, is that nearly all nerve fibers that innervate the bone express trkA and p75, and these are the receptors through which NGF sensitizes and/or activates nociceptors. The present results suggest that anti-NGF therapy may be effective in reducing pain and enhancing the quality of life in patients with prostate tumor-induced bone cancer pain.

  12. Bone alloplasty and rehabilitation of children with maxillo-facial tumors (United States)

    Zhelezny, P. A.; Sadovoy, M. A.; Kirilova, I. A.; Zhelezny, S. P.; Podorozhnaya, B. T.; Zheleznaya, A. P.


    The clinical observations in the treatment and rehabilitation of 117 children with maxillofacial tumors are presented. Malignant tumors were observed in 4 patients, other 113 children had benign tumors and tumor mass. Different bone defects of maxilla of both sub-total perforating and small segmental cavity appeared after the removal of neoplasms. The orthopedic transplants from the laboratory of tissue preservation of Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics preserved by different methods were used for maxilla defects restoration. Frozen transplants were applied in 48 patients, "Kostma" transplants were used in 14 patients, "Deprodex"—in 28 patients, "Orgamax"—in 27 patients. Orthopedic transplants from mandibular bone were used for chin and condylar process defects restoration. The orthopedic and orthodontic rehabilitation of the patients with the use of removable and unremovable orthodontic equipment and dental implantation systems was carried out in the postoperative period. Good anatomical functional and esthetic results of rehabilitation were received in 92 patients (89.3%) on long dates by 10 years. In some people the face asymmetry, bite disturbance, reduction of masticatory function were registered.

  13. Non-odontogenic tumors of the facial bones in children and adolescents: role of multiparametric imaging

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    Becker, Minerva; Stefanelli, Salvatore; Poletti, Pierre Alexandre; Merlini, Laura [University of Geneva, Division of Radiology, Department of Imaging and Medical Informatics, Geneva University Hospital, Geneva (Switzerland); Rougemont, Anne-Laure [University of Geneva, Division of Clinical Pathology, Department of Genetic and Laboratory Medicine, Geneva University Hospital, Geneva (Switzerland)


    Tumors of the pediatric facial skeleton represent a major challenge in clinical practice because they can lead to functional impairment, facial deformation, and long-term disfigurement. Their treatment often requires a multidisciplinary approach, and radiologists play a pivotal role in the diagnosis and management of these lesions. Although rare, pediatric tumors arising in the facial bones comprise a wide spectrum of benign and malignant lesions of osteogenic, fibrogenic, hematopoietic, neurogenic, or epithelial origin. The more common lesions include Langerhans cell histiocytosis and osteoma, while rare lesions include inflammatory myofibroblastic and desmoid tumors; juvenile ossifying fibroma; primary intraosseous lymphoma; Ewing sarcoma; and metastases to the facial bones from neuroblastoma, Ewing sarcoma, or retinoblastoma. This article provides a comprehensive approach for the evaluation of children with non-odontogenic tumors of the facial skeleton. Typical findings are discussed with emphasis on the added value of multimodality multiparametric imaging with computed tomography (CT), magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI), positron emission tomography CT (PET CT), and PET MRI. Key imaging findings and characteristic histologic features of benign and malignant lesions are reviewed and the respective role of each modality for pretherapeutic assessment and post-treatment follow-up. Pitfalls of image interpretation are addressed and how to avoid them. (orig.)

  14. Medical image computing and computer-assisted intervention - MICCAI 2006. Pt. 1. Proceedings

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    Larsen, R. [Technical Univ. of Denmark, Lyngby (Denmark). Informatics and Mathematical Modelling; Nielsen, M. [IT Univ. of Copenhagen (Denmark); Sporring, J. (eds.) [Copenhagen Univ. (Denmark). Dept. of Computer Science


    The two-volume set LNCS 4190 and LNCS 4191 constitute the refereed proceedings of the 9th International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2006, held in Copenhagen, Denmark in October 2006. The program committee carefully selected 39 revised full papers and 193 revised poster papers from 578 submissions for presentation in two volumes, based on a rigorous peer reviews. The first volume includes 114 contributions related to bone shape analysis, robotics and tracking, segmentation, analysis of diffusion tensor MRI, shape analysis and morphometry, simulation and interaction, robotics and intervention, cardio-vascular applications, image analysis in oncology, brain atlases and segmentation, cardiac motion analysis, clinical applications, and registration. The second volume collects 118 papers related to segmentation, validation and quantitative image analysis, brain image processing, motion in image formation, image guided clinical applications, registration, as well as brain analysis and registration. (orig.)

  15. Medical image computing and computer-assisted intervention - MICCAI 2006. Pt. 2. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, R. [Technical Univ. of Denmark, Lyngby (Denmark). Informatics and Mathematical Modelling; Nielsen, M. [IT Univ. of Copenhagen (Denmark); Sporring, J. (eds.) [Copenhagen Univ. (Denmark). Dept. of Computer Science


    The two-volume set LNCS 4190 and LNCS 4191 constitute the refereed proceedings of the 9th International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2006, held in Copenhagen, Denmark in October 2006. The program committee carefully selected 39 revised full papers and 193 revised poster papers from 578 submissions for presentation in two volumes, based on a rigorous peer reviews. The first volume includes 114 contributions related to bone shape analysis, robotics and tracking, segmentation, analysis of diffusion tensor MRI, shape analysis and morphometry, simulation and interaction, robotics and intervention, cardio-vascular applications, image analysis in oncology, brain atlases and segmentation, cardiac motion analysis, clinical applications, and registration. The second volume collects 118 papers related to segmentation, validation and quantitative image analysis, brain image processing, motion in image formation, image guided clinical applications, registration, as well as brain analysis and registration. (orig.)

  16. Aneurysmal bone cyst secondary to giant cell tumor of the mobile spine: a report of 11 cases. (United States)

    Wu, Zhipeng; Yang, Xinghai; Xiao, Jianru; Feng, Dapeng; Huang, Quan; Zheng, Wei; Huang, Wending; Zhou, Zhenhua


    A retrospective analysis was performed. To analyze the characteristics of aneurysmal bone cyst arising from giant cell tumor of the mobile spine and to discuss the outcome of corresponding surgical and nonsurgical treatment. Giant cell tumors are generally benign neoplasms that exhibit aggressive behavior with a tendency to recur locally. Aneurysmal bone cysts are benign, highly vascular osseous lesions. Although both of them have been described separately in previous literatures, few reports have described aneurysmal bone cyst secondary to giant cell tumor of the mobile spine. Between January 2004 and December 2009, 11 patients were identified with an aneurysmal bone cyst arising from giant cell tumor of the mobile spine. Four patients underwent subtotal tumor resection followed by radiotherapy, and the other 7 patients underwent total tumor resection. Patients with lesions located below T6 were treated with selective arterial embolization before surgery. Clinical data and the efficacy of surgery were analyzed via chart review Of the eleven patients identified for inclusion in this study, the average age was 33 months (range ∇ 14-65 months). The mean length of follow-up was 31 months. Seven patients kept disease-free during the follow-ups. The remaining four patients recurred and one died of local re-recurrence and lung metastasis. Unlike primary aneurysmal bone cyst, secondary aneurysmal bone cyst arising from giant cell tumor of the mobile spine has a more aggressive tendency to recurrence locally. Complete resection with systematic radiotherapy should be undertaken for the treatment of aneurysmal bone cyst secondary to giant cell tumor of the mobile spine, which is associated with a good prognosis for local tumor control. As complete or as radical an operation as possible should be performed at first presentation. The best chance for the patient is the first chance. Selective preoperative embolization is advised to minimize intraoperative blood loss.

  17. Gene transfection in primary stem-like cells of giant cell tumor of bone

    Directory of Open Access Journals (Sweden)

    Shalini Singh


    Full Text Available Shalini Singh1, Isabella Mak1, Patricia Power1, Melissa Cunnigham2, Robert Turcotte3, Michelle Ghert11Departments of Surgery, 2Biology, McMaster University, Hamilton, Ontario; 3Department of Orthopaedic Surgery, McGill University Medical Centre, Montreal, Quebec, CanadaAbstract: The neoplastic stem-like stromal cell of giant cell tumor of bone (GCT survives for multiple passages in primary culture with a stable phenotype, and exhibits multipotent characteristics. The pathophysiology of this tumor has been studied through the primary culture of these cells. However, successful gene transfer of these cells has not been reported to date. In this short report, we describe the development of the first reported technique that results in efficient gene transfection in primary stem-like cells of GCT.Keywords: gene, transfection, primary cells, TWIST, giant cell tumor

  18. Computer assisted navigation in total knee and hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Deep Kamal


    Full Text Available Introduction: Computer assisted surgery was pioneered in early 1990s. The first computer assisted surgery (CAS total knee replacement with an imageless system was carried out in 1997. In the past 25 years, CAS has progressed from experimental in vitro studies to established in vivo surgical procedures. Methods: A comprehensive body of evidence establishing the advantages of computer assisted surgery in knee and hip arthroplasty is available. Established benefits have been demonstrated including its role as an excellent research tool. Its advantages include dynamic pre-operative and per-operative assessment, increased accuracy in correction of deformities, kinematics and mechanical axis, a better alignment of components, better survival rates of prostheses and a better functional outcome. Adoption of computer navigation in the hip arthroplasty is still at an early stage compared to knee arthroplasty, though the results are well documented. Evidence suggests improved accuracy in acetabular orientation, positioning, hip offset and leg length correction. Results: Among the orthopaedic surgeons, navigated knee arthroplasty is gaining popularity though slowly. The uptake rates vary from country to country. The Australian joint registry data shows increased navigated knee arthroplasty from 2.4% in 2003 to 28.6% in 2015 and decreased revision rates with navigated knee arthroplasty in comparison with traditional instrumented knee arthroplasty in patient cohort under the age of 55 years. Conclusion: Any new technology has a learning curve and with practice the navigation assisted knee and hip arthroplasty becomes easy. We have actively followed the evidence of CAS in orthopaedics and have successfully adopted it in our routine practice over the last decades. Despite the cautious inertia of orthopaedic surgeons to embrace CAS more readily; we are certain that computer technology has a pivotal role in lower limb arthroplasty. It will evolve to become a

  19. Computer assisted navigation in total knee and hip arthroplasty. (United States)

    Deep, Kamal; Shankar, Shivakumar; Mahendra, Ashish


    Computer assisted surgery was pioneered in early 1990s. The first computer assisted surgery (CAS) total knee replacement with an imageless system was carried out in 1997. In the past 25 years, CAS has progressed from experimental in vitro studies to established in vivo surgical procedures. A comprehensive body of evidence establishing the advantages of computer assisted surgery in knee and hip arthroplasty is available. Established benefits have been demonstrated including its role as an excellent research tool. Its advantages include dynamic pre-operative and per-operative assessment, increased accuracy in correction of deformities, kinematics and mechanical axis, a better alignment of components, better survival rates of prostheses and a better functional outcome. Adoption of computer navigation in the hip arthroplasty is still at an early stage compared to knee arthroplasty, though the results are well documented. Evidence suggests improved accuracy in acetabular orientation, positioning, hip offset and leg length correction. Among the orthopaedic surgeons, navigated knee arthroplasty is gaining popularity though slowly. The uptake rates vary from country to country. The Australian joint registry data shows increased navigated knee arthroplasty from 2.4% in 2003 to 28.6% in 2015 and decreased revision rates with navigated knee arthroplasty in comparison with traditional instrumented knee arthroplasty in patient cohort under the age of 55 years. Any new technology has a learning curve and with practice the navigation assisted knee and hip arthroplasty becomes easy. We have actively followed the evidence of CAS in orthopaedics and have successfully adopted it in our routine practice over the last decades. Despite the cautious inertia of orthopaedic surgeons to embrace CAS more readily; we are certain that computer technology has a pivotal role in lower limb arthroplasty. It will evolve to become a standard practice in the future in various forms like navigation


    Directory of Open Access Journals (Sweden)

    Alejandro Alcaraz Sintes


    Full Text Available This article offer a general but thorougli survey of Computer Assisted lnstruction as applied to the Old English language íkoni the work of the late 80's pioneers to December 2001. It enibraces all the different facets of the question: stand-alone and web-based applications, Internet sites. CD-ROMs, grammars, dictioriaries, general courses, reading software, extralinguistic material, exercises, handouts, audio files ... Each instruction itee whether it be a website, a java exercise, an online course or an electronic book- is reviewed and URLs are provided in Sootiiotes. These reviews are accompanied all throughout by the pertinent theoretical background and practical advice.

  1. Computer assisted learning: a new paradigm in dental education. (United States)

    Hollis, Wainscott; Darnell, Laura A; Hottel, Timothy L


    Computer assisted simulation is an important teaching modality in the preclinical training of students. In order to maximize the potential of this learning tool, the University of Tennessee's College of Dentistry has successfully incorporated DentSim technology into the restorative curriculum and has recently acquired the technology to make image guided implantology available to students, residents and faculty. This article describes the university's history and experience with simulation as a learning tool. The purpose of this article is to provide information to other educational institutions on the use of virtual reality simulation in the classroom.

  2. Computer-assisted virtual autopsy using surgical navigation techniques. (United States)

    Ebert, Lars Christian; Ruder, Thomas D; Martinez, Rosa Maria; Flach, Patricia M; Schweitzer, Wolf; Thali, Michael J; Ampanozi, Garyfalia


    OBJECTIVE; Virtual autopsy methods, such as postmortem CT and MRI, are increasingly being used in forensic medicine. Forensic investigators with little to no training in diagnostic radiology and medical laypeople such as state's attorneys often find it difficult to understand the anatomic orientation of axial postmortem CT images. We present a computer-assisted system that permits postmortem CT datasets to be quickly and intuitively resliced in real time at the body to narrow the gap between radiologic imaging and autopsy. Our system is a potentially valuable tool for planning autopsies, showing findings to medical laypeople, and teaching CT anatomy, thus further closing the gap between radiology and forensic pathology.

  3. TU-B-210-01: MRg HIFU - Bone and Soft Tissue Tumor Ablation

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    Ghanouni, P. [Stanford University (United States)


    MR guided focused ultrasound (MRgFUS), or alternatively high-intensity focused ultrasound (MRgHIFU), is approved for thermal ablative treatment of uterine fibroids and pain palliation in bone metastases. Ablation of malignant tumors is under active investigation in sites such as breast, prostate, brain, liver, kidney, pancreas, and soft tissue. Hyperthermia therapy with MRgFUS is also feasible, and may be used in conjunction with radiotherapy and for local targeted drug delivery. MRI allows in situ target definition and provides continuous temperature monitoring and subsequent thermal dose mapping during HIFU. Although MRgHIFU can be very precise, treatment of mobile organs is challenging and advanced techniques are required because of artifacts in MR temperature mapping, the need for intercostal firing, and need for gated HIFU or tracking of the lesion in real time. The first invited talk, “MR guided Focused Ultrasound Treatment of Tumors in Bone and Soft Tissue”, will summarize the treatment protocol and review results from treatment of bone tumors. In addition, efforts to extend this technology to treat both benign and malignant soft tissue tumors of the extremities will be presented. The second invited talk, “MRI guided High Intensity Focused Ultrasound – Advanced Approaches for Ablation and Hyperthermia”, will provide an overview of techniques that are in or near clinical trials for thermal ablation and hyperthermia, with an emphasis of applications in abdominal organs and breast, including methods for MRTI and tracking targets in moving organs. Learning Objectives: Learn background on devices and techniques for MR guided HIFU for cancer therapy Understand issues and current status of clinical MRg HIFU Understand strategies for compensating for organ movement during MRgHIFU Understand strategies for strategies for delivering hyperthermia with MRgHIFU CM - research collaboration with Philips.

  4. Bone morphogenetic protein modulator BMPER is highly expressed in malignant tumors and controls invasive cell behavior. (United States)

    Heinke, J; Kerber, M; Rahner, S; Mnich, L; Lassmann, S; Helbing, T; Werner, M; Patterson, C; Bode, C; Moser, M


    Bone morphogenetic proteins (BMPs) are growth factors that exert important functions in cell proliferation, migration and differentiation. Till date, multiple human tumors have been reported to display a dysregulation of several members of the BMP pathway that is associated with enhanced malignant tumor growth and metastasis. BMPER (BMP endothelial cell precursor-derived regulator) is a direct BMP modulator that is necessary for BMPs to exert their full-range signaling activity. Moreover, BMPER is expressed by endothelial cells and their progenitors, and has pro-angiogenic features in these cells. Here, we describe the expression of BMPER in human specimens of lung, colon and cervix carcinomas and cell lines derived from such carcinomas. In contrast to healthy tissues, BMPER is highly expressed upon malignant deterioration. Functionally, loss of BMPER in the lung tumor cell line A549 impairs proliferation, migration, invasion as well as tumor cell-induced endothelial cell sprout formation. In contrast, stimulation of A549 cells with exogenous BMPER had no further effect. We found that the BMPER effect may be transduced by regulation of the BMP target transcription factor inhibitor of DNA binding 1 (Id1) and matrix metalloproteinases (MMPs) 9 and 2. These facilitators of cell migration are downregulated when BMPER is absent. To prove the relevance of our in vitro results in vivo, we generated Lewis lung carcinoma cells with impaired BMPER expression and implanted them into the lungs of C57BL/6 mice. In this model, the absence of BMPER resulted in severely reduced tumor growth and tumor angiogenesis. Taken together, these data unequivocally demonstrate that the BMP modulator BMPER is highly expressed in malignant tumors and tumor growth is dependent on the presence of BMPER.

  5. Tumores ósseos benignos e lesões ósseas Pseudotumorais: tratamento atual e novas tendências Benign bone tumors and tumor-like bone lesions: treatment update and new trends

    Directory of Open Access Journals (Sweden)

    José Marcos Nogueira Drumond


    Full Text Available O tratamento dos tumores ósseos benignos (TOB e lesões ósseas pseudotumorais (LOP tem visto surgir novos medicamentos, como os bisfosfonatos de uso intravenoso, que têm mostrado bons resultados no controle das lesões da displasia fibrosa. O cisto ósseo aneurismático tem sido tratado com agentes esclerosantes com sucesso. Tratamentos adjuvantes permitem a realização de cirurgias que preservam a articulação e a função, com baixas taxas de recidiva. Têm sido mais utilizados o cimento ósseo (PMMA, o fenol, a crioterapia com nitrogênio líquido, a água oxigenada, o álcool etílico e a radioterapia. Entre os novos métodos de tratamento surgidos destaca-se a ablação térmica por radiofrequência e por laser, utilizada principalmente para tratamento do osteoma osteoide. A artroscopia permite a ressecção de lesões benignas intra-articulares e assiste na ressecção de tumores subcondrais. Um grande avanço foi a utilização de substitutos sintéticos do osso, que associam substâncias osteoindutivas com material osteocondutivo e têm apresentado resultados comparáveis aos do enxerto ósseo autógeno. Há uma tendência atual para tratamentos fechados, fazendo-se a injeção percutânea de matriz óssea desmineralizada (DBM associada com sulfato de cálcio. O enxerto ósseo esponjoso autógeno permanece como o padrão ouro. O enxerto de fíbula vascularizado apresenta os melhores resultados para incorporação em lesões maiores e agressivas. Também o suporte cortical alogênico provê resistência estrutural aumentada nessas lesões mais agressivas. O aloenxerto liofilizado tem indicação para preencher defeitos contidos e para reforço do enxerto autógeno. As endopróteses articulares são utilizadas em grandes lesões destrutivas no fêmur distal, no quadril e no ombro.The treatment of benign bone tumors (BBT and tumor-like bone lesions (TBL has observed the introduction of new drugs, such as intravenous bisphosphonates

  6. [Bone loss treatment, pseudoarthrosis, arthrodesis and benign tumors using xenoimplant: clinical study]. (United States)

    Cueva-Del Castillo, José Fernando; Valdés-Gutiérrez, Gustavo Adolfo; Elizondo-Vázquez, Francisco; Pérez-Ortiz, Omar; Piña Barba, María Cristina; León-Mancilla, Benjamín Herminio


    Bone loss as a result of arthrodesis, pseudarthrosis, benign tumors and bone defects was treated using a xenoimplant (Nukbone). The effectiveness of the material was evaluated through a longitudinal and observational study at the Hospital Regional "General Ignacio Zaragoza" (HRGIZ) ISSSTE. The Mexican xenoimplant is a patent of the National Autonomous University of Mexico (UNAM). Fifty two patients were considered regardless of age or gender. Of these patients, 28 were male and 24 female. Average age of the patients was 47.7 years (9-84 years). Twenty eight patients had arthrodesis, 16 were treated with pseudarthrosis, three patients had benign tumors and five patients presented bone defects, which were implanted with Nukbone at the site and was the correct treatment for the problem. The xenoimplant is fully integrated during a period of 3-18 months, depending on the size of the pathology and the region where it was placed. Fracture healing was evaluated radiographically according to the classification of Montoya. No patient had clinical signs of rejection. In Mexico, bony xenoimplants (osseous) have been used, all of foreign origin due to the high degree of technological dependence in this country. In this study we describe the use, for the first time, of a Mexican xenoimplant with a patent from the Universidad Nacional Autónoma de México (UNAM). The Mexican xenoimplant is biocompatible and can be adapted to treat pathologies where bony (osseous) material is needed.

  7. Imaging differentiation of pathologic fractures caused by primary and secondary bone tumors. (United States)

    Soldatos, Theodoros; Chalian, Majid; Attar, Samer; McCarthy, Edward F; Carrino, John A; Fayad, Laura M


    To describe pre-treatment imaging features of pathologic fractures caused by primary bone tumors (PBTs) and metastatic bone tumors (MBTs) and determine if radiographic or cross-sectional features can differentiate the underlying pathologies associated with the fractures. Sixty-nine patients with a diagnosis of a pathologic fracture were enrolled. Biopsy established PBT as the cause of the pathologic fracture in 16 (23%) cases and MBT in 53 (77%) cases. The radiographs, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans of the subjects were retrospectively reviewed for the presence of multiple imaging features. Compared to pathologic fractures caused by MBTs, the fractures caused by PBTs demonstrated a higher incidence of lytic bone cortex, mineralization and a soft-tissue mass on radiographs, mineralization and a soft-tissue mass on CT scans, and periosteal abnormality on MRI scans (Pfractures caused by PBT and MBT may be differentiated by a few specific radiographic and CT imaging features, though MRI was poor for characterization of the underlying lesion. Such knowledge may assist radiologists in raising the possibility of a PBT as the cause of a pathologic fracture. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. General purpose computer-assisted clustering and conceptualization (United States)

    Grimmer, Justin; King, Gary


    We develop a computer-assisted method for the discovery of insightful conceptualizations, in the form of clusterings (i.e., partitions) of input objects. Each of the numerous fully automated methods of cluster analysis proposed in statistics, computer science, and biology optimize a different objective function. Almost all are well defined, but how to determine before the fact which one, if any, will partition a given set of objects in an “insightful” or “useful” way for a given user is unknown and difficult, if not logically impossible. We develop a metric space of partitions from all existing cluster analysis methods applied to a given dataset (along with millions of other solutions we add based on combinations of existing clusterings) and enable a user to explore and interact with it and quickly reveal or prompt useful or insightful conceptualizations. In addition, although it is uncommon to do so in unsupervised learning problems, we offer and implement evaluation designs that make our computer-assisted approach vulnerable to being proven suboptimal in specific data types. We demonstrate that our approach facilitates more efficient and insightful discovery of useful information than expert human coders or many existing fully automated methods. PMID:21292983

  9. Computer-Assisted Concept Mapping: Visual Aids for Knowledge Construction. (United States)

    Mammen, Jennifer R


    Concept mapping is a visual representation of ideas that facilitates critical thinking and is applicable to many areas of nursing education. Computer-assisted concept maps are more flexible and less constrained than traditional paper methods, allowing for analysis and synthesis of complex topics and larger amounts of data. Ability to iteratively revise and collaboratively create computerized maps can contribute to enhanced interpersonal learning. However, there is limited awareness of free software that can support these types of applications. This educational brief examines affordances and limitations of computer-assisted concept maps and reviews free software for development of complex, collaborative malleable maps. Free software, such as VUE, XMind, MindMaple, and others, can substantially contribute to the utility of concept mapping for nursing education. Computerized concept-mapping is an important tool for nursing and is likely to hold greater benefit for students and faculty than traditional pen-and-paper methods alone. [J Nurs Educ. 2016;55(7):403-406.]. Copyright 2016, SLACK Incorporated.

  10. [Use of a xenoimplant for the treatment of bone defects, benign tumors, pseudoarthrosis and arthrodesis. Preliminary report]. (United States)

    Cueva del Castillo, J Fernando; Francisco Osuna, J; Elizondo, F; Pérez, O; Pérez, A; Hernández, Sergio; Mejía, Carlos


    To show that the ceramic produced at the Institute for Materials Research, National Autonomous University of Mexico, is an appropriate replacement of bone graft in patients with bone tumors, benign tumors, pseudoarthrosis and arthrodesis treated at "General Ignacio Zaragoza" Regional Hospital. An experimental, longitudinal study using bovine ceramic xenoimplants in patients covered by the Security and Social Services Institute for Civil Servants (ISSSTE), regardless of age and gender, all of whom consented to receiving the ceramic xenoimplant. Patients who did not consent or who discontinued treatment were excluded. A total of 24 patients were enrolled from March 1st to August 31st, 2006; two patients were withdrawn due to treatment discontinuation. They underwent X-ray evaluation of bone healing using the Montoya classification. The sample is composed of 14 male and 8 female patients, with a mean age of 46.6 years, and a standard deviation (s=) of 13.8. The most frequent indication was arthrodesis in 10 patients (45.45%), pseudoarthrosis in 6 (27.27%), benign tumors in 3 (13.63%), and bone defects in 3 (13.63%). Type II to type IV bone healing was observed in the sample. The use of ceramic xenoimplants is appropriate as a replacement of bone graft in patients with arthrodesis and bone defects, thus avoiding the need for autologous bone graft. This results in a decreased patient morbidity.

  11. Endonasal endoscopic excision of a rare tumor: nasal bone osteoid osteoma. (United States)

    Yazici, Haşmet; Soy, Fatih Kemal; Kulduk, Erkan; Dündar, Riza; Doğan, Sedat; Kaymakçi, Mustafa; Bülbül, Erdoğan


    Osteomas are slow-growing, benign tumors that frequently occur in paranasal areas; are detected by their symptoms, depending on their location and size, or incidentally on radiologic examination; and rarely arise from the nasal bone. We present an isolated nasal bone osteoma--which has not, to our knowledge, been reported previously--that was excised using an endoscopic endonasal approach via intercartilaginous incision and reconstructed with MEDPOR. A 21-year-old male patient attended the Mardin State Hospital ENT Clinic with the complaint of a slowly enlarging mass on the left side of the nose. The clinical, radiologic, and histologic findings pointed to a diagnosis of nasal bone osteoma. An endoscopic-assisted endonasal approach was performed, and defect was reconstructed with MEDPOR. At postoperative 6-month evaluation, no recurrence was observed, and the cosmetic result was satisfying in both external and intranasal views. In the removal of rare nasal bone osteomas, endoscopic endonasal surgery could be preferred over an external approach because of its favorable cosmetic results, comfort for the patient, and graft viability.

  12. Tumor Response After Stereotactic Body Radiation Therapy to Nonspine Bone Metastases: An Evaluation of Response Criteria

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, Rachel [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Probyn, Linda [Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Poon, Ian; Erler, Darby; Brotherston, Drew; Soliman, Hany; Cheung, Patrick; Chung, Hans; Chu, William; Loblaw, Andrew; Thavarajah, Nemica [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Lang, Catherine [Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Chin, Lee [Department of Physics, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Chow, Edward, E-mail: [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Sahgal, Arjun [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)


    Purpose: To evaluate the applicability of the Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and University of Texas MD Anderson (MDA) Cancer Center criteria in the setting of stereotactic body radiation therapy (SBRT) to nonspine bone metastases. Methods: Patients who were treated with SBRT to nonspine bone metastases were identified by retrospective chart review. An independent musculoskeletal radiologist evaluated response to treatment using computed tomography (CT) scans. Results: Thirty-three patients were treated to 42 nonspine bone metastases. The most common primary cancer cites were renal cell carcinoma (RCC) (33.3%), lung (24.2%), and prostate (18.2%). Bone metastases were either mainly lytic (57.1%), mainly sclerotic (28.6%), or mixed (14.3%). When lytic and sclerotic lesions were evaluated according to RECIST 1.1, local control (LC) was 83%, 85%, 88%, and 80% for those with CT imaging between months 1 to 3, 4 to 6, 7 to 9, and 10 to 12, respectively. When evaluated by the MDA criteria by density, LC within each time period was slightly greater. Overall LC decreased considerably when evaluated by MDA in terms of size. Conclusions: Consensus definitions of response are required as they have implications on clinical trials and disease management. Without consistent response criteria, outcomes from clinical trials cannot be compared and treatment efficacy remains undetermined.

  13. Application of a computer-assisted surgical navigation system in temporomandibular joint ankylosis surgery: a retrospective study. (United States)

    He, Y; Huang, T; Zhang, Y; An, J; He, L


    This retrospective study evaluated the effect of surgical computer-assisted navigation in temporomandibular joint (TMJ) ankylosis gap arthroplasty. Eighteen patients (25 sides) with bony ankylosis who underwent surgical treatment under computer-assisted navigation (navigation group) from May 2011 to April 2013 were assessed, along with 19 such patients (25 sides) treated without computer-assisted navigation (non-navigation group) from March 2009 to April 2011. The navigation group patients underwent surgery with the preservation of ≥3mm bone thickness in the skull base and anterior wall of the external auditory canal. Postoperatively, computed tomography (CT) was used to measure the residual bone thickness in the skull base and anterior wall of the external auditory canal. Maximum mouth opening (MMO) changes were evaluated at >1 year of follow-up. Postoperative CT measurements showed that the lowest skull base thickness in the navigation group was significantly lower than that in the non-navigation group (3.86±1.95mm vs. 6.01±3.07mm, P=0.009). The lowest thicknesses of the anterior wall of the external auditory canal were similar in the two groups. Postoperative follow-up showed similar average MMO in the two groups. Therefore, with the navigation system, TMJ ankylosis gap arthroplasty can achieve more extensive removal of the ankylosed bone, at least towards the skull base, under the premise of ensuring a safety distance of 3mm. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Giant cell tumor of the bone: aggressive case initially treated with denosumab and intralesional surgery

    Energy Technology Data Exchange (ETDEWEB)

    Von Borstel, Donald; Strle, Nicholas A. [Oklahoma State University Medical Center, Department of Radiology, Tulsa, OK (United States); Taguibao, Roberto A. [University of California, Irvine, UCI Medical Center, Department of Pathology, Orange, CA (United States); Burns, Joseph E. [University of California, Irvine, UCI Medical Center, Department of Radiological Sciences, Orange, CA (United States)


    Giant cell tumor of the bone (GCTB) is a locally aggressive benign tumor, which has historically been treated with wide surgical excision. We report a case of a 29-year-old male with histology-proven GCTB of the distal ulna. The initial imaging study was a contrast-enhanced magnetic resonance imaging (MRI) examination of the left wrist, which was from an outside facility performed before presenting to our institution. On the initial MRI, the lesion had homogenous T2-hyperintense and T1-hypointense signal with expansive remodeling of the osseous contour. A radiographic study performed upon presentation to our institution 1 month later showed progression of the lesion with atypical imaging characteristics. After confirming the diagnosis, denosumab therapy was implemented allowing for reconstitution of bone and intralesional treatment. The patient was treated with five doses of denosumab over the duration of 7 weeks. Therapeutic changes of the GCTB were evaluated by radiography and a post-treatment MRI. This MRI was interpreted as suspicious for worsening disease due to the imaging appearance of intralesional signal heterogeneity, increased perilesional fluid-like signal, and circumferential cortical irregularity. However, on subsequent intralesional curettage and bone autografting 6 weeks later, no giant cells were seen on the specimen. Thus, the appearance on the MRI, rather than representing a manifestation of lesion aggressiveness or a non-responding tumor, conversely represented the imaging appearance of a positive response to denosumab therapy. On follow-up evaluation, 5 months after intralesional treatment, the patient had recurrent disease and is now scheduled for wide-excision with joint prosthesis. (orig.)

  15. Maxillary arch rehabilitation using implant-supported computer-assisted design-computer-assisted manufacturing-milled titanium framework

    Directory of Open Access Journals (Sweden)

    Tulika S Khanna


    Full Text Available Esthetic and functional rehabilitation of completely edentulous maxillary arch with fixed implant supported prosthesis is a challenging task. Newer technologies such as computer assisted design computer assisted manufacturing (CAD CAM and cone beam conventional tomography play an important role in achieving predictable results. Full mouth porcelain fused to metal (PFM individual crowns on CAD CAM milled titanium framework provides positive esthetic and functional outcome. This is a case report of rehabilitation of partially edentulous maxillary arch patient. Staged rehabilitation of this patient was planned. In the first stage, root canal treatment of key abutment teeth was done, nonsalvageable teeth were removed, and immediate interim overdenture was provided. In the second stage, five Nobel Biocare dental implants were placed. After integration impressions were made, CAD CAM milled titanium bar was fabricated. Individual PFM crowns were made and cemented. This method gives better esthetic compared to acrylic fused to metal hybrid prosthesis with the advantage of retrievability just like screw retained prosthesis. Hence, this technique is good for rehabilitation of patients with high esthetic demands.

  16. Computer-assisted preoperative simulation for positioning of plate fixation in Lefort I osteotomy: A case report

    Directory of Open Access Journals (Sweden)

    Hideyuki Suenaga


    Full Text Available Computed tomography images are used for three-dimensional planning in orthognathic surgery. This facilitates the actual surgery by simulating the surgical scenario. We performed a computer-assisted virtual orthognathic surgical procedure using optically scanned three-dimensional (3D data and real computed tomography data on a personal computer. It helped maxillary bone movement and positioning and the titanium plate temporary fixation and positioning. This simulated the surgical procedure, which made the procedure easy, and we could perform precise actual surgery and could forecast the postsurgery outcome. This simulation method promises great potential in orthognathic surgery to help surgeons plan and perform operative procedures more precisely.

  17. Late bone metastasis from an apparently benign oncocytic follicular thyroid tumor (United States)

    Boronat, Mauro; Cabrera, Juan J; Perera, Carmen; Isla, Concepción; Nóvoa, Francisco J


    A man underwent total thyroidectomy for goiter when he was 62 years old. The pathology report informed on a 5.5 cm oncocytic follicular adenoma and a 3.5 mm papillary microcarcinoma. Due to the papillary tumor, he was treated with ablative radioiodine therapy and suppressive doses of levothyroxine. After uneventful follow-up for 9 years, increased levels of serum thyroglobulin were detected. Further imaging studies including a whole body scan (WBS) after an empirical dose of 200 mCi 131I were negative. Two years later, a 99mTc SestaMIBI WBS and a 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography showed a well-delimited focal uptake in the right femur. A bone biopsy of the lesion demonstrated metastasis of follicular thyroid carcinoma. Retrospective histological reexamination of available material from the primary oncocytic thyroid tumor failed to reveal definitive traits of malignancy. Learning points Oncocytic follicular thyroid tumors are a relatively uncommon variant of follicular thyroid neoplasms mostly composed of distinctive large oxyphilic cells (Hürthle cells).Criteria for the distinction between benign and malignant oncocytic neoplasms are not different from those used in the diagnosis of ordinary follicular tumors.Some cases of apparently benign oncocytic neoplasms have been found to develop malignant behavior.Search to rule out vascular and capsular invasion should be particularly exhaustive in histological assessment of oncocytic thyroid tumors.Even so, long-term surveillance remains appropriate for patients with large apparently benign oncocytic tumors. PMID:24616777

  18. Effects of computer-assisted oral anticoagulant therapy

    DEFF Research Database (Denmark)

    Rasmussen, Rune Skovgaard; Corell, Pernille; Madsen, Poul


    the therapeutic target range compared to traditional oral anticoagulant therapy by physicians. METHODS: 54 patients were randomized equally into 3 groups. Patients in two groups used CoaguChek® systems to measure international normalized ratio (INR) values and had dosages of anticoagulation treatment calculated...... in a computer system by an algorithm specific to each group. The third group received traditional anticoagulation treatment by physicians. The obtained INR values were compared regarding the time to reach, and the time spent within, the therapeutic target range, corresponding to INR values from 2 to 3. RESULTS......: Patients randomized to computer-assisted anticoagulation and the CoaguChek® system reached the therapeutic target range after 8 days compared to 14 days by prescriptions from physicians (p = 0.04). Time spent in the therapeutic target range did not differ between groups. The median INR value measured...

  19. Computer-assisted Orthopaedic Surgery: Current State and Future Perspective

    Directory of Open Access Journals (Sweden)

    Guoyan eZheng


    Full Text Available Introduced about two decades ago, computer-assisted orthopaedic surgery (CAOS has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopaedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined.

  20. The Potential of Computer-Assisted Direct Observation Apps

    Directory of Open Access Journals (Sweden)

    Daniel Wessel


    Full Text Available Direct behavior observation, i.e., without first creating a video recording, is a challenging, one-shot task. The behavior has to be coded accurately during the situation itself. Mobile devices can assist direct observation, and there already are applications available for these purposes. However, the mobile revolution has led to new developments in devices, infrastructure, and market penetration that have opened up new, yet untapped, possibilities. In this article, expanded activity theory is used to highlight the unused potential of computer assisted direct observation (CADO apps. If this potential is realized, it can provide observation with the same advantages online questionnaires and sites like Mechanical Turk have provided for surveys and Internet experiments.

  1. Implementation of computer assisted assessment: lessons from the literature

    Directory of Open Access Journals (Sweden)

    Gavin Sim


    Full Text Available This paper draws attention to literature surrounding the subject of computer-assisted assessment (CAA. A brief overview of traditional methods of assessment is presented, highlighting areas of concern in existing techniques. CAA is then defined, and instances of its introduction in various educational spheres are identified, with the main focus of the paper concerning the implementation of CAA. Through referenced articles, evidence is offered to inform practitioners, and direct further research into CAA from a technological and pedagogical perspective. This includes issues relating to interoperability of questions, security, test construction and testing higher cognitive skills. The paper concludes by suggesting that an institutional strategy for CAA coupled with staff development in test construction for a CAA environment can increase the chances of successful implementation.

  2. Translation Memory and Computer Assisted Translation Tool for Medieval Texts

    Directory of Open Access Journals (Sweden)

    Törcsvári Attila


    Full Text Available Translation memories (TMs, as part of Computer Assisted Translation (CAT tools, support translators reusing portions of formerly translated text. Fencing books are good candidates for using TMs due to the high number of repeated terms. Medieval texts suffer a number of drawbacks that make hard even “simple” rewording to the modern version of the same language. The analyzed difficulties are: lack of systematic spelling, unusual word orders and typos in the original. A hypothesis is made and verified that even simple modernization increases legibility and it is feasible, also it is worthwhile to apply translation memories due to the numerous and even extremely long repeated terms. Therefore, methods and algorithms are presented 1. for automated transcription of medieval texts (when a limited training set is available, and 2. collection of repeated patterns. The efficiency of the algorithms is analyzed for recall and precision.

  3. Computer-Assisted Orthopedic Surgery: Current State and Future Perspective. (United States)

    Zheng, Guoyan; Nolte, Lutz P


    Introduced about two decades ago, computer-assisted orthopedic surgery (CAOS) has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined.

  4. Bayesian pretest probability estimation for primary malignant bone tumors based on the Surveillance, Epidemiology and End Results Program (SEER) database. (United States)

    Benndorf, Matthias; Neubauer, Jakob; Langer, Mathias; Kotter, Elmar


    In the diagnostic process of primary bone tumors, patient age, tumor localization and to a lesser extent sex affect the differential diagnosis. We therefore aim to develop a pretest probability calculator for primary malignant bone tumors based on population data taking these variables into account. We access the SEER (Surveillance, Epidemiology and End Results Program of the National Cancer Institute, 2015 release) database and analyze data of all primary malignant bone tumors diagnosed between 1973 and 2012. We record age at diagnosis, tumor localization according to the International Classification of Diseases (ICD-O-3) and sex. We take relative probability of the single tumor entity as a surrogate parameter for unadjusted pretest probability. We build a probabilistic (naïve Bayes) classifier to calculate pretest probabilities adjusted for age, tumor localization and sex. We analyze data from 12,931 patients (647 chondroblastic osteosarcomas, 3659 chondrosarcomas, 1080 chordomas, 185 dedifferentiated chondrosarcomas, 2006 Ewing's sarcomas, 281 fibroblastic osteosarcomas, 129 fibrosarcomas, 291 fibrous malignant histiocytomas, 289 malignant giant cell tumors, 238 myxoid chondrosarcomas, 3730 osteosarcomas, 252 parosteal osteosarcomas, 144 telangiectatic osteosarcomas). We make our probability calculator accessible at . We provide exhaustive tables for age and localization data. Results from tenfold cross-validation show that in 79.8 % of cases the pretest probability is correctly raised. Our approach employs population data to calculate relative pretest probabilities for primary malignant bone tumors. The calculator is not diagnostic in nature. However, resulting probabilities might serve as an initial evaluation of probabilities of tumors on the differential diagnosis list.

  5. Sports activities and endurance capacity of bone tumor patients after rotationplasty. (United States)

    Hillmann, Axel; Weist, Roger; Fromme, Albert; Völker, Klaus; Rosenbaum, Dieter


    To investigate the preferred types of sports activities of patients with rotationplasty and to measure their physiologic performance characteristics through treadmill ergometry. Cross-sectional, descriptive analysis and repeated measures of different velocities. Biomechanics research laboratory. Patients (n=61) with rotationplasty after bone tumor surgery, 30 of whom participated in a functional trial (treadmill), and a control group (n=20). Not applicable. Patients' participation in sports compared with that of the healthy population, treadmill performance at 2 or 3 different speeds, heart rate, lactate accumulation, oxygen consumption, ventilatory equivalent, efficiency, respiratory minute volume, and respiratory quotient. High activity in sports participation (85%) in most common sports (8 competitive, 17 sports club members, the remaining subjects were recreational athletes). At the same treadmill speed, lactate accumulation and all cardiorespiratory functions were higher in rotationplasty patients than in the control group. Patients can re-engage in a high level of physical activity after rotationplasty for bone tumor treatment. This physical activity is necessary if patients want to maintain or improve a desired level of sports activity.

  6. Computer-Assisted Designed and Manufactured Procedures Facilitate the Lingual Application of Mandible Reconstruction Plates. (United States)

    Probst, Florian Andreas; Metzger, Marc; Ehrenfeld, Michael; Cornelius, Carl-Peter


    Lingual positioning of mandible reconstruction plates can prevent typical complications such as plate exposure and orocutaneous fistulas. The aim of this study was to evaluate the feasibility and clinical outcomes of lingually applied patient-specific reconstruction plates. A retrospective cohort study of patients managed with reconstruction plates positioned at the lingual side of the mandible was performed. The following outcome variables were analyzed: feasibility and handling of the lingual application, fitting accuracy, and postoperative complications. The study sample included 8 patients (4 women, 4 men) with a mean age of 68.8 years (range, 43 to 79 yr). The indications for plate use were defect-like zones owing to multiple fractures in the atrophic mandible (n = 2) and segmental defects attributed to squamous cell carcinoma, osteomyelitis, and bisphosphonate-related osteonecrosis (n = 6). Off-the-shelf reconstruction plates, which were intraoperatively bent (n = 2) or pre-bent to a stereolithographic model (n = 1), or fully computer-assisted designed and computer-assisted manufactured (CAD/CAM) patient-specific reconstruction plates (n = 5) were used. Lingual application of reconstruction plates was feasible in all cases and considerably facilitated by the CAD/CAM plates. The fitting accuracy was high. Within an average follow-up period of 15.3 months, no loosening of plates or screws, plate fracture, or orocutaneous fistula occurred and no dysphagia was observed with the exception of 1 case, in which plate exposure was due to extreme soft tissue thinning and tumor recurrence. Lingual application of CAD/CAM patient-specific reconstruction plates is technically feasible with high accuracy. It has great potential for low complication rates, especially in unfavorable soft tissue conditions. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Advantages of Pressurized-Spray Cryosurgery in Giant Cell Tumors of the Bone

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    Nevzat Dabak


    Full Text Available Background: Giant Cell Tumor is considered a benign, local and aggressive tumor. Although considered a benign bone tumor, it is still the subject of discussion and research because of the associated local bone destruction, as well as high rates of recurrence and distant metastases. Options are being developed for both surgical techniques and adjuvant therapies. Aims: The present study evaluated the administration of cryotherapy via a pressurized-spray technique in giant cell tumors of the bone. Study Design: Cross-sectional study. Methods: The study included 40 patients who were treated with extensive curettage and cryotherapy at various locations during the period from February 2006 to December 2013. Informed consent forms were obtained from the participants and ethics committee approval was taken from the local ethics committee of Ondokuz Mayıs University. The pressurized-spray technique was performed using liquid nitrogen. The patients were evaluated with respect to age, gender, radiological appearance, treatment modality, duration of follow-up, skin problems and recurrence. Results: Twenty-one patients were female; 19 were male. The average age of the patients was 33 years (range: 16–72 years, and the average duration of follow-up was 43 months (range: 12–80 months. The average time from the onset of the complaints to the diagnosis was 6 months (range: 2–12 months. Based on the Campanacci classification: 9 patients were Grade I; 25 patients were Grade II; six patients were Grade III. The lesion was located in the femur in 14 patients, in the tibia in 11 patients, in the radius in 5 patients, in the pelvis in 4 patients, in the fibula in 3 patients, in the metatarsal in 2 patients and in the phalanges of the hand in one patient. One patient had postoperative early fracture. None of the patients had skin problems and infection. Three (7.5% of the patients had recurrence. Conclusion: It was found that cryotherapy was highly effective in

  8. Tumorer

    DEFF Research Database (Denmark)

    Prause, J.U.; Heegaard, S.


    oftalmologi, øjenlågstumorer, conjunctivale tumorer, malignt melanom, retinoblastom, orbitale tumorer......oftalmologi, øjenlågstumorer, conjunctivale tumorer, malignt melanom, retinoblastom, orbitale tumorer...

  9. Combined Zoledronic Acid and Meloxicam Reduced Bone Loss and Tumor Growth in an Orthotopic Mouse Model of Bone-Invasive Oral Squamous Cell Carcinoma (United States)

    Martin, C.K.; Dirksen, W.P.; Carlton, M.M.; Lanigan, L.G.; Pillai, S.P.; Werbeck, J.L.; Simmons, J.K.; Hildreth, B.E.; London, C.A.; Toribio, R.E.; Rosol, T.J.


    Oral squamous cell carcinoma is common in cats and humans and invades oral bone. We hypothesized that the cyclooxygenase-2 inhibitor, meloxicam, with the bisphosphonate, zoledronic acid (ZOL), would inhibit tumor growth, osteolysis and invasion in feline oral squamous cell carcinoma (OSCC) xenografts in mice. Human and feline OSCC cell lines expressed cyclooxygenase (COX)-1 and 2 and the SCCF2 cells had increased COX-2 mRNA expression with bone conditioned medium. Luciferase-expressing feline SCCF2Luc cells were injected beneath the perimaxillary gingiva and mice were treated with 0.1 mg/kg ZOL twice weekly, 0.3 mg/kg meloxicam daily, combined ZOL and meloxicam, or vehicle. ZOL inhibited osteoclastic bone resorption at the tumor-bone interface. Meloxicam was more effective than ZOL at reducing xenograft growth but did not affect osteoclastic bone resorption. Although a synergistic effect of combined ZOL and meloxicam was not observed, combination therapy was well tolerated and may be useful in the clinical management of bone-invasive feline OSCC. PMID:23651067

  10. Coverage planning in computer-assisted ablation based on Genetic Algorithm. (United States)

    Ren, Hongliang; Guo, Weian; Sam Ge, Shuzhi; Lim, Wancheng


    An ablation planning system plays a pivotal role in tumor ablation procedures, as it provides a dry run to guide the surgeons in a complicated anatomical environment. Over-ablation, over-perforation or under-ablation may result in complications during the treatments. An optimal solution is desired to have complete tumor coverage with minimal invasiveness, including minimal number of ablations and minimal number of perforation trajectories. As the planning of tumor ablation is a multi-objective problem, it is challenging to obtain optimal covering solutions based on clinician׳s experiences. Meanwhile, it is effective for computer-assisted systems to decide a set of optimal plans. This paper proposes a novel approach of integrating a computational optimization algorithm into the ablation planning system. The proposed ablation planning system is designed based on the following objectives: to achieve complete tumor coverage and to minimize the number of ablations, number of needle trajectories and over-ablation to the healthy tissue. These objectives are taken into account using a Genetic Algorithm, which is capable of generating feasible solutions within a constrained search space. The candidate ablation plans can be encoded in generations of chromosomes, which subsequently evolve based on a fitness function. In this paper, an exponential weight-criterion fitness function has been designed by incorporating constraint parameters that were reflective of the different objectives. According to the test results, the proposed planner is able to generate the set of optimal solutions for tumor ablation problem, thereby fulfilling the aforementioned multiple objectives. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Do Malignant Bone Tumors of the Foot Have a Different Biological Behavior than Sarcomas at Other Skeletal Sites?

    Directory of Open Access Journals (Sweden)

    M. Brotzmann


    Full Text Available We analyze the delay in diagnosis and tumor size of malignant bone tumors of the foot in a retrospective study. We compared the oncological and surgical long-term results with identical tumor at other anatomical sites in order to analyze the biological behavior of sarcomas that are found in the foot. Thirty-two patients with a histologically proven malignant bone tumor (fifteen chondrosarcomas, nine osteosarcomas, and eight Ewing sarcomas between the years 1969 and 2008 were included. The median follow-up was 11.9 years. The overall median time gap between the beginning of symptoms and diagnosis in the study group was 10 months. Ewing sarcoma presented with the longest delay in diagnosis (median of 18 months, followed by osteosarcoma (median of 15 months and chondrosarcoma (median of 7.5 months. The delay in diagnosis of these tumors was significantly longer than that of equivalent tumors at other skeletal sites, but the 5- and 10-year survival rates and the occurrence of distant metastases were comparable. In contrast, the average size of foot tumors was 5- to 30-fold less than that of tumors analyzed at other skeletal sites. This study indicates that sarcomas of the foot demonstrate a distinct biological behavior compared to the same tumor types at other skeletal sites.

  12. Surgical treatment of malignant and aggressive bone tumors around the knee by segmental resection and rotationplasty. (United States)

    Hahn, Soo Bong; Park, Hong Jun; Kim, Hyoung Sik; Kim, Sung Hun; Shin, Kyoo Ho


    In patients having malignant or aggressive bone tumors around the knee joint and requiring amputation, segmental resection and rotationplasty was performed and the clinical results were analyzed. Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994. The mean follow-up period was 57 (6 - 120) months and the average age of patients was 21.4 (5 - 37) years. Out of 26 patients, there were 18 osteosarcomas (>/= stage IIB), 2 synovial sarcomas, and 6 giant cell tumors. Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and the remaining twenty-two patients were included for assessment. Eighteen patients had excellent results, 3 good, and 1 fair. Range of motion of the ankle joint was -11 (dorsiflexion) - 80 (plantarflexion) degrees and daily walking activity was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications include 3 thromboses and 1 sepsis, and late complications were 6 nonunion, 2 malrotation and 1 stiffness of the ankle joint. Rotationplasty, which is functionally excellent, may serve as an effective partial limb salvage procedure, especially in patients younger than 10 years old who are expected to have leg length discrepancy or loosening of the tumor prosthesis due to the growth of the medullary cavity or when amputation is inevitable for a wide resection margin.

  13. Giant Cell Tumor of Bone: Documented Progression over 4 Years from Its Origin at the Metaphysis to the Articular Surface

    Directory of Open Access Journals (Sweden)

    Colin Burke


    Full Text Available The exact location of origin for giant cell tumors of bone (GCTB remains controversial, as lesions are not routinely imaged early but rather late when the tumor is large and clinically symptomatic. At the time of diagnosis, GCTB are classically described as lucent, eccentric lesions with nonsclerotic margins, located within the epiphysis to a greater extent than the metaphysis. Here we present a case of a biopsy proven GCTB initially incidentally seen on MRI as a small strictly metaphyseal lesion, which over the course of several years expanded across a closed physis to involve the epiphysis and abut the articular surface/subchondral bone plate.

  14. Osteoblastomatosis of bone. A benign, multifocal osteoblastic lesion, distinct from osteoid osteoma and osteoblastoma, radiologically simulating a vascular tumor

    Energy Technology Data Exchange (ETDEWEB)

    Kyriakos, Michael [Washington University School of Medicine, Division of Surgical Pathology, Campus Box 8118, St. Louis, MO (United States); El-Khoury, Georges Y. [University of Iowa, Department of Radiology, Roy J. and Lucille A. Carver School of Medicine, Iowa City, IA (United States); McDonald, Douglas J. [Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, MO (United States); Buckwalter, Joseph A. [University of Iowa, Department of Orthopaedics, Roy J. and Lucille A. Carver School of Medicine, Iowa City, IA (United States); Sundaram, Murali [Cleveland Clinic Foundation, Department of Radiology, Cleveland, OH (United States); DeYoung, Barry [University of Iowa, Department of Pathology, School of Medicine, Iowa City, IA (United States); O' Brien, Michael P. [University of Wisconsin Hospital, Department of Radiology, Madison, WI (United States)


    Two adult patients are described with multifocal osteolytic lesions radiologically simulating a vascular tumor. One patient had multiple bones involved. Histologically, the individual lesions had the features of the nidus of osteoid osteoma/osteoblastoma. A review of the English language medical literature yielded only one other reported case with similar features. The process is designated as osteoblastomatosis to indicate its bone-forming character, prominent osteoblast proliferation, and multiplicity. The cases are distinguished from multifocal/multicentric osteoid osteoma and osteoblastoma, and from benign and malignant vascular tumors. (orig.)

  15. Breed-specific incidence rates of canine primary bone tumors — A population based survey of dogs in Norway (United States)

    Anfinsen, Kristin P.; Grotmol, Tom; Bruland, Oyvind S.; Jonasdottir, Thora J.


    This is one of few published population-based studies describing breed specific rates of canine primary bone tumors. Incidence rates related to dog breeds could help clarify the impact of etiological factors such as birth weight, growth rate, and adult body weight/height on development of these tumors. The study population consisted of dogs within 4 large/giant breeds; Irish wolfhound (IW), Leonberger (LB), Newfoundland (NF), and Labrador retriever (LR), born between January 1st 1989 and December 31st 1998. Questionnaires distributed to owners of randomly selected dogs — fulfilling the criteria of breed, year of birth, and registration in the Norwegian Kennel Club — constituted the basis for this retrospective, population-based survey. Of the 3748 questionnaires received by owners, 1915 were completed, giving a response rate of 51%. Forty-three dogs had been diagnosed with primary bone tumors, based upon clinical examination and x-rays. The breeds IW and LB, with 126 and 72 cases per 10 000 dog years at risk (DYAR), respectively, had significantly higher incidence rates of primary bone tumors than NF and LR (P dogs, like NF and LB, observed in this study. Defining these breed-specific incidence rates enables subsequent case control studies, ultimately aiming to identify specific etiological factors for developing primary bone tumors. PMID:22210997

  16. Percutaneous CT-Guided Cryoablation as an Alternative Treatment for an Extensive Pelvic Bone Giant Cell Tumor

    Energy Technology Data Exchange (ETDEWEB)

    Panizza, Pedro Sergio Brito; Albuquerque Cavalcanti, Conrado Furtado de [Sírio Libânes Hospital, Radiology and Imaged Guided Intervention Service (Brazil); Yamaguchi, Nise Hitomi [Instituto Avanços em Medicina (Brazil); Leite, Claudia Costa; Cerri, Giovanni Guido; Menezes, Marcos Roberto de, E-mail: [Sírio Libânes Hospital, Radiology and Imaged Guided Intervention Service (Brazil)


    A giant cell tumor (GCT) is an intermediate grade, locally aggressive neoplasia. Despite advances in surgical and clinical treatments, cases located on the spine and pelvic bones remain a significant challenge. Failure of clinical treatment with denosumab and patient refusal of surgical procedures (hemipelvectomy) led to the use of cryoablation. We report the use of percutaneous CT-guided cryoablation as an alternative treatment, shown to be a minimally invasive, safe, and effective option for a GCT with extensive involvement of the pelvic bones and allowed structural and functional preservation of the involved bones.

  17. Contaminação tumoral em trajeto de biópsia de tumores ósseos malignos primários Tumor contamination in the biopsy path of primary malignant bone tumors

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    Marcelo Parente Oliveira


    Full Text Available OBJETIVO: Estudar os fatores possivelmente associados à contaminação tumoral do trajeto de biópsia de tumores ósseos malignos primários. MÉTODO: Foram estudados, retrospectivamente, 35 pacientes submetidos a tratamento cirúrgico com diagnóstico de osteossarcoma, tumor de Ewing e condrossarcoma. A amostra foi analisada para caracterização quanto à técnica de biópsia empregada, tipo histológico do tumor, realização de quimioterapia neoadjuvante, ocorrência de recidiva local e contaminação tumoral no trajeto da biópsia. RESULTADOS: Nos 35 pacientes avaliados ocorreram quatro contaminações (11,43%. Um caso era de osteossarcoma, dois casos de tumor de Ewing e um caso de condrossarcoma, não se observando associação entre o tipo de tumor e a presença de contaminação tumoral no trajeto da biópsia (p = 0,65. Também não se observou associação entre a presença de contaminação tumoral e a técnica de biópsia (p = 0,06. Por outro lado, observou-se associação entre a presença de contaminação tumoral e a ocorrência de recidiva local (p = 0,01 e entre a presença de contaminação e a não realização de quimioterapia neoadjuvante (p = 0,02. CONCLUSÃO: A contaminação tumoral no trajeto de biópsia de tumores ósseos malignos primários esteve associada à ocorrência de recidiva local. Por outro lado, não mostrou ser influenciada pelo tipo de biópsia realizada e pelo tipo histológico de tumor estudado. A quimioterapia neoadjuvante mostrou um efeito protetor contra esta complicação. A despeito desses achados, a contaminação tumoral é uma complicação que deve sempre ser considerada, sendo recomendada a remoção do trajeto da biópsia na cirurgia de ressecção do tumor.OBJECTIVE: To study factors possibly associated with tumor contamination in the biopsy path of primary malignant bone tumors. METHOD: Thirty-five patients who underwent surgical treatment with diagnoses of osteosarcoma, Ewing's tumor and

  18. {sup 18}F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    London, Kevin [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, NSW (Australia); Stege, Claudia; Kaspers, Gertjan [VU Medical Centre, Divisions of Paediatric Oncology/Haematology, Amsterdam (Netherlands); Cross, Siobhan; Dalla-Pozza, Luciano [The Children' s Hospital at Westmead, Department of Oncology, Sydney (Australia); Onikul, Ella [The Children' s Hospital at Westmead, Department of Medical Imaging, Sydney (Australia); Graf, Nicole [The Children' s Hospital at Westmead, Department of Pathology, Sydney (Australia); Howman-Giles, Robert [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Imaging, Sydney Medical School, Sydney, NSW (Australia)


    F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children. To compare hybrid FDG positron emission tomography/computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors. Retrospective analysis of PET/CT and CI reports with histopathology or follow-up > 6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology. A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUV{sub max} and greater SUV{sub max} reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement. PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy. (orig.)

  19. Testosterone Replacement and Bone Mineral Density in Male Pituitary Tumor Patients

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    Min Jeong Lee


    Full Text Available BackgroundHypopituitarism is associated with osteoporosis and osteopenia especially when hypogonadotropic hypogonadism is present. Despite hypopituitarism being an important cause of secondary osteoporosis, osteoporosis in patients receiving surgery for pituitary tumors in Korea has not been studied. In this study, we evaluated the effects of testosterone replacement therapy (TRT on bone mineral density (BMD in postoperative hypogonadal patients with pituitary tumors.MethodsTo examine the effect of TRT on BMD, we performed a retrospective observational study in 21 postoperative male patients who underwent pituitary tumor surgery between 2003 and 2012 at the Ajou University Hospital. Testosterone was replaced in postoperative hypogonadal patients by regular intramuscular injection, daily oral medication, or application of transdermal gel. BMD (g/cm2 measurements of central skeletal sites (lumbar spine, femoral neck, and total femur were obtained using dual-energy X-ray absorptiometry (GE Lunar. For lumbar spine BMD, L1 to L4 values were chosen for analysis. Femur neck and total femur were also analyzed.ResultsDuring the follow-up period (mean, 56 months; range, 12 to 99 months serum testosterone levels increased with the administration of TRT (P=0.007. There was significant improvement (4.56%±9.81% in the lumbar spine BMD compared to baseline BMD. There were no significant changes in the femur neck BMD or total femur BMD. We did not find any statistically significant relationships between changes in testosterone levels and BMD using Spearman correlation analysis.ConclusionOur results indicated that TRT used in the postoperative period for hypogonadal pituitary tumor surgery patients may have beneficial effects on the BMD of the spine.

  20. Computer-assisted dieting: effects of a randomised controlled intervention. (United States)

    Schroder, Kerstin E E


    In this pilot study, the effects of two computer-assisted dieting (CAD) interventions on weight loss and blood chemistry were examined among overweight and obese adults. Participants (91 community members, average age 42.6 years) were randomly assigned to CAD-only (a single-session introduction and provision of a dieting software, n = 30), CAD plus an additional four-session self-management group training (CAD+G, n = 31) and a waitlist control group whose members were randomised into the two interventions at the 3-month follow-up (n = 30). A three (group)-by-two (time) repeated measures ANOVA revealed no significant group by time interaction during the initial 3-month period. However, the two intervention groups combined showed a significant, though moderate weight loss relative to the control group. Further, although a general improvement was found with regard to the lipid panel results during the first 3 months of the trial, the treatment by time interaction was not significant. A comparison of the developments in the two intervention groups during the 3- to 6-month follow-up time period revealed a tendency towards greater weight regain in the CAD-only condition. The evidence suggests that CAD supports initial weight loss; however, additional self-management training might be necessary to support maintenance.

  1. Computer-assisted ultrasonic tissue characterization of the heart (United States)

    Berger, Reinhard; Lieback, Evelin; Hetzer, Roland


    In ultrasonic tissue characterization the small reflections originating from the scattering structures inside the tissue are analyzed. To obtain diagnostic performance for tissue characterization by means of analysis of echocardiographic images we use methods of mathematical texture analysis. We investigate whether myocardial changes effect the texture of ultrasonic images and if this could be described using quantitative texture analysis. The texture analysis was computed in a single window of an ultrasound image/sequence covering the inner myocardial septum. Parameters from gray level histogram, co-occurrence matrices, run length statistics and run difference, from power spectrum and fractal dimensions were investigated to provide satisfying and generalizable results for classification of the myocardium. A set of parameters that could discriminate between normal and pathological myocardium were extracted. The results of 142 biopsies were compared with those of texture analysis in echocardiograms of 106 patients suspected having myocarditis. Using the reduced set of parameters the best sensitivity was 89.0% and the specificity was 83.6%. Myocarditis is associated with echocardiographic texture alteration. Texture analysis with methods of digital image processing can reliably identify myocarditis. A suitable solution for a computer-assisted non- invasive support for the diagnosis and detection of myocarditis was found.

  2. Implementation of Computer Assisted Test Selection System in Local Governments

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    Abdul Azis Basri


    Full Text Available As an evaluative way of selection of civil servant system in all government areas, Computer Assisted Test selection system was started to apply in 2013. In phase of implementation for first time in all areas in 2014, this system selection had trouble in several areas, such as registration procedure and passing grade. The main objective of this essay was to describe implementation of new selection system for civil servants in the local governments and to seek level of effectiveness of this selection system. This essay used combination of study literature and field survey which data collection was made by interviews, observations, and documentations from various sources, and to analyze the collected data, this essay used reduction, display data and verification for made the conclusion. The result of this essay showed, despite there a few parts that be problem of this system such as in the registration phase but almost all phases of implementation of CAT selection system in local government areas can be said was working clearly likes in preparation, implementation and result processing phase. And also this system was fulfilled two of three criterias of effectiveness for selection system, they were accuracy and trusty. Therefore, this selection system can be said as an effective way to select new civil servant. As suggestion, local governments have to make prime preparation in all phases of test and make a good feedback as evaluation mechanism and together with central government to seek, fix and improve infrastructures as supporting tool and competency of local residents.

  3. Analisis cualitativo asistido por computadora Computer-assisted qualitative analysis

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    César A. Cisneros Puebla


    Full Text Available Los objetivos de este ensayo son: por un lado, presentar una aproximación a la experiencia hispanoamericana en el Análisis Cualitativo Asistido por Computadora (ACAC al agrupar mediante un ejercicio de sistematización los trabajos realizados por diversos colegas provenientes de disciplinas afines. Aunque hubiese querido ser exhaustivo y minucioso, como cualquier intento de sistematización de experiencias, en este ejercicio son notables las ausencias y las omisiones. Introducir algunas reflexiones teóricas en torno al papel del ACAC en el desarrollo de la investigación cualitativa a partir de esa sistematización y con particular énfasis en la producción del dato es, por otro lado, objetivo central de esta primera aproximación.The aims of this article are: on the one hand, to present an approximation to the Hispano-American experience on Computer-Assisted Qualitative Data Analysis (CAQDAS, grouping as a systematization exercise the works carried out by several colleagues from related disciplines. Although attempting to be exhaustive and thorough - as in any attempt at systematizing experiences - this exercise presents clear lacks and omissions. On the other hand, to introduce some theoretical reflections about the role played by CAQDAS in the development of qualitative investigation after that systematization, with a specific focus on data generation.

  4. Is Computer-assisted Distance Learning Possible in Nematology? (United States)

    Francl, L J


    In many institutions of higher education, introductory nematology is taught to small numbers of students. Nematology and other low-enrollment courses may be placed under scrutiny, reformatted, or dropped from the curriculum to cut costs and improve faculty efficiency. Computer-assisted distance education (CADE) offers a way to increase faculty productivity and job satisfaction, student learning and socialization, and cost-effectiveness. Participating institutions gain by sharing resources with other schools and may retain or even increase enrollments through broadened educational opportunities. CADE ranges from complete course offerings and video interaction to supplemental materials on a personal computer for independent learning. A modular approach to course development is the most successfuI model because of the flexibility it offers. While an entire hematology course through CADE is not possible without substantial institutional and faculty investment, supplemental materials can help remotely located students gain an appreciation for hematology. Nematological images, text, computer programs, and other resources can easily be placed on Internet web pages. Nematologists in all sectors need to continue to reach out to the next generation of leaders to tell them what nematologists do and why nematodes are important. The Society of Nematologists can be a leader in the systematic development of CADE in nematology.

  5. Computer-Assisted Inverse Design of Inorganic Electrides

    Directory of Open Access Journals (Sweden)

    Yunwei Zhang


    Full Text Available Electrides are intrinsic electron-rich materials enabling applications as excellent electron emitters, superior catalysts, and strong reducing agents. There are a number of organic electrides; however, their instability at room temperature and sensitivity to moisture are bottlenecks for their practical uses. Known inorganic electrides are rare, but they appear to have greater thermal stability at ambient conditions and are thus better characterized for application. Here, we develop a computer-assisted inverse-design method for searching for a large variety of inorganic electrides unbiased by any known electride structures. It uses the intrinsic property of interstitial electron localization of electrides as the global variable function for swarm intelligence structure searches. We construct two rules of thumb on the design of inorganic electrides pointing to electron-rich ionic systems and low electronegativity of the cationic elements involved. By screening 99 such binary compounds through large-scale computer simulations, we identify 24 stable and 65 metastable new inorganic electrides that show distinct three-, two-, and zero-dimensional conductive properties, among which 18 are existing compounds that have not been pointed to as electrides. Our work reveals the rich abundance of inorganic electrides by providing 33 hitherto unexpected structure prototypes of electrides, of which 19 are not in the known structure databases.

  6. Generalization of Computer Assisted Prosody Training: Quantitative and Qualitative Findings

    Directory of Open Access Journals (Sweden)

    Debra M. Hardison


    Full Text Available Two experiments investigated the effectiveness of computer-assisted prosody training, its generalization to novel sentences and segmental accuracy, and the relationship between prosodic and lexical information in long-term memory. Experiment 1, using a pretest-posttest design, provided native English-speaking learners of French with 3 weeks of training focused on prosody using a real-time computerized pitch display. Multiple exemplars produced by native speakers (NSs of French and stored on hard disk provided training feedback. Learners' recorded pre- and posttest productions were presented to NSs for evaluation in two conditions: filtered (unintelligible segmental information and unfiltered. Ratings using 7-point scales for the prosody and segmental accuracy of unfiltered samples revealed significant improvement in prosody with generalization to segmental production and novel sentences. Comparison of prosody ratings for filtered and unfiltered samples revealed some segmental influence on the pretest ratings of prosody. In Experiment 2, involving a memory recall task using filtered stimuli of reduced intelligibility, learners identified the exact lexical content of an average of 80% of the training sentences based on prosodic cues consistent with exemplar-based learning models. Questionnaire responses indicated a greater awareness of the various aspects of speech and increased confidence in producing another language.

  7. Computer-Assisted Inverse Design of Inorganic Electrides (United States)

    Zhang, Yunwei; Wang, Hui; Wang, Yanchao; Zhang, Lijun; Ma, Yanming


    Electrides are intrinsic electron-rich materials enabling applications as excellent electron emitters, superior catalysts, and strong reducing agents. There are a number of organic electrides; however, their instability at room temperature and sensitivity to moisture are bottlenecks for their practical uses. Known inorganic electrides are rare, but they appear to have greater thermal stability at ambient conditions and are thus better characterized for application. Here, we develop a computer-assisted inverse-design method for searching for a large variety of inorganic electrides unbiased by any known electride structures. It uses the intrinsic property of interstitial electron localization of electrides as the global variable function for swarm intelligence structure searches. We construct two rules of thumb on the design of inorganic electrides pointing to electron-rich ionic systems and low electronegativity of the cationic elements involved. By screening 99 such binary compounds through large-scale computer simulations, we identify 24 stable and 65 metastable new inorganic electrides that show distinct three-, two-, and zero-dimensional conductive properties, among which 18 are existing compounds that have not been pointed to as electrides. Our work reveals the rich abundance of inorganic electrides by providing 33 hitherto unexpected structure prototypes of electrides, of which 19 are not in the known structure databases.

  8. Natural language processing tools for computer assisted language learning

    Directory of Open Access Journals (Sweden)

    Vandeventer Faltin, Anne


    Full Text Available This paper illustrates the usefulness of natural language processing (NLP tools for computer assisted language learning (CALL through the presentation of three NLP tools integrated within a CALL software for French. These tools are (i a sentence structure viewer; (ii an error diagnosis system; and (iii a conjugation tool. The sentence structure viewer helps language learners grasp the structure of a sentence, by providing lexical and grammatical information. This information is derived from a deep syntactic analysis. Two different outputs are presented. The error diagnosis system is composed of a spell checker, a grammar checker, and a coherence checker. The spell checker makes use of alpha-codes, phonological reinterpretation, and some ad hoc rules to provide correction proposals. The grammar checker employs constraint relaxation and phonological reinterpretation as diagnosis techniques. The coherence checker compares the underlying "semantic" structures of a stored answer and of the learners' input to detect semantic discrepancies. The conjugation tool is a resource with enhanced capabilities when put on an electronic format, enabling searches from inflected and ambiguous verb forms.

  9. Helping Children Learn Vocabulary during Computer-Assisted Oral Reading

    Directory of Open Access Journals (Sweden)

    Gregory Aist


    Full Text Available This paper addresses an indispensable skill using a unique method to teach a critical component: helping children learn to read by using computer-assisted oral reading to help children learn vocabulary. We build on Project LISTEN’s Reading Tutor, a computer program that adapts automatic speech recognition to listen to children read aloud, and helps them learn to read ( To learn a word from reading with the Reading Tutor, students must encounter the word and learn the meaning of the word in context. We modified the Reading Tutor first to help students encounter new words and then to help them learn the meanings of new words. We then compared the Reading Tutor to classroom instruction and to human-assisted oral reading as part of a yearlong study with 144 second and third graders. The result: Second graders did about the same on word comprehension in all three conditions. However, third graders who read with the 1999 Reading Tutor, modified as described in this paper, performed statistically significantly better than other third graders in a classroom control on word comprehension gains – and even comparably with other third graders who read one-on-one with human tutors.

  10. Curettage with cement augmentation of large bone defects in giant cell tumors with pathological fractures in lower-extremity long bones. (United States)

    Gupta, Som P; Garg, Gaurav


    Thorough curettage and cement augmentation is the procedure of choice for treating giant cell tumor lesions, particularly those associated with large defects. Its association with pathological fractures has not been studied to a great extent, although a pathological fracture following a giant cell tumor is not a contraindication to treatment by curettage and cementation. We present our experience of bone cementation following intralesional curettage for treatment of giant cell tumors of the long bones of lower limbs with associated pathological fractures. A total of 38 patients who had undergone a procedure in the weight-bearing long bones of lower limbs were included in the study. The age of the patients ranged from 18-79 years with a mean age of 38.57 years. The average follow-up was 102.42 months (8.5 years) ranging from 60-186 months (5-15.5 years). Results were based on serial radiographs showing consolidation of the lesion along with a subjective clinical examination and Enneking functional evaluation noted in the patient's records. Approximately 76 % of the lesions occurred around the knee. The results were graded as excellent (72 %), good (12.82 %) fair (10.25 %) and poor (5.12 %). Four cases developed a recurrence. Apart from a few documented complications, the lesions showed good consolidation and healed well. Giant cell tumors of the long bones of lower limbs with an associated pathological fracture at diagnosis can be managed with thorough curettage and cement augmentation of the bone defect with a satisfactory outcome. Level IV.

  11. A monoclonal antibody cocktail for detection of micrometastatic tumor cells in the bone marrow of breast cancer patients. (United States)

    Taha, M; Ordoñez, N G; Kulkarni, S; Owen, M; Ro, J S; Hortobagyi, G; Reading, C L; Dicke, K A; Spitzer, G


    We investigated whether monoclonal antibodies (MoAbs) reactive against both acidic and basic cytokeratins alone were sufficient to detect minimal numbers of contaminating epithelial tumor cells in the bone marrow of breast cancer patients. Monoclonal anti-cytokeratin antibodies (AE1 and AE3) were used to stain 14 breast carcinomas by the avidin-biotin-peroxidase technique. Nine tumors (64.3%) showed high reactivity and five (35.7%) showed low or moderate reactivity. Nine MoAbs that proved to be unreactive to light density bone marrow cells by immunoalkaline phosphatase histochemistry were screened for reactivity to breast carcinomas having only low or moderate positivity to cytokeratin antibodies. Three of nine MoAbs showed high percentages of positivity and were selected to supplement the anti-cytokeratin antibodies for immunohistochemical detection of minimal marrow disease in breast cancer patients. A MoAb cocktail was prepared, further tested for reactivity to another five breast carcinomas, and compared with cytokeratin staining alone. The cocktail labeled 100% of carcinoma cells in all the examined specimens. To determine the sensitivity of this panel for detecting minimal numbers of contaminating tumor cells in bone marrow, in vitro mixing experiments were performed. T47D breast carcinoma cells were mixed with bone marrow mononuclear cells at ratios from one tumor cell per 10 bone marrow cells up to one tumor cell per 1 x 10(6) marrow cells, and cytospin preparations were subsequently stained with the MoAb cocktail by the immunoalkaline phosphatase method. Our approach could detect one tumor cell in 1 x 10(5) hematopoietic cells.

  12. Adaptive Bone Remodeling of the Femoral Bone After Tumor Resection Arthroplasty With an Uncemented Proximally Hydroxyapatite-Coated Stem

    DEFF Research Database (Denmark)

    Andersen, Mikkel R.; Petersen, Michael M.


    -fluted 125-mm uncemented press-fit titanium alloy stem with hydroxyapatite coating of the proximal part of the stem. Measurements of bone mineral density (BMD; g/cm2) were done postoperatively and after 3, 6, and 12 mo in the part of the femur bone containing the Global Modular Replacement System stem using...... of 8%-9% during the first postoperative year was seen along the femoral stem, but in the bone containing the hydroxyapatite-coated part of the stem, the decrease in BMD was 14%, thus indicating that stress shielding of this part of the bone may play a role for the adaptive bone remodeling....

  13. Ewing's sarcoma, fibrogenic tumors, giant cell tumor, hemangioma of bone. Radiology and pathology; Ewing-Sarkom, fibrogene Tumoren, Riesenzelltumor, Haemangiom des Skeletts. Radiologie und Pathologie

    Energy Technology Data Exchange (ETDEWEB)

    Freyschmidt, J. [Beratungsstelle und Referenzzentrum fuer Osteoradiologie, Bremen (Germany); Ostertag, H. [Klinikum Region Hannover GmbH, Pathologisches Institut, Hannover (Germany)


    Radiological imaging only reflects the anatomy and its pathological abnormalities. Therefore, the radiologist should be able to recognize the basic features of the pathological anatomy of bone tumors. This can only be learned working closely with a pathologist who is experienced in this field. On the other hand, the pathologist needs from the radiologist their diagnostic assessment with information on size, location, aggressiveness and the existence of a bone tumor's matrix, of the whole lesion, because he usually only receives a small part for examination in the form of a biopsy. In this article, the features and fundamentals (standards) of radiological-pathological cooperation as the mainstay for a precise diagnosis in bone tumors are outlined. The radiological appearance and the histopathological features behind it are presented for Ewing's sarcoma, fibrogenic tumors, giant cell tumor, and hemangioma of the bone. (orig.) [German] Radiologische Bilder spiegeln nichts anderes als die Anatomie und ihre pathologischen Abweichungen wider. Deshalb sollte der Radiologe die Grundzuege der pathologischen Anatomie auch von Knochentumoren kennen. Das kann er nur durch eine enge Zusammenarbeit mit einem auf diesem Gebiet erfahrenen Pathologen erlernen. Andererseits braucht der Pathologe vom Radiologen dessen diagnostische Einschaetzung mit Informationen ueber die Groesse, Lage, Aggressivitaet und das Vorhandensein einer Matrix eines Knochentumors und zwar von der gesamten Laesion, denn er bekommt inform einer Biopsie i. d. R. nur einen mehr oder weniger kleinen Teil zur Untersuchung. In diesem Beitrag werden die Grundzuege und Standards der radiologisch-pathologischen Zusammenarbeit aufgezeigt, auf denen eine praezise Diagnosestellung beruht. Radiologisches Erscheinungsbild und die dahintersteckenden - und erklaerenden - histopathologischen Merkmale werden fuer das Ewing-Sarkom, fuer fibrogene Tumoren, den Riesenzelltumor und das Haemangiom des Knochens

  14. Middle School Teachers' Perceptions of Computer-Assisted Reading Intervention Programs (United States)

    Bippert, Kelli; Harmon, Janis


    Middle schools often turn to computer-assisted reading intervention programs to improve student reading. The questions guiding this study are (a) in what ways are computer-assisted reading intervention programs utilized, and (b) what are teachers' perceptions about these intervention programs? Nineteen secondary reading teachers were interviewed…

  15. Public Computer Assisted Learning Facilities for Children with Visual Impairment: Universal Design for Inclusive Learning (United States)

    Siu, Kin Wai Michael; Lam, Mei Seung


    Although computer assisted learning (CAL) is becoming increasingly popular, people with visual impairment face greater difficulty in accessing computer-assisted learning facilities. This is primarily because most of the current CAL facilities are not visually impaired friendly. People with visual impairment also do not normally have access to…

  16. The Effect of Computer-Assisted Teaching on Remedying Misconceptions: The Case of the Subject "Probability" (United States)

    Gurbuz, Ramazan; Birgin, Osman


    The aim of this study is to determine the effects of computer-assisted teaching (CAT) on remedying misconceptions students often have regarding some probability concepts in mathematics. Toward this aim, computer-assisted teaching materials were developed and used in the process of teaching. Within the true-experimental research method, a pre- and…

  17. Promoting Intrinsic and Extrinsic Motivation among Chemistry Students Using Computer-Assisted Instruction (United States)

    Gambari, Isiaka A.; Gbodi, Bimpe E.; Olakanmi, Eyitao U.; Abalaka, Eneojo N.


    The role of computer-assisted instruction in promoting intrinsic and extrinsic motivation among Nigerian secondary school chemistry students was investigated in this study. The study employed two modes of computer-assisted instruction (computer simulation instruction and computer tutorial instructional packages) and two levels of gender (male and…

  18. Effect Sizes Associated with Micro-PROLOG-Based Computer-Assisted Learning. (United States)

    Fraser, Barry J.; Teh, George P. L.


    Discussion of effect sizes in computer-assisted learning research focuses on a study conducted in Singapore high school geography classes that used micro-PROLOG to determine the efficacy of computer-assisted learning. Topics include impact on achievement, student attitudes, and classroom environment. (53 references) (LRW)

  19. The Effects of Computer-Assisted Feedback Strategies in Technology Education: A Comparison of Learning Outcomes (United States)

    Adams, Ruifang Hope; Strickland, Jane


    This study investigated the effects of computer-assisted feedback strategies that have been utilized by university students in a technology education curriculum. Specifically, the study examined the effectiveness of the computer-assisted feedback strategy "Knowledge of Response feedback" (KOR), and the "Knowledge of Correct Responses feedback"…

  20. Applications of NLP Techniques to Computer-Assisted Authoring of Test Items for Elementary Chinese (United States)

    Liu, Chao-Lin; Lin, Jen-Hsiang; Wang, Yu-Chun


    The authors report an implemented environment for computer-assisted authoring of test items and provide a brief discussion about the applications of NLP techniques for computer assisted language learning. Test items can serve as a tool for language learners to examine their competence in the target language. The authors apply techniques for…

  1. Computer-Assisted Diagnostic Decision Support: History, Challenges, and Possible Paths Forward (United States)

    Miller, Randolph A.


    This paper presents a brief history of computer-assisted diagnosis, including challenges and future directions. Some ideas presented in this article on computer-assisted diagnostic decision support systems (CDDSS) derive from prior work by the author and his colleagues (see list in Acknowledgments) on the INTERNIST-1 and QMR projects. References…

  2. Imaging Findings of Pelvic Tumor Thrombosis Extending from Sacral Bone Metastasis of Adrenocortical Carcinoma

    Directory of Open Access Journals (Sweden)

    Kenichiro Ishida


    Full Text Available We report the imaging findings of a patient with adrenocortical carcinoma who showed pelvic tumor thrombosis extending from sacral bone metastasis. Contrast-enhanced computed tomography demonstrated extensive intraluminal filling defects in the pelvic veins. A lytic lesion in the sacrum was also noted and continuity between the sacral lesion and the filling defect in the branch of pelvic veins was indicated. The filling defects showed increased uptake on positron emission tomography with 18F-fluorodeoxyglucose and single-photon emission computed tomography with 131I-iodomethylnorcholesterol, and fusion images with computed tomography aided the localization of the increased uptake areas. Multimodality imaging may be beneficial for the characterization and localization of lesions in patients suspected of having metastatic adrenocortical carcinoma.

  3. Evaluation of the lymph flow with lymphoscintigraphy after rotationplasty for the treatment of bone tumors. (United States)

    Taminiau, A H; Arndt, J W; van Bockel, J H; Steenhoff, J R; Pauwels, E K


    We studied the cases of eleven patients in whom a rotationplasty had been done after wide resection of the distal part of the femur. All patients had had a malignant tumor of bone, but none had the complication of edema or leakage of lymph after the rotationplasty. We made lymphoscintiscans soon after the operation in four patients and weeks or months later in all eleven patients. There was a delay in the flow of lymph in three of the four patients who were examined lymphoscintigraphically soon after the operation and there was obstruction of flow in the fourth patient, but there was evidence of a decreased rate of flow in only two of the eleven patients at the time of the later examination.

  4. Results of computer assisted mini-incision subvastus approach for total knee arthroplasty. (United States)

    Turajane, Thana; Larbpaiboonpong, Viroj; Kongtharvonskul, Jatupon; Maungsiri, Samart


    groups), and Knee society score preoperative and postoperative [64.6 (59.8-69.4) and 93.7 (90.8-96.65)]: 69 (63.6-74.39) 92.36 (88.22-96.5)]. The complications found in both groups were similar. No deep vein thrombosis, no fracture at both femur and tibia, no vascular injury, and no pin tract pain or infection was found in both groups. The computer assisted CMS-TKA) is one of the appropriate procedures for all varus deformity, no limitation with the associated bone loss, flexion contractor, BMI, except the fixed valgus deformity. To ensure the clinical outcomes, multiple key steps were considered as the appropriate techniques for this approach which included the accurate registration, precision bone cut and ligament balances, and the good cement techniques.

  5. Clinical Outcomes of Surgical Treatments for Primary Malignant Bone Tumors Arising in the Acetabulum

    Directory of Open Access Journals (Sweden)

    Tomohiro Fujiwara


    Full Text Available The functional and oncologic results of eighteen patients with primary malignant periacetabular tumors were reviewed to determine the impact of surgical treatment. The reconstruction procedures were endoprosthesis (11, hip transposition (4, iliofemoral arthrodesis (2, and frozen bone autograft (1. After a mean follow-up of 62 months, 13 patients were alive and 5 had died of their disease; the 5-year overall survival rate was 67.2%. The corresponding mean MSTS scores of patients with endoprosthesis (11 and other reconstructions (7 were 42% and 55% (49%, 68%, and 50%, respectively. Overall, postoperative complications including deep infection or dislocation markedly worsened the functional outcome. Iliofemoral arthrodesis provided better function than the other procedures, whereas endoprosthetic reconstruction demonstrated poor functional outcome except for patients who were reconstructed with the adequate soft tissue coverage. Avoiding postoperative complications is highly important for achieving better function, suggesting that surgical procedures with adequate soft tissue coverage or without the massive use of nonbiological materials are preferable. Appropriate selection of the reconstructive procedures for individual patients, considering the amount of remaining bone and soft tissues, would lead to better clinical outcomes.

  6. Development of finite element model for customized prostheses design for patient with pelvic bone tumor. (United States)

    Iqbal, Taimoor; Shi, Lei; Wang, Ling; Liu, Yaxiong; Li, Dichen; Qin, Mian; Jin, Zhongmin


    The aim of this study was to design a hemi-pelvic prosthesis for a patient affected by pelvic sarcoma. To investigate the biomechanical functionality of the pelvis reconstructed with designed custom-made prosthesis, a patient-specific finite element model of whole pelvis with primary ligaments inclusive was constructed based on the computed tomography images of the patient. Then, a finite element analysis was performed to calculate and compare the stress distribution between the normal and implanted pelvis models when undergoing three different static conditions-both-leg standing, single-leg standing for the healthy and the affected one. No significant differences were observed in the stresses between the normal and reconstructed pelvis for both-leg standing, but 20%-40% larger stresses were predicted for the peak stress of the single-leg standing (affected side). Moreover, two- to threefold of peak stresses were predicted within the prostheses compared to that of the normal pelvis especially for single-leg standing case, however, still below the allowable fatigue limitation. The study on the load transmission functionality of prosthesis indicated that it is crucial to carry out finite element analysis for functional evaluation of the designed customized prostheses before three-dimensional printing manufacturing, allowing better understanding of the possible peak stresses within the bone as well as the implants for safety precaution. The finite element model can be equally applicable to other bone tumor model for biomechanical studying.

  7. Role of bone and kidney in tumor-induced hypercalcemia and its treatment with bisphosphonate and sodium chloride

    NARCIS (Netherlands)

    Harinck, H.I.J.; Bijvoet, O.L.M.; Plantingh, A.S.T.; Body, J.; Elte, J.W.F.; Sleeboom, H.P.; Wildiers, J.; Neijt, J.P.

    The efficacy of intravenous aminohydroxypropylidene bisphosphonate as treatment for the hypercalcemia of malignancy was examined in a phase II multicenter study in 132 patients with a large variety of primary tumors. This provided an opportunity for an analysis of the separate influences of bone

  8. Quality of life in young patients after bone tumor surgery around the knee joint and comparison with healthy controls.

    NARCIS (Netherlands)

    Bekkering, W.P.; Vliet Vlieland, T.P.M.; Koopman, H.M.; Schaap, G.R.; Schreuder, H.W.B.; Beishuizen, A.; Tissing, W.J.; Hoogerbrugge, P.M.; Anninga, J.K.; Taminiau, A.H.M.


    BACKGROUND: This study aimed to compare the health related quality of life (HRQoL) of children and adolescents after malignant bone tumor surgery of the leg with healthy controls. PROCEDURE: Patients between 8 and 25 years old were cross-sectional recruited. Patients under 16 years of age received

  9. Quality of life in young patients after bone tumor surgery around the knee joint and comparison with healthy controls

    NARCIS (Netherlands)

    Bekkering, W. Peter; Vliet Vlieland, Theodora P. M.; Koopman, Hendrik M.; Schaap, Gerard R.; Schreuder, H. W. Bart; Beishuizen, Auke; Tissing, Wim J. E.; Hoogerbrugge, Peter M.; Anninga, Jacob K.; Taminiau, Antonie H. M.


    This study aimed to compare the health related quality of life (HRQoL) of children and adolescents after malignant bone tumor surgery of the leg with healthy controls. Patients between 8 and 25 years old were cross-sectional recruited. Patients under 16 years of age received the TNO (Netherlands

  10. Quality of Life in Young Patients After Bone Tumor Surgery Around the Knee Joint and Comparison With Healthy Controls

    NARCIS (Netherlands)

    Bekkering, W. Peter; Vlieland, Theodora P. M. Vliet; Koopman, Hendrik M.; Schaap, Gerard R.; Schreuder, H. W. Bart; Beishuizen, Auke; Tissing, Wim J. E.; Hoogerbrugge, Peter M.; Anninga, Jacob K.; Taminiau, Antonie H. M.

    Background. This study aimed to compare the health related quality of life (HRQoL) of children and adolescents after malignant bone tumor surgery of the leg with healthy controls. Procedure. Patients between 8 and 25 years old were cross-sectional recruited. Patients under 16 years of age received

  11. A Hybrid Segmentation Framework for Computer-Assisted Dental Procedures (United States)

    Hosntalab, Mohammad; Aghaeizadeh Zoroofi, Reza; Abbaspour Tehrani-Fard, Ali; Shirani, Gholamreza; Reza Asharif, Mohammad

    Teeth segmentation in computed tomography (CT) images is a major and challenging task for various computer assisted procedures. In this paper, we introduced a hybrid method for quantification of teeth in CT volumetric dataset inspired by our previous experiences and anatomical knowledge of teeth and jaws. In this regard, we propose a novel segmentation technique using an adaptive thresholding, morphological operations, panoramic re-sampling and variational level set algorithm. The proposed method consists of several steps as follows: first, we determine the operation region in CT slices. Second, the bony tissues are separated from other tissues by utilizing an adaptive thresholding technique based on the 3D pulses coupled neural networks (PCNN). Third, teeth tissue is classified from other bony tissues by employing panorex lines and anatomical knowledge of teeth in the jaws. In this case, the panorex lines are estimated using Otsu thresholding and mathematical morphology operators. Then, the proposed method is followed by calculating the orthogonal lines corresponding to panorex lines and panoramic re-sampling of the dataset. Separation of upper and lower jaws and initial segmentation of teeth are performed by employing the integral projections of the panoramic dataset. Based the above mentioned procedures an initial mask for each tooth is obtained. Finally, we utilize the initial mask of teeth and apply a variational level set to refine initial teeth boundaries to final contour. In the last step a surface rendering algorithm known as marching cubes (MC) is applied to volumetric visualization. The proposed algorithm was evaluated in the presence of 30 cases. Segmented images were compared with manually outlined contours. We compared the performance of segmentation method using ROC analysis of the thresholding, watershed and our previous works. The proposed method performed best. Also, our algorithm has the advantage of high speed compared to our previous works.

  12. Soft tissue recurrence of giant cell tumor of the bone: Prevalence and radiographic features

    Directory of Open Access Journals (Sweden)

    Leilei Xu


    Full Text Available Aim: Recurrence of giant cell tumor of bone (GCTB in the soft tissue is rarely seen in the clinical practice. This study aims to determine the prevalence of soft tissue recurrence of GCTB, and to characterize its radiographic features. Methods: A total of 291 patients treated by intralesional curettage for histologically diagnosed GCTB were reviewed. 6 patients were identified to have the recurrence of GCTB in the soft tissue, all of whom had undergone marginal resection of the lesion. Based on the x-ray, CT and MRI imaging, the radiographic features of soft tissue recurrence were classified into 3 types. Type I was defined as soft tissue recurrence with peripheral ossification, type II was defined as soft tissue recurrence with central ossification, and type III was defined as pure soft tissue recurrence without ossification. Demographic data including period of recurrence and follow-up duration after the second surgery were recorded for these 6 patients. Musculoskeletal Tumor Society (MSTS scoring system was used to evaluate functional outcomes. Results: The overall recurrence rate was 2.1% (6/291. The mean interval between initial surgery and recurrence was 11.3 ± 4.1 months (range, 5–17. The recurrence lesions were located in the thigh of 2 patients, in the forearm of 2 patients and in the leg of the other 2 patients. According to the classification system mentioned above, 2 patients were classified with type I, 1 as type II and 3 as type III. After the marginal excision surgery, all patients were consistently followed up for a mean period of 13.4 ± 5.3 months (range, 6–19, with no recurrence observed at the final visit. All the patients were satisfied with the surgical outcome. According to the MSTS scale, the mean postoperative functional score was 28.0 ± 1.2 (range, 26–29. Conclusions: The classification of soft tissue recurrence of GCTB may be helpful for the surgeon to select the appropriate imaging procedure to

  13. Reconstructive procedures for segmental resection of bone in giant cell tumors around the knee

    Directory of Open Access Journals (Sweden)

    Aggarwal Aditya


    Full Text Available Background: Segmental resection of bone in Giant Cell Tumor (GCT around the knee, in indicated cases, leaves a gap which requires a complex reconstructive procedure. The present study analyzes various reconstructive procedures in terms of morbidity and various complications encountered. Materials and Methods: Thirteen cases (M-six and F-seven; lower end femur-six and upper end tibia -seven of GCT around the knee, radiologically either Campanacci Grade II, Grade II with pathological fracture or Grade III were included. Mean age was 25.6 years (range 19-30 years. Resection arthrodesis with telescoping (shortening over intramedullary nail ( n=5, resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail ( n=3 and resection arthrodesis with intercalary fibular autograft and simultaneous limb lengthening ( n=5 were the procedure performed. Results: Shortening was the major problem following resection arthrodesis with telescoping (shortening over intramedullary nail. Only two patients agreed for subsequent limb lengthening. The rest continued to walk with shortening. Infection was the major problem in all cases of resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail and required multiple drainage procedures. Fusion was achieved after two years in two patients. In the third patient the allograft sequestrated. The patient underwent sequestrectomy, telescoping of fragments and ilizarov fixator application with subsequent limb lengthening. The patient was finally given an ischial weight relieving orthosis, 54 months after the index procedure. After resection arthrodesis with intercalary autograft and simultaneous lengthening the resultant gap (~15cm was partially bridged by intercalary nonvascularized dual fibular strut graft (6-7cm and additional corticocancellous bone graft from ipsilateral patella. Simultaneous limb lengthening with a distal tibial corticotomy was performed on an

  14. SU11248 inhibits tumor growth and CSF-1R-dependent osteolysis in an experimental breast cancer bone metastasis model. (United States)

    Murray, Lesley J; Abrams, Tinya J; Long, Kelly R; Ngai, Theresa J; Olson, Lisa M; Hong, Weiru; Keast, Paul K; Brassard, Jacqueline A; O'Farrell, Anne Marie; Cherrington, Julie M; Pryer, Nancy K


    The aim of the study was to investigate inhibitory effects of the receptor tyrosine kinase (RTK) inhibitor SU11248 against CSF-1R and osteoclast (OC) formation. We developed an in vivo model of breast cancer metastasis to evaluate efficacy of SU11248 against tumor growth and tumor-induced osteolysis in bone. The in vitro effects of SU11248 on CSF-1R phosphorylation, OC formation and function were evaluated. Effects on 435/HAL-Luc tumor growth in bone were monitored by in vivo bioluminescence imaging (BLI), and inhibition of osteolysis was evaluated by measurement of serum pyridinoline (PYD) concentration and histology. Phosphorylation of the receptor for M-CSF (CSF-1R) expressed by NIH3T3 cells was inhibited by SU11248 with an IC50 of 50-100 nM, consistent with CSF-1R belonging to the class III split kinase domain RTK family. The early M-CSF-dependent phase of in vitro murine OC development and function were inhibited by SU11248 at 10-100 nM. In vivo inhibition of osteolysis was confirmed by significant lowering of serum PYD levels following SU11248 treatment of tumor-bearing mice (P = 0.047). Using BLI, SU11248 treatment at 40 mg/kg/day for 21 days showed 64% inhibition of tumor growth in bone (P = 0.006), and at 80 mg/kg/day showed 89% inhibition (P = 0.001). Collectively, these data suggest that SU11248 may be an effective and tolerated therapy to inhibit growth of breast cancer bone metastases, with the additional advantage of inhibiting tumor-associated osteolysis.

  15. Array-based comparative genomic hybridization for genomic-wide screening of DNA copy number alterations in aggressive bone tumors

    Directory of Open Access Journals (Sweden)

    Kanamori Masahiko


    Full Text Available Abstract Background The genetic pathways of aggressive changes of bone tumors are still poorly understood. It is very important to analyze DNA copy number alterations (DCNAs, to identify the molecular events in the step of progression to the aggressive change of bone tissue. Methods Genome-wide array-based comparative genomic hybridization (array CGH was used to investigate DCNAs of 14 samples from 13 aggressive bone tumors, such as giant cell tumors (GCTs and osteosarcoma (OS, etc. Results Primary aggressive bone tumors had copy number gains of 17.8±12.7% in the genome, and losses of 17.3±11.4% in 287 target clones (threshold for each DCNA: ≦085, 1.15≦. Genetic unstable cases, which were defined by the total DCNAs aberration ≧30%, were identified in 9 of 13 patients (3 of 7 GCTs and all malignant tumors. High-level amplification of TGFβ2, CCND3, WI-6509, SHGC-5557, TCL1A, CREBBP, HIC1, THRA, AFM217YD10, LAMA3, RUNX1 and D22S543, were commonly observed in aggressive bone tumors. On the other hand, NRAS, D2S447, RAF1, ROBO1, MYB, MOS, FGFR2, HRAS, D13S319, D13S327, D18S552, YES1 and DCC, were commonly low. We compared genetic instability between a primary OS and its metastatic site in Case #13. Metastatic lesion showed increased 9 DCNAs of remarkable change (m/p ratio ≧1.3 folds, compared to a primary lesion. D1S214, D1S1635, EXT1, AFM137XA11, 8 M16/SP6, CCND2, IGH, 282 M15/SP6, HIC1 and LAMA3, were overexpressed. We gave attention to HIC1 (17p13.3, which was common high amplification in this series. Conclusion Our results may provide several entry points for the identification of candidate genes associated with aggressive change of bone tumors. Especially, the locus 17p11-13 including HIC1 close to p53 was common high amplification in this series and review of the literature.

  16. Risks and benefits of combining denosumab and surgery in giant cell tumor of bone-a case series. (United States)

    Müller, Daniel A; Beltrami, Giovanni; Scoccianti, Guido; Campanacci, Domenico A; Franchi, Alessandro; Capanna, Rodolfo


    The RANK ligand inhibitor denosumab is being investigated for treatment of giant cell tumor of bone, but the available data in the literature remains sparse and controversial. This study analyzes the results of combining denosumab with surgical treatment and highlights possible changes for the oncologic surgeon in daily practice. A total of 91 patients were treated surgically for giant cell tumor of bone between 2010 and 2014 in an institution, whereas 25 patients of the total additionally received denosumab and were part of this study. The average age of the patients was 35 years. Eleven patients received denosumab pre- and postoperatively, whereas with 14 patients, the denosumab treatment was applied either before (7 patients) or after (7 patients) the surgery. The average preoperative therapy duration was 3.9 months and the postoperative therapy 6 months by default. Sixteen patients presented a large tumor extension necessitating a resection of the involved bone or joint. In 10 of these patients, the indication for a resection procedure was abandoned due to the preoperative denosumab treatment and a curettage was performed. In the remaining six cases, the surgical indication was not changed despite the denosumab treatment, and two of them needed a joint replacement after the tumor resection. Also with patients treated with curettage, denosumab seems to facilitate the procedure as a new peripheral bone rim around the tumor was built, though a histologic analysis reveals viable tumor cells persisting in the denosumab-induced bone formation. After an average follow-up of 23 months, one histologically proven local recurrence occurred, necessitating a second curettage. A second patient showed a lesion in the postoperative imaging highly suspicious for local relapse which remained stable under further denosumab treatment. No adverse effect of the denosumab medication was observed in this study. Denosumab can be a help to the oncologic surgeon by reconstituting a

  17. Role of denosumab in the management of skeletal complications in patients with bone metastases from solid tumors

    Directory of Open Access Journals (Sweden)

    Stopeck AT


    Full Text Available Ursa Brown-Glaberman, Alison T StopeckUniversity of Arizona Cancer Center, Tucson, AZ, USAAbstract: Skeletal-related events (SREs including pain, fractures, and hypercalcemia are a major source of morbidity for cancer patients with bone metastases. The receptor activator of NF-κB ligand (RANKL is a key mediator of osteoclast formation and activity in normal bone physiology as well as cancer-induced bone resorption. The first commercially available drug that specifically targets and inhibits the RANKL pathway is denosumab, a fully human monoclonal antibody that binds and neutralizes RANKL, thereby inhibiting osteoclast function. In this review, we summarize the major studies leading to the US Food and Drug Administration-approval of denosumab for the prevention of SREs in patients with bone metastases from solid tumors. Further, we discuss the role of denosumab in the prevention and treatment of SREs and bone loss in cancer patients. As a monoclonal antibody, denosumab has several advantages over bisphosphonates, including improved efficacy, better tolerability, and the convenience of administration by subcutaneous injection. In addition, as denosumab has no known renal toxicity, it may be the preferred choice over bisphosphonates in patients with baseline renal insufficiency or receiving nephrotoxic therapies. However, other toxicities, including osteonecrosis of the jaw and hypocalcemia, appear to be class effects of agents that potently inhibit osteoclast activity and are associated with both denosumab and bisphosphonate use. The data presented highlight the differences associated with intravenous bisphosphonate and denosumab use as well as confirm the essential role bone-modifying agents play in maintaining the quality of life for patients with bone metastases.Keywords: denosumab, bone metastases, solid tumor, breast cancer, prostate cancer, skeletal related events, skeletal complications 

  18. Origins of the tumor microenvironment: quantitative assessment of adipose-derived and bone marrow-derived stroma.

    Directory of Open Access Journals (Sweden)

    Shannon Kidd

    Full Text Available To meet the requirements for rapid tumor growth, a complex array of non-neoplastic cells are recruited to the tumor microenvironment. These cells facilitate tumor development by providing matrices, cytokines, growth factors, as well as vascular networks for nutrient and waste exchange, however their precise origins remain unclear. Through multicolored tissue transplant procedures; we have quantitatively determined the contribution of bone marrow-derived and adipose-derived cells to stromal populations within syngeneic ovarian and breast murine tumors. Our results indicate that subpopulations of tumor-associated fibroblasts (TAFs are recruited from two distinct sources. The majority of fibroblast specific protein (FSP positive and fibroblast activation protein (FAP positive TAFs originate from mesenchymal stem/stromal cells (MSC located in bone marrow sources, whereas most vascular and fibrovascular stroma (pericytes, α-SMA(+ myofibroblasts, and endothelial cells originates from neighboring adipose tissue. These results highlight the capacity for tumors to utilize multiple sources of structural cells in a systematic and discriminative manner.

  19. [Efficacy of the RIMAG unconventional hip prosthesis in patients with primary bone tumors, metastasis and non-tumor osteoarticular losses]. (United States)

    Rico-Martínez, G; Delgado-Cedillo, E A; Linares-González, L M; Lindoro-Félix, H; León-Hernández, S R


    To assess the functional efficacy of the RIMAG unconventional hip prosthesis in cancer and non-cancer patients. Functional analysis of 38 patients with RIMAG arthroplasty, using the Musculoskeletal Tumor Society Scoring System and including the following: functionality versus histologic diagnosis (5 malignancies, 3 metastases, 14 giant cell tumors (GCT), 8 with other benign tumors, and 8 had no tumor), age (40.4 +/- 19.1 years), sex (24 females, 14 males), postoperative follow-up (34.7 +/- 31.3 months). Analysis of intraoperative, immediate and late complications, time to weight bearing, gait and work or social reintegration were also assessed. Global mean of ideal functionality was 65.6 +/- 23.2%. Age was negatively correlated with the functionality rate (r = -0.507, p = 0.001); significant difference with the histologic diagnosis: malignant tumors 54.8, metastasis 58.6, giant cell tumor 25.6, other benign tumors 34.2, non-tumor causes 56.6 (p = 0.001). When functionality means were adjusted for age with a covariance analysis, better percentages were found for benign tumors (79.2 +/- 6.8%) and giant cell tumors (76.4 +/- 6.3%), less functionality for non-tumor causes (45.7 +/- 7.6%), and intermediate percentages for malignant tumors and metastasis (p = 0.03). Intraoperative complications occurred in 4 cases (28.6%), immediate in 3 (7.8%), late in 15 (39.4%); 62.5% of patients started immediate weight bearing, 92.1% resumed their usual activities after surgery. The reconstruction of the proximal femur with RIMAG is a safe and reliable treatment option, with complication rates below the ones reported in the literature. Satisfactory results were obtained, with high functional rates for benign tumors, and low rates in older patients, malignant tumors and metastasis.

  20. Interobserver variability in the differential diagnosis of benign bone tumors and tumor-like lesions; Interobservervariabilitaet in der Differentialdiagnose gutartiger Knochentumoren und tumoraehnlicher Knochenlaesionen

    Energy Technology Data Exchange (ETDEWEB)

    Scheitza, P.; Hauschild, O.; Zwingmann, J.; Suedkamp, N.P. [University Medical Centre Freiburg (Germany). Dept. of Orthopaedics and Traumatology; Uhl, M. [St. Josefshospital Freiburg (Germany). Dept. of Diagnostic and Therapeutic Radiology; Bannasch, H. [University Medical Centre Freiburg (Germany). Dept. of Plastic and Hand Surgery; Kayser, C. [University Medical Centre Freiburg (Germany). Dept. of Pathology; Herget, G.W. [University Medical Centre Freiburg (Germany). Dept. of Orthopaedics and Traumatology/Comprehensive Cancer Centre Freiburg CCCF


    The interobserver-variability of radiological diagnosis of benign bone tumors (BBT) and tumor-like lesions (TLL) was examined in order to identify difficult-to-diagnose entities, to examine the frequency of advanced diagnostics and to describe the number of interdisciplinary tumor center diagnoses (IDT) in comparison with diagnoses upon referral (ED) and radiologists' diagnoses (RD). We retrospectively reviewed 413 patients with 272 BBT and 141 TLL, classified either histologically or through interdisciplinary consultation. Discrepancies between groups were analyzed and rates of additional imaging and biopsy to establish diagnosis were assessed. In BBT the number of identical radiological diagnoses was 56 (ED) and 81 % (RD) compared to the IDT, while in the latter additional imaging were obtained in 30 % cases. In 21 % (12 % to establish diagnosis) BBT were biopsied, the ED matching the histology 40 %, the RD 60 % and the IDT 76 % of the time. For TLL diagnosed through radiology, ED and RD matched IDT 31 % and 61 % of the time, with additional imaging being obtained in 21 % of cases (IDT). In 36 % (27 % to establish diagnosis) biopsy was performed, with histological diagnosis matching the IDT, RD and ED in 51, 27 and 20 %. Diagnostic challenges were apparent in enchondromas, non-ossifying fibromas (NOF), solitary (SBC) and aneurysmal bone cysts (ABC). Ganglia can be misinterpreted as a tumor. Establishing a definitive diagnosis for BBT and TLL can be challenging with the latter posing greater difficulties. An interdisciplinary approach involving radiologists, orthopedics and pathologists was found to improve diagnostic accuracy.

  1. Computer-assisted sperm analysis (CASA): capabilities and potential developments. (United States)

    Amann, Rupert P; Waberski, Dagmar


    Computer-assisted sperm analysis (CASA) systems have evolved over approximately 40 years, through advances in devices to capture the image from a microscope, huge increases in computational power concurrent with amazing reduction in size of computers, new computer languages, and updated/expanded software algorithms. Remarkably, basic concepts for identifying sperm and their motion patterns are little changed. Older and slower systems remain in use. Most major spermatology laboratories and semen processing facilities have a CASA system, but the extent of reliance thereon ranges widely. This review describes capabilities and limitations of present CASA technology used with boar, bull, and stallion sperm, followed by possible future developments. Each marketed system is different. Modern CASA systems can automatically view multiple fields in a shallow specimen chamber to capture strobe-like images of 500 to >2000 sperm, at 50 or 60 frames per second, in clear or complex extenders, and in CASA cannot accurately predict 'fertility' that will be obtained with a semen sample or subject. However, when carefully validated, current CASA systems provide information important for quality assurance of semen planned for marketing, and for the understanding of the diversity of sperm responses to changes in the microenvironment in research. The four take-home messages from this review are: (1) animal species, extender or medium, specimen chamber, intensity of illumination, imaging hardware and software, instrument settings, technician, etc., all affect accuracy and precision of output values; (2) semen production facilities probably do not need a substantially different CASA system whereas biology laboratories would benefit from systems capable of imaging and tracking sperm in deep chambers for a flexible period of time; (3) software should enable grouping of individual sperm based on one or more attributes so outputs reflect subpopulations or clusters of similar sperm with unique

  2. Computer Assistance for "Discovering" Formulas in System Engineering and Operator Theory

    National Research Council Canada - National Science Library

    Helton J.W; Foias M.C


    The objective of this paper is two-fold. First we present a methodology for using a combination of computer assistance and human intervention to discover highly algebraic theorems in operator, matrix, and linear systems engineering theory...


    Jia, Di; Li, Yanlin; Wang, Guoliang; Gao, Huanyu; Yu, Yang


    To conclude the revision reason of unicompartmental knee arthroplasty (UKA) using computer-assisted technology so as to provide reference for reducing the revision incidence and improving the level of surgical technique and rehabilitation. The relevant literature on analyzing revision reason of UKA using computer-assisted technology in recent years was extensively reviewed. The revision reasons by computer-assisted technology are fracture of the medial tibial plateau, progressive osteoarthritis of reserved compartment, dislocation of mobile bearing, prosthesis loosening, polyethylene wear, and unexplained persistent pain. Computer-assisted technology can be used to analyze the revision reason of UKA and guide the best operating method and rehabilitation scheme by simulating the operative process and knee joint activities.

  4. Computer assisted orthopaedic and trauma surgery. State of the art and future perspectives

    NARCIS (Netherlands)

    Schep, N. W. L.; Broeders, I. A. M. J.; van der Werken, Chr


    In recent years computer technologies have become more and more integrated in surgical procedures. The potential advantages of computer assisted surgery (CAS) are: increase of accuracy of surgical interventions, less invasive operations, better planning and simulation and reduction of radiation

  5. Computer Assisted Language Learning (CALL): Using Internet for Effective Language Learning

    NARCIS (Netherlands)

    Kremenska, Anelly


    Please, cite this publication as: Kremenska, A. (2006). Computer Assisted Language Learning (CALL): Using Internet for Effective Language Learning. Proceedings of International Workshop in Learning Networks for Lifelong Competence Development, TENCompetence Conference. March 30th-31st, Sofia,

  6. Computer-Assisted Traffic Engineering Using Assignment, Optimal Signal Setting, and Modal Split (United States)


    Methods of traffic assignment, traffic signal setting, and modal split analysis are combined in a set of computer-assisted traffic engineering programs. The system optimization and user optimization traffic assignments are described. Travel time func...

  7. Contact-2: A computer-assisted instructional strategy for promoting conceptual change

    NARCIS (Netherlands)

    Biemans, H.J.A.; Simons, P.R.J.


    Previous research seems to support the assumption that students need instructional guidance to activate and correct their preconceptions. Such an instructional strategy is the CONTACT strategy, characterised by continuous, computer-assisted activation of the conceptions of individual learners. Our

  8. Effect of Tutorial Mode of Computer-Assisted Instruction on Students ...

    African Journals Online (AJOL)

    Effect of Tutorial Mode of Computer-Assisted Instruction on Students' Academic Performance in Secondary School Practical Geography in Nigeria. ... If you would like more information about how to print, save, and work with PDFs, Highwire ...

  9. Computer-assisted instruction of arrhythmia for MS-windows. (United States)

    Takeuchi, A; Nara, Y; Ikeda, N; Miyahara, H; Mitobe, H


    1. INTRODUCTION. Training in the diagnosis of arrhythmias is an important part of the curriculum for medical students, postgraduates, and paramedical staff. Although several CAI for arrhythmia have been developed [1-3], we could not get CAI software for arrhythmia for the MS-Windows environment. In this report, we present a newly-developed computer-assisted reference system for arrhythmia that functions in the Windows environment. 2. DESCRIPTION OF THE SYSTEM. The system consists of a program and two data files. An MS-Windows program (ECG9405.EXE, 180kB) was compiled using Borland's C++ v.3.1. A binary file (ECPAT.BAS 33kB) includes data of normal and abnormal wave segments of ECG: P wave, PQ interval segment, and QRs complex with/without T wave. A mother file (ECG9405.sys, 57kB) includes 85 data sets to generate ECG waveforms of arrhythmia. Each data set contains a sequence of wave form numbers, the text for questions and answers, and the commands strings. There are five major commands: 1) to create a new window as "wave window"; 2) to make electrocardiogram data; 3) to plot the data on the window; 4) to create a "dialog box" for questions and explanations; and 5) to check the answers. he program gets a data set from the data according to the user's choice. The program then interprets the data set and executes the commands. The wave segment data are plotted in a "wave window" at every 10 milliseconds; this is controlled by the MS-Windows' timer. The timer interval can be changed by selecting the speed button. The ECG waveforms are displayed on a window just like an ordinary ECG monitor with beat sound. Many windows can be created by the user and many ECG waves simultaneously plotted on CRT. 3. USAGE OF THE SYSTEM. The "main window" has a menu that has three items corresponding to the training course: BASIC, TRY, and TEST. Thirty-five types of arrythmias are listed in the "list box" of the windows in BASIC course e.g., sinus arrhythmia, atrial flutter, atrial

  10. Spinal tumor (United States)

    Tumor - spinal cord ... tissue) Myeloma (blood cancer that starts in the plasma cells of the bone marrow) A small number of spinal tumors occur in the nerves of the spinal cord itself. Tumors that start in spinal tissue are ...

  11. Adaptive Computer-Assisted Mammography Training for Improved Breast Cancer Screening (United States)


    detection in mammography ." Medical Physics 31: 958. Timp, S., N. Karssemeijer and J. Hendriks (2003). Analysis of changes in masses using contrast and...Award Number: W81XWH-11-1-0755 TITLE: Adaptive Computer-Assisted Mammography Training for Improved Breast Cancer Screening PRINCIPAL...14Dec2014 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-11-1-0755 Adaptive Computer-Assisted Mammography Training for Improved Breast Cancer

  12. Endolymphatic sac tumor (aggressive papillary tumor of middle ear and temporal bone): sine qua non radiology-pathology and the University of Texas MD Anderson Cancer Center experience. (United States)

    Bell, Diana; Gidley, Paul; Levine, Nicholas; Fuller, Gregory N


    Endolymphatic sac tumor (ELST) is a rare lesion of the skull base for which the origin has recently been ascertained. The endolymphatic sac is derived from neuroectoderm and is located subjacent to the posteromedial surface of the temporal bone. Patients characteristically present with hearing loss, tinnitus, and vertigo; facial nerve paralysis occurs less commonly. An indolent clinical course and long-standing symptom history is typical. Endolymphatic sac tumors are known to occur more frequently in patients with von Hippel-Lindau disease, but this is not a prerequisite for diagnosis because sporadic occurrence is common. Morphologically, all of the ELSTs showed a papillary and glandular architecture. The papillary and glandular structures were lined by a single layer of flattened cuboidal-to-columnar cells that were variably ciliated. Surgery is the treatment of choice for small ELST. Remission may last for years, but local recurrence after surgery, likely secondary to incomplete resection, can occur. Radiotherapy has a 50% cure rate with large or residual tumors. Endolymphatic sac tumor is a rare tumor that can easily be confused with other papillary lesions on histopathologic grounds, with significant treatment implications. Precise preoperative anatomic localization and computed tomography and magnetic resonance imaging feature interpretation play a paramount role in achieving an accurate final diagnosis. Published by Elsevier Inc.

  13. Serum total acid phosphatase for monitoring the clinical course of giant cell tumors of bone--26 patients with 5 local recurrences. (United States)

    Akahane, Tsutomu; Isobe, Ken'ichi; Shimizu, Tominaga


    Giant cell tumor of bone (GCT) is a bone-destroying tumor that sometimes recurs locally after treatment. A recent study showed increased levels of serum total acid phosphatase (TACP). We assessed TACP in the serum of 26 patients with primary GCT, and in 5 of them who developed a local recurrence. We found a correlation between TACP level in serum and tumor size. TACP levels that were elevated preoperatively in patients with GCT became normalized after surgery, but increased in 3 of the 5 patients with local recurrence. TACP could be used as a tumor marker for monitoring response to treatment of GCT.

  14. Computer-assisted versus non-computer-assisted preoperative planning of corrective osteotomy for extra-articular distal radius malunions: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Stockmans Filip


    Full Text Available Abstract Background Malunion is the most common complication of distal radius fracture. It has previously been demonstrated that there is a correlation between the quality of anatomical correction and overall wrist function. However, surgical correction can be difficult because of the often complex anatomy associated with this condition. Computer assisted surgical planning, combined with patient-specific surgical guides, has the potential to improve pre-operative understanding of patient anatomy as well as intra-operative accuracy. For patients with malunion of the distal radius fracture, this technology could significantly improve clinical outcomes that largely depend on the quality of restoration of normal anatomy. Therefore, the objective of this study is to compare patient outcomes after corrective osteotomy for distal radius malunion with and without preoperative computer-assisted planning and peri-operative patient-specific surgical guides. Methods/Design This study is a multi-center randomized controlled trial of conventional planning versus computer-assisted planning for surgical correction of distal radius malunion. Adult patients with extra-articular malunion of the distal radius will be invited to enroll in our study. After providing informed consent, subjects will be randomized to two groups: one group will receive corrective surgery with conventional preoperative planning, while the other will receive corrective surgery with computer-assisted pre-operative planning and peri-operative patient specific surgical guides. In the computer-assisted planning group, a CT scan of the affected forearm as well as the normal, contralateral forearm will be obtained. The images will be used to construct a 3D anatomical model of the defect and patient-specific surgical guides will be manufactured. Outcome will be measured by DASH and PRWE scores, grip strength, radiographic measurements, and patient satisfaction at 3, 6, and 12 months

  15. Magnetic resonance guided focused ultrasound surgery (MRgFUS) of bone metastases: From primary pain palliation to local tumor control (United States)

    Napoli, A.; Leonardi, A.; Andrani, F.; Boni, F.; Anzidei, M.; Catalano, C.


    Purpose: To evaluate the clinical performance of MRgFUS in primary pain palliation of painful bone metastases and in local tumor control. Materials and Methods: We enrolled 26 consecutive patients (female/male 12/14; age: 64.7±7.5yrs) with painful bone metastases. Before and 3 months after MRgFUS treatment pain severity and pain interference scores were assessed according to Brief Pain Inventory-Quality of Life (BPI-QoL) criteria and patients underwent both CT and MRI. Local tumor control was evaluated according to lesion size, density and perfusion at CT, dynamic contrast enhancement at MRI (Discovery 750HD, GE; Gd-Bopta, Bracco) and metabolic activity at PET or scintigraphy. Patients were classified as responders or non-responders. Results: No treatment-related adverse events were recorded during the study. As statistically significant difference between baseline and follow-up values for both pain severity and pain interference scores was observed (pmean SUV=1.2). Conclusion: MRgFUS can be safely and effectively used as the primary treatment for pain palliation in patients with painful bone metastases; moreover our experience demonstrated also a potential role for the MRgFUS in local tumor control.

  16. Morphologic evaluation of the effect of denosumab on giant cell tumors of bone and a new grading scheme

    Directory of Open Access Journals (Sweden)

    Kivilcim Eren Erdogan


    Full Text Available Giant cell tumor (GCT is a rare, usually benign but locally aggressive neoplasm. Recent studies suggest new approaches in light of the elucidation of molecular pathways in bone. The osteolytic nature of GCT is caused by the receptor for activating nuclear factor-kB ligand (RANKL associated osteoclasts. Denosumab is a monoclonal antibody that affects GCT through RANKL and it prevents normal and neoplastic osteolysis. The aim of this study is to evaluate the histopathologic alterations due to denosumab treatment and the efficiency of this drug in GCT therapy. Ten patients had been treated with denosumab and were included in the study. Pretreatment biopsies were interpreted as conventional GCTs and posttreatment biopsies of the ten patients’ GCTs were classified in accordance with the grading system. Only one patient had tumor remaining after treatment. There is limited data on histopathologic alterations that follow denosumab treatment. The bone pathologist should keep these changes in mind because they mimic different types of bone tumors. Furthermore, there is no widely accepted grading system to evaluate the effect of denosumab in GCT. Our study suggested a scheme that would be helpful to evaluate the efficiency of denosumab treatment in GCT.

  17. Computer-assisted discrimination among malignant lymphomas and leukemia using immunophenotyping, intelligent image repositories, and telemicroscopy. (United States)

    Foran, D J; Comaniciu, D; Meer, P; Goodell, L A


    The process of discriminating among pathologies involving peripheral blood, bone marrow, and lymph node has traditionally begun with subjective morphological assessment of cellular materials viewed using light microscopy. The subtle visible differences exhibited by some malignant lymphomas and leukemia, however, give rise to a significant number of false negatives during microscopic evaluation by medical technologists. We have developed a distributed, clinical decision support prototype for distinguishing among hematologic malignancies. The system consists of two major components, a distributed telemicroscopy system and an intelligent image repository. The hybrid system enables individuals located at disparate clinical and research sites to engage in interactive consultation and to obtain computer-assisted decision support. Software, written in JAVA, allows primary users to control the specimen stage, objective lens, light levels, and focus of a robotic microscope remotely while a digital representation of the specimen is continuously broadcast to all session participants. Primary user status can be passed as a token. The system features shared graphical pointers, text messaging capability, and automated database management. Search engines for the database allow one to automatically identify and retrieve images, diagnoses, and correlated clinical data of cases from a "gold standard" database which exhibit spectral and spatial profiles which are most similar to a given query image. The system suggests the most likely diagnosis based on majority logic of the retrieved cases. The system was used to discriminate among three lymphoproliferative disorders and healthy cells. The system provided the correct classification in more than 83% of the cases studied. System performance was evaluated using rigorous statistical assessment and by comparison with human observers.

  18. Hematopoietic colony-stimulating factors mediate tumor-nerve interactions and bone cancer pain

    NARCIS (Netherlands)

    Schweizerhof, Matthias; Stösser, Sebastian; Kurejova, Martina; Njoo, Christian; Gangadharan, Vijayan; Agarwal, Nitin; Schmelz, Martin; Bali, Kiran Kumar; Michalski, Christoph W.; Brugger, Stefan; Dickenson, Anthony; Simone, Donald A.; Kuner, Rohini


    Pain is one of the most severe and debilitating symptoms associated with several forms of cancer. Various types of carcinomas and sarcomas metastasize to skeletal bones and cause spontaneous bone pain and hyperalgesia, which is accompanied by bone degradation and remodeling of peripheral nerves.

  19. Bortezomib Inhibits Giant Cell Tumor of Bone through Induction of Cell Apoptosis and Inhibition of Osteoclast Recruitment, Giant Cell Formation, and Bone Resorption. (United States)

    Xu, Leqin; Luo, Jian; Jin, Rongrong; Yue, Zhiying; Sun, Peng; Yang, Zhengfeng; Yang, Xinghai; Wan, Wei; Zhang, Jishen; Li, Shichang; Liu, Mingyao; Xiao, Jianru


    Giant cell tumor of bone (GCTB) is a rare and highly osteolytic bone tumor that usually leads to an extensive bone lesion. The purpose of this study was to discover novel therapeutic targets and identify potential agents for treating GCTB. After screening the serum cytokine profiles in 52 GCTB patients and 10 normal individuals using the ELISA assay, we found that NF-κB signaling-related cytokines, including TNFα, MCP-1, IL1α, and IL17A, were significantly increased in GCTB patients. The results were confirmed by IHC that the expression and activity of p65 were significantly increased in GCTB patients. Moreover, all of the NF-κB inhibitors tested suppressed GCTB cell growth, and bortezomib (Velcade), a well-known proteasome inhibitor, was the most potent inhibitor in blocking GCTB cells growth. Our results showed that bortezomib not only induced GCTB neoplastic stromal cell (NSC) apoptosis, but also suppressed GCTB NSC-induced giant cell differentiation, formation, and resorption. Moreover, bortezomib specifically suppressed GCTB NSC-induced preosteoclast recruitment. Furthermore, bortezomib ameliorated GCTB cell-induced bone destruction in vivo As a result, bortezomib suppressed NF-κB-regulated gene expression in GCTB NSC apoptosis, monocyte migration, angiogenesis, and osteoclastogenesis. Particularly, the inhibitory effects of bortezomib were much better than zoledronic acid, a drug currently used in treating GCTB, in our in vitro experimental paradigms. Together, our results demonstrated that NF-κB signaling pathway is highly activated in GCTB, and bortezomib could suppress GCTB and osteolysis in vivo and in vitro, indicating that bortezomib is a potential agent in the treatment of GCTB. Mol Cancer Ther; 15(5); 854-65. ©2016 AACR. ©2016 American Association for Cancer Research.

  20. Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. II. Juxtacortical cartilage tumors

    Energy Technology Data Exchange (ETDEWEB)

    Brien, E.W. [Orthopaedic Oncology Service, Orthopaedic Hospital, Los Angeles, CA (United States)]|[Musculoskeletal Tumor Service, Orthopaedic Hospital, Los Angeles, CA (United States); Mirra, J.M.; Luck, J.V. Jr. [Orthopaedic Oncology Service, Orthopaedic Hospital, Los Angeles, CA (United States)


    In part I, we reviewed the varied clinical presentations, pathogenesis, histologic findings, radiologic findings, and treatment of intramedullary cartilaginous lesions of bone. In this section, we will evaluate our cases and consultations of juxtacortical cartilaginous tumors. Radiographic differential diagnosis includes the numerous juxtacortical lesions particularly osteochondroma, parosteal chondroma, Trevor`s disease, trauma (fracture and periostitis ossificans), and the low- and high-grade surface osteosarcomas. By emphasizing pathogenesis in conjunction with radiographic and histologic findings, pitfalls in diagnosis and subsequent treatment can be avoided in such cases. (orig.) With 32 figs., 2 tabs., 32 refs.

  1. Outcome of lower-limb preservation with an expandable endoprosthesis after bone tumor resection in children. (United States)

    Henderson, Eric R; Pepper, Andrew M; Marulanda, German; Binitie, Odion T; Cheong, David; Letson, G Douglas


    The optimal treatment of malignant pediatric lower-extremity bone tumors is controversial. Expandable endoprostheses allow limb preservation, but the revision rate and limited function are considered barriers to their use. This study investigated the functional, emotional, and oncologic outcomes of thirty-eight patients treated with an expandable endoprosthesis. A retrospective chart review was performed, and surviving patients were asked to complete the Musculoskeletal Tumor Society (MSTS) outcomes instrument and the Pediatric Outcomes Data Collection Instrument (PODCI). Additional data including the range of hip and knee motion, limb-length discrepancy, and total lengthening were also obtained. Thirty-eight patients were treated with an expandable endoprosthesis, and twenty-six of these patients were alive at the time of the study. The mean global MSTS score was 26.1, and the mean global PODCI score was 85.8. The mean emotional acceptance and happiness subscores were high. The mean sagittal-plane hip motion in patients who had undergone replacement of the proximal aspect of the femur was 103°. The mean knee motion in patients who had undergone replacement of the proximal aspect of the femur, the distal aspect of the femur, or the proximal aspect of the tibia was 127°, 97°, and 107°, respectively. The mean lengthening at the time of skeletal maturity was 4.5 cm, and the mean limb-length discrepancy was 0.7 cm. Forty-two percent of the patients experienced complications, with ten patients requiring prosthesis revision and two of these patients requiring amputation. Current technology does not offer a single best reconstruction option for children. Previous studies and the present series have indicated that physical and emotional functioning in patients treated with an expandable endoprosthesis are good but that complication rates remain high. Amputation and rotationplasty are alternative treatments if patients and their families are amenable to these procedures

  2. [Psychopathological factors of surgical biopsy within the scope of bone tumors]. (United States)

    Pacault-Legendre, V; Anract, P; Courpied, J P; Ferrand, I


    Some particularities of cancerous conditions in bone surgery have profound psychological implications for the patients involved: their angst of death is compounded by the fear of mutilation or physical impairment. All medical treatment is undertaken to save the patient's life, but at what cost? The reactions of some patients at different stages of the process, before the diagnosis is established--during a brief stay at the hospital, when biopsy is performed--, when the diagnosis is disclosed and later, during the period of treatment, affect the medical team and are apt to seriously undermine the relationship between doctors and patients. The emergence of a tumor is a major event in a patient's life, even if this tumor eventually turns out to be of the non-malicious kind. Psychological counseling and even the prescription of psychotropic medication may prove necessary: the patient must be helped to cope with a newly acquired sense of powerlessness and the awareness of his or her own mortality. At every step of this personal experience, whether before, during or after the performance of the biopsy, the patient is likely to need help to cope with a sense of anxiety, uncertainty, loneliness, or the consequences of a brutal disclosure of his or her medical condition. Some psychic reactions may take us by surprise. In the first place, we have been puzzled by the discrepancy between the simplicity of the biopsy in operative, surgical terms and the highly emotional reaction it elicited among some patients. To the surgeon, biopsy often amounts to a quick surgical gesture. During their brief stay at the hospital, patients whose condition commands no particular attention are likely to suffer a sense of loneliness while they expect the verdict of the biopsy, and these emotions may be harder to cope with than the implications of serious surgery, should the preliminary analysis require it. Even if it turns out that surgery is not necessary, the anxiety just won't go away and a

  3. Enrichment and Molecular Analysis of Breast Cancer Disseminated Tumor Cells from Bone Marrow Using Microfiltration.

    Directory of Open Access Journals (Sweden)

    Sreeraj G Pillai

    Full Text Available Molecular characterization of disseminated tumor cells (DTCs in the bone marrow (BM of breast cancer (BC patients has been hindered by their rarity. To enrich for these cells using an antigen-independent methodology, we have evaluated a size-based microfiltration device in combination with several downstream biomarker assays.BM aspirates were collected from healthy volunteers or BC patients. Healthy BM was mixed with a specified number of BC cells to calculate recovery and fold enrichment by microfiltration. Specimens were pre-filtered using a 70 μm mesh sieve and the effluent filtered through CellSieve microfilters. Captured cells were analyzed by immunocytochemistry (ICC, FISH for HER-2/neu gene amplification status, and RNA in situ hybridization (RISH. Cells eluted from the filter were used for RNA isolation and subsequent qRT-PCR analysis for DTC biomarker gene expression.Filtering an average of 14×106 nucleated BM cells yielded approximately 17-21×103 residual BM cells. In the BC cell spiking experiments, an average of 87% (range 84-92% of tumor cells were recovered with approximately 170- to 400-fold enrichment. Captured BC cells from patients co-stained for cytokeratin and EpCAM, but not CD45 by ICC. RNA yields from 4 ml of patient BM after filtration averaged 135ng per 10 million BM cells filtered with an average RNA Integrity Number (RIN of 5.3. DTC-associated gene expression was detected by both qRT-PCR and RISH in filtered spiked or BC patient specimens but, not in control filtered normal BM.We have tested a microfiltration technique for enrichment of BM DTCs. DTC capture efficiency was shown to range from 84.3% to 92.1% with up to 400-fold enrichment using model BC cell lines. In patients, recovered DTCs can be identified and distinguished from normal BM cells using multiple antibody-, DNA-, and RNA-based biomarker assays.

  4. Bone marrow-derived myofibroblasts are the providers of pro-invasive matrix metalloproteinase 13 in primary tumor

    DEFF Research Database (Denmark)

    Lecomte, Julie; Masset, Anne; Blacher, Silvia


    Carcinoma-associated fibroblasts are key contributors of the tumor microenvironment that regulates carcinoma progression. They consist of a heterogeneous cell population with diverse origins, phenotypes, and functions. In the present report, we have explored the contribution of bone marrow (BM...... provide evidence that one third of BM-derived GFP(+) cells infiltrating the tumor expressed the chondroitin sulfate proteoglycan NG2 (pericytic marker) or α-smooth muscle actin (α-SMA, myofibroblast marker), whereas almost 90% of Thy1(+) fibroblasts were originating from resident GFP-negative cells. MMP13......producing cells were exclusively α-SMA(+) cells and derived from GFP(+) BM cells. To investigate their impact on tumor invasion, we isolated mesenchymal stem cells (MSCs) from the BM of wild-type and MMP13-deficient mice. Wild-type MSC promoted cancer cell invasion in a spheroid assay, whereas MSCs obtained...

  5. Does the presence of tumor-induced cortical bone destruction at CT have any prognostic value in newly diagnosed diffuse large B-cell lymphoma?

    NARCIS (Netherlands)

    Adams, Hugo J A; de Klerk, John M H; Fijnheer, Rob; Heggelman, Ben G F; Dubois, Stefan V.; Nievelstein, Rutger A J; Kwee, Thomas C.


    Purpose: To determine the prognostic value of tumor-induced cortical bone destruction at computed tomography (CT) in newly diagnosed diffuse large B-cell lymphoma (DLBCL). Materials and methods: This retrospective study included 105 patients with newly diagnosed DLBCL who had undergone CT and bone

  6. Phenotypic characterization of drug resistance and tumor initiating cancer stem cells from human bone tumor osteosarcoma cell line OS-77

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    Yue Zhang


    Full Text Available The cancer stem cell theory suggest that presence of small subpopulation of cancer stem cells are the major implication in the cancer treatment and also responsible for tumor recurrence. Based on Hoechst 33342 dye exclusion technique, we have identified about 3.3% of cancer stem like side population (SP cells from human osteosarcoma OS-77 cell line whose prevalence is significantly reduced to 0.3% after treatment with verapamil. The sphere formation assay revealed that osteosarcoma SP cells are highly capable to form tumor spheres (sarcospheres. Further by immunocytochemistry and RT-PCR, we show that OS-77 SP cells have enhanced expression of stem cell surface markers such as CD44, Nanog and ATP-binding cassette (ABC transporter gene (ABCG2 which contributes to self-renewal and drug resistance, respectively. Our findings help to designing a novel therapeutic drug which could effectively target the cancer stem cells and prevent the tumor relapse.

  7. A gene signature of bone metastatic colonization sensitizes for tumor-induced osteolysis and predicts survival in lung cancer. (United States)

    Luis-Ravelo, D; Antón, I; Zandueta, C; Valencia, K; Ormazábal, C; Martínez-Canarias, S; Guruceaga, E; Perurena, N; Vicent, S; De Las Rivas, J; Lecanda, F


    Bone metastasis of lung adenocarcinoma (AC) is a frequent complication of advanced disease. The purpose of this study was to identify key mediators conferring robust prometastatic activity with clinical significance. We isolated highly metastatic subpopulations (HMS) using a previously described in vivo model of lung AC bone metastasis. We performed transcriptomic profiling of HMS and stringent bioinformatics filtering. Functional validation was assessed by overexpression and lentiviral silencing of single, double and triple combination in vivo and in vitro. We identified HDAC4, PITX1 and ROBO1 that decreased bone metastatic ability after their simultaneous abrogation. These effects were solely linked to defects in osseous colonization. The molecular mechanisms related to bone colonization were mediated by non-cell autonomous effects that include the following: (1) a marked decrease in osteoclastogenic activity in vitro and in vivo, an effect associated with reduced pro-osteoclastogenic cytokines IL-11 and PTHrP expression levels, as well as decreased in vitro expression of stromal rankl in conditions mimicking tumor-stromal interactions; (2) an abrogated response to TGF-β signaling by decreased phosphorylation and levels of Smad2/3 in tumor cells and (3) an impaired metalloproteolytic activity in vitro. Interestingly, coexpression of HDAC4 and PITX1 conferred high prometastatic activity in vivo. Further, levels of both genes correlated with patients at higher risk of metastasis in a clinical lung AC data set and with a poorer clinical outcome. These findings provide functional and clinical evidence that this metastatic subset is an important determinant of osseous colonization. These data suggest novel therapeutic targets to effectively block lung AC bone metastasis.

  8. En Bloc Resection of Primary Malignant Bone Tumor in the Cervical Spine Based on 3-Dimensional Printing Technology. (United States)

    Xiao, Jian-Ru; Huang, Wen-Ding; Yang, Xing-Hai; Yan, Wang-Jun; Song, Dian-Wen; Wei, Hai-Feng; Liu, Tie-Long; Wu, Zhi-Peng; Yang, Cheng


    To investigate the feasibility and safety of en bloc resection of cervical primary malignant bone tumors by a combined anterior and posterior approach based on a three-dimensional (3-D) printing model. Five patients with primary malignant bone tumors of the cervical spine underwent en bloc resection via a one-stage combined anteroposterior approach in our hospital from March 2013 to June 2014. They comprised three men and two women of mean age 47.2 years (range, 26-67 years). Three of the tumors were chondrosarcomas and two chordomas. Preoperative 3-D printing models were created by 3-D printing technology. Sagittal en bloc resections were planned based on these models and successfully performed. A 360° reconstruction was performed by spinal instrumentation in all cases. Surgical margins, perioperative complications, local control rate and survival rate were assessed. All patients underwent en bloc excision via a combined posterior and anterior approach in one stage. Mean operative time and estimated blood loss were 465 minutes and 1290 mL, respectively. Mean follow-up was 21 months. Wide surgical margins were achieved in two patients and marginal resection in three; these three patients underwent postoperative adjuvant radiation therapy. One vertebral artery was ligated and sacrificed in each of three patients. Nerve root involved by tumor was sacrificed in three patients with preoperative upper extremity weakness. One patient (Case 3) had significant transient radiculopathy with paresis postoperatively. Another (Case 4) with C 4 and C 5 chordoma had respiratory difficulties and pneumonia after surgery postoperatively. He recovered completely after 2 weeks' management with a tracheotomy tube and antibiotics in the intensive care unit. No cerebrovascular complications and wound infection were observed. No local recurrence or instrumentation failure were detected during follow-up. Though technically challenging, it is feasible and safe to perform en

  9. Radiation therapy for glomus tumors of the temporal bone; Tratamento radioterapico dos tumores glomicos do osso temporal

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    Dall' Igna, Celso; Antunes, Marcelo B. [Rio Grande do Sul Univ., Porto Alegre, RS (Brazil). Hospital das Clinicas. Servico de Otorrinolaringologia e Cirurgia da Cabeca e Pescoco; Dall' Igna, Daniela Pernigotti [Parana Univ., Curitiba, PR (Brazil)


    The treatment of glomic tumors has been controversial since its first description. It can be done with surgery, radiotherapy or just expectation. Aim: the objective of this paper was to evaluate the effectiveness and complications of radiotherapy.Study Design: clinical with transversal cohort. Material and method: it was made a retrospective review in the charts of the patients with glomus jugular tumors treated with radiotherapy. Disease control was determined by (1) no progression of symptoms or cranial nerve dysfunction or (2) no progression of the lesion in radiological follow-up. It was also evaluated the follow-up period and the sequelae of the treatment. Results: twelve patients were included, 8 of then women. The follow-up period was from 3 to 35 years, with a media of 11,6 years. The main symptoms were: hearing loss, pulsate tinnitus, dizziness and vertigo. The signs were pulsate retrotympanic mass, facial palsy and cofosis. The tumors were staged using Fischs classification. The radiotherapy was performed with linear accelerator with dose ranging from 4500-5500 in 4-6 weeks. In the follow-up period were possible to identify sequelaes like dermatitis, meatal stenosis, cofosis and facial palsy. Discussion: the signs and symptoms were the same found in the medical literature. The type and dosages of the radiotherapy were also the same of others reports. All patients had improvement of the symptoms and only one was not considered as having disease controlled. Complications were, in general, minor complications, with exception of the cofosis and facial palsy. Conclusion: radiotherapy is a viable alternative to treatment of these tumors because their good response and low level of complications. It should be considered specially in advanced tumors where a surgical procedure could bring a high level of morbidity. (author)

  10. Benefits of molecular pathology in the diagnosis of musculoskeletal disease : Part II of a two-part review: bone tumors and metabolic disorders. (United States)

    Flanagan, Adrienne M; Delaney, David; O'Donnell, Paul


    The second part of this review, on the benefits of molecular pathology in the diagnosis disease, focuses on the genetics of bone tumors and metabolic disease. Unlike soft tissue tumors, the number of currently exploitable molecular abnormalities for diagnosing bone neoplasms is small, although the same gene rearrangements are found in primitive neuroectodermal tumor/Ewing sarcoma in both skeletal and extraskeletal sites. Compared with soft tissue tumors, genetic abnormalities, which are valuable to diagnosticians in skeletal disease, are often germline and post-zygotic aberrations rather than somatic translocations. In addition, the review highlights the range of disease entities classified as "osteoclast-rich lesions," some of which harbor germline mutations. It also addresses the importance of phosphate metabolism in skeletal disorders including phosphaturic mesenchymal tumor, vitamin D-resistant rickets, and tumoral calcinosis.

  11. Use of warm Ringer's lactate solution in the management of locally advanced giant cell tumor of bone. (United States)

    Waikakul, Saranatra; Asavamongkolkul, Apichat; Phimolsarnti, Rapin


    This study was conducted to discover the effectiveness and safety of using warm Ringer's lactate solution (RLS) as a local treatment in the management of locally advanced giant cell tumor of bone with marked soft tissue invasion, including nearby neurovascular bundles. This was a longitudinal cohort study with an average follow-up period of 4.6 ± 0.3 years, ranging from 4.2 to 5.9 years. There were 21 patients (9 male and 12 female), with the ages of subjects ranging from 12 to 64 years. Eight patients (38 %) were tumor recurrence cases. Pathological fracture was found in 15 patients (71 %). After extended curettage, warm RLS (50 °C) was locally applied for 20 min. Bone stabilization and reconstruction were then performed. All patients survived the operation. No additional neurovascular injury resulting from the use of warm RLS was found. Patients who had neurological deficit before the operation experienced significant improvement in motor and sensory function during the follow-up period. Complication was found in one patient (5 %). Two patients (9.5 %), had tumor recurrence and 19 patients (90.5 %) were tumor-free with good to acceptable function. Use of warm Ringer's lactate solution as an adjunctive local treatment during intra-lesional curettage of giant cell tumor with locally soft tissue extension was found to be safe with relatively low recurrence rate. However, additional studies to identify the optimum thermoablation dose at each part of the body should be undertaken before this technique can be used as a standard treatment.

  12. Low Infection Rate after Tumor Hip Arthroplasty for Metastatic Bone Disease in a Cohort Treated with Extended Antibiotic Prophylaxis

    Directory of Open Access Journals (Sweden)

    Werner H. Hettwer


    Full Text Available Background. Compared to conventional hip arthroplasty, endoprosthetic reconstruction after tumor resection is associated with a substantially increased risk of periprosthetic joint infection (PJI, with reported rates of around 10% in a recent systematic review. The optimal duration of antibiotic prophylaxis for this patient population remains unknown. Material and Methods. To establish the infection rate associated with prolonged antibiotic prophylaxis in our department, we performed a retrospective review of all adult patients who underwent endoprosthetic reconstruction of the proximal femur after tumor resection for metastatic bone disease during a 4-year period from 2010 to 2013 (n=105 patients. Results. Intravenous antibiotic prophylaxis was administrated for an extended duration of a mean of 7.4 days. The overall infection rate was 3.6% (4/111 implants, infection free survival was 96% at 2 years, and the risk of amputation associated with infection was 25% (1/4 patients. Discussion. Preemptive eradication of bacterial contamination may be of value in certain clinical situations, where the risk level and consequences of implant-associated infection are unacceptable. Our findings suggest that extended postoperative antibiotic prophylaxis may reduce the risk of PJI in patients undergoing tumor resection and endoprosthetic replacement for metastatic bone disease associated impending or de facto pathologic fractures of the proximal femur.

  13. Experimental validation of predicted application accuracies for computer-assisted (CAS) intraoperative navigation with paired-point registration. (United States)

    Perwög, Martina; Bardosi, Zoltan; Freysinger, Wolfgang


    The target registration error (TRE) is a crucial parameter to estimate the potential usefulness of computer-assisted navigation intraoperatively. Both image-to-patient registration on base of rigid-body registration and TRE prediction methods are available for spatially isotropic and anisotropic data. This study presents a thorough validation of data obtained in an experimental operating room setting with CT images. Optical tracking was used to register a plastic skull, an anatomic specimen, and a volunteer to their respective CT images. Plastic skull and anatomic specimen had implanted bone fiducials for registration; the volunteer was registered with anatomic landmarks. Fiducial localization error, fiducial registration error, and total target error (TTE) were measured; the TTE was compared to isotropic and anisotropic error prediction models. Numerical simulations of the experiment were done additionally. The user localization error and the TTE were measured and calculated using predictions, both leading to results as expected for anatomic landmarks and screws used as fiducials. TRE/TTE is submillimetric for the plastic skull and the anatomic specimen. In the experimental data a medium correlation was found between TRE and target localization error (TLE). Most of the predictions of the application accuracy (TRE) fall in the 68% confidence interval of the measured TTE. For the numerically simulated data, a prediction of TTE was not possible; TRE and TTE show a negligible correlation. Experimental application accuracy of computer-assisted navigation could be predicted satisfactorily with adequate models in an experimental setup with paired-point registration of CT images to a patient. The experimental findings suggest that it is possible to run navigation and prediction of navigation application accuracy basically defined by the spatial resolution/precision of the 3D tracker used.


    Directory of Open Access Journals (Sweden)

    Mariana FAUR


    Full Text Available The computer-assisted instruction play an increasingly important role in providing enhancement to instruction. The purpose of this study was to evaluate the effectiveness of computer assisted instruction in Biology lessons. In this study we compared the differences in retention of information by pupils using the two different instructional modes, CAI or written text. Initial results of the study indicated that pupils in treatment classes with the computer-assisted instruction, and in control classes, all made important gains in knowledge. Further research may be needed to determine whether the students' improved learning performance could be attributed to the use of the computer or to the restructuring of the conventional lesson with interesting informations.

  15. Freezing Nitrogen Ethanol Composite May be a Viable Approach for Cryotherapy of Human Giant Cell Tumor of Bone. (United States)

    Wu, Po-Kuei; Chen, Cheng-Fong; Wang, Jir-You; Chen, Paul Chih-Hsueh; Chang, Ming-Chau; Hung, Shih-Chieh; Chen, Wei-Ming


    Liquid nitrogen has been used as adjuvant cryotherapy for treating giant cell tumor (GCT) of bone. However, the liquid phase and ultrafreezing (-196° C) properties increase the risk of damage to the adjacent tissues and may lead to perioperative complications. A novel semisolid cryogen, freezing nitrogen ethanol composite, might mitigate these shortcomings because of less-extreme freezing. We therefore wished to evaluate freezing nitrogen ethanol composite as a coolant to determine its properties in tumor cryoablation. (1) Is freezing nitrogen ethanol composite-mediated freezing effective for tumor cryoablation in an ex vivo model, and if yes, is apoptosis involved in the tumor-killing mechanism? (2) Does freezing nitrogen ethanol composite treatment block neovascularization and neoplastic progression of the grafted GCTs and is it comparable to that of liquid nitrogen in an in vivo chicken model? (3) Can use of freezing nitrogen ethanol composite as an adjuvant to curettage result in successful short-term treatment, defined as absence of GCT recurrence at a minimum of 1 year in a small proof-of-concept clinical series? The cryogenic effect on bone tissue mediated by freezing nitrogen ethanol composite and liquid nitrogen was verified by thermal measurement in a time-course manner. Cryoablation on human GCT tissue was examined ex vivo for effect on morphologic features (cell shrinkage) and DNA fragmentation (apoptosis). The presumed mechanism was investigated by molecular analysis of apoptosis regulatory proteins including caspases 3, 8, and 9 and Bax/Bcl-2. Chicken chorioallantoic membrane was used as an in vivo model to evaluate the effects of freezing nitrogen ethanol composite and liquid nitrogen treatment on GCT-derived neovascularization and tumor neoplasm. A small group of patients with GCT of bone was treated by curettage and adjuvant freezing nitrogen ethanol composite cryotherapy in a proof-of-concept study. Tumor recurrence and perioperative

  16. Ossified soft tissue recurrence of giant cell tumor of the bone: four case reports with follow-up radiographs, CT, ultrasound, and MR images

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    Park, Sun-Young; Lee, Min Hee; Chung, Hye Won [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Lee, Jong Suk [University of Ulsan College of Medicine, Asan Medical Center, Department of Orthopaedic Surgery, Seoul (Korea, Republic of); Song, Joon Seon [University of Ulsan College of Medicine, Asan Medical Center, Department of Pathology, Seoul (Korea, Republic of)


    Giant cell tumor (GCT) of the bone is a benign tumor with a high incidence of recurrence. The majority of recurrence occurs in the bone, typically where curettage was performed previously. Soft tissue recurrence is much less common and often shows ossification at the periphery of the soft tissue mass. We report four cases of ossified soft tissue recurrence of giant cell tumor of the bone after surgery at follow-up examination using plain radiography, ultrasound, CT, and MR imagings. Imaging findings of soft tissue recurrence with peripheral or central ossification were reviewed with pathologic correlation. To the best of our knowledge, this is the first report to describe soft tissue tumor recurrence with ossification illustrated and monitored at various imaging modalities over an extended follow-up period. (orig.)

  17. Computer-assisted radiographic characterization of alloimplant materials used as bone substitutes in dentistry (United States)

    Abdel-Wahed, Naglaa; Ahmed, Abdel-Wahab S.; Zein Elabedeen, Adel; Gadallah, Shabaan M.; Solouma, Nahed H.; Kadah, Yasser M.


    We develop a computerized system for evaluation of alloimplant procedures in dentistry from x-ray images. The goal of this system is to help clinicians make more accurate evaluation of their surgical procedures as well as to guide them in selecting the most appropriate alloimplant material in an objective manner. A study was conducted whereby three types of alloimplant materials were inserted in surgical defects in the tibia of dogs. Each animal had four such defects for the three different materials in addition to a control defect that was intentionally left empty. The defect locations were imaged using x-rays at periodic intervals starting immediately after the operation. The animals were sacrificed at different times after the surgical operation. The acquired images were paired with their correct diagnosis and split into two sets representing the learning and testing data for our computerized system. The plain x-ray films were scanned using a standard film digitizer and standardized in size and intensity using a step wedge that was imaged beside the region of interest. A set of first and second order textural and radiometric parameters were extracted from each alloimplant location outlined by the radiographer to describe its clinical status in a quantitative manner.

  18. [Computer-assisted teaching in medical education--development of methods and supplemental materials]. (United States)

    Santek, F; Bozikov, J; Kern, J; Dezelić, G


    A review of the elementary types of materials for the computer assisted learning (CAI--Computer Assisted Instruction) is given in this paper. It shows our initial experiences in creating the computer educational materials of the patient management simulation type, destinated for the primary care physicians. A computer simulation program "First Aid in Traffic Accident" is described as an example. A typical structure of these materials is shown. The materials had been developed using the own authoring system, a computer program which enables the teachers and other experts to create the computer educational materials independently, with the minimal help of the professional computer experts.

  19. [Clinical analysis of 12 cases of orthognathic surgery with digital computer-assisted technique]. (United States)

    Tan, Xin-ying; Hu, Min; Liu, Chang-kui; Liu, Hua-wei; Liu, San-xia; Tao, Ye


    This study was to investigate the effect of the digital computer-assisted technique in orthognathic surgery. Twelve patients from January 2008 to December 2011 with jaw malformation were treated in our department. With the help of CT and three-dimensional reconstruction technique, 12 patients underwent surgical treatment and the results were evaluated after surgery. Digital computer-assisted technique could clearly show the status of the jaw deformity and assist virtual surgery. After surgery all patients were satisfied with the results. Digital orthognathic surgery can improve the predictability of the surgical procedure, and to facilitate patients' communication, shorten operative time, and reduce patients' pain.

  20. CT-Guided Bone Biopsies in Metastatic Castration-Resistant Prostate Cancer: Factors Predictive of Maximum Tumor Yield. (United States)

    Holmes, Michael G; Foss, Erik; Joseph, Gabby; Foye, Adam; Beckett, Brooke; Motamedi, Daria; Youngren, Jack; Thomas, George V; Huang, Jiaoti; Aggarwal, Rahul; Alumkal, Joshi J; Beer, Tomasz M; Small, Eric J; Link, Thomas M


    To evaluate the success rate of CT-guided bone biopsies in metastatic castration-resistant prostate cancer (mCRPC) and to investigate associated technical, imaging, and clinical parameters affecting diagnostic yields. Eighty CT-guided bone biopsy specimens were obtained from 72 men (median age, 68 y; range, 49-89 y) enrolled in a multicenter trial to identify mechanisms of resistance in mCRPC. Successful biopsy was determined by histologic confirmation of tumor cells and successful isolation of RNA for molecular analysis. The overall success rate of CT-guided bone biopsies was 69% (55/80) based on histology and 64% (35/55) based on isolation of molecular material for RNA sequencing. Biopsies performed in lesions with areas of radiolucency had significantly higher diagnostic yields compared with lesions of predominantly dense sclerosis (95% vs 33%; P = .002) and lesions of predominantly subtle sclerosis (95% vs 65%; P = .04). Success rates increased in lesions with density ≤ 475 HU (79% for ≤ 475 HU vs 33% for > 475 HU; P = .001) and in lesions with ill-defined margins (76% for ill-defined margins vs 36% for well-circumscribed margins; P = .005). Alkaline phosphatase was the only clinical parameter to correlate significantly with diagnostic yield (83% for > 110 U/L vs 50% for ≤ 110 U/L; P = .001). Image-guided bone tumor biopsies can be successfully used to acquire cellular and molecular material for analyses in patients with osteoblastic prostate cancer metastases. Diagnostic yields are significantly increased in lesions with areas of radiolucency, density ≤ 475 HU, ill-defined margins, and interval growth and in patients with alkaline phosphatase > 110 U/L. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  1. Surgical treatment of metastasic tumors to long bones in the material of the Unit. (United States)

    Karwicki, Lech; Kmieciak, Marek; Kopka, Maciej


    Background. Neoplasms of limbs are appear as primary of changes or as bone metastases. Material and methods. In 1989-2002 due to neoplasms limbs 795 patients were hospitalised, of which 278 suffered from malignant metastases to bones. In this group, 242 patients with lesions localised within the femoral (169), humeral (55) and tibial (18) bones were identified. In 75% of patients pathological fractures were diagnosed, in the remaining ones the metastasis was manifested in the form of osteolytic lesion. In most cases early surgical treatment was performed to eliminate pain complaints, improve patient's physical mobility through restoration of limb functions and also to enable nursing care to be performed in palliative management. The choice of treatment method depended on: location of metastasis, degree of bone tissue destruction, type of primary tumour, progression of malignant process and technical resources. Within the long bones intramedullary nails (189) of different generations were implanted. In the proximal part of femoral bone various types of endoprostheses (65) were used, enabling oncological radicalism and early rehabilitation of the patients. Results. Resection of bones with neoplasm-induced lesions, filling the lesion with bony cement and stabilisation with blocking nails permitted early rehabilitation of patients. In our material the most common malignancies inducing metastases were: breast, kidney, lung cancers and myeloma. Patients with these neoplasms constituted nearly 74% of all hospitalised subjects. Conclusions. Necessity of systemic management and importance of early surgical treatment of metastases in specialized centres were underlined.

  2. Computed tomography in the analysis of calcification patterns in pediatric bone tumors of the hip: a new approach; Tomografia computadorizada na analise dos padroes de calcificacoes nos tumores osseos da bacia em pediatria: nova abordagem

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    Oliveira, Gabriel Antonio de; Werlang, Henrique Zambenedetti; Bergoli, Pedro Martins [Hospital Universitario Cassiano Antonio de Morais/Hospital Infantil Nossa Senhora da Gloria, Vitoria, ES (Brazil). Centro de Diagnostico por Imagem]. E-mail:; Frechiani, Madalena; Oliveira, Fernao [Hospital Infantil Nossa Senhora da Gloria, Vitoria, ES (Brazil)


    Objective: In the pediatric group, the radiological diagnosis of bone tumors of the hip is difficult and presents some peculiarities, but reviewed literature does not approach this specific problem. The objective of the present study was to investigate the existence of reliable radiological patterns for the differential diagnosis of these tumors. Materials And Methods: Radiological findings of bone tumors of the hip in ten patients in the age range between 8 and 19 years have been reviewed. Results: Bone reaction (sclerosis or lysis), periosteal reaction (lamellar with single or multiple layers, or radial), tumor extent in the bone and level of soft tissues invasion have presented low specificity. Soft tissue calcifications, when considered as a whole, were non-specific. However, when those calcifications with varied shapes and sizes, nearby the affected bone (pattern I) were separated from those, thin and amorphous, away from the bone (pattern II), we have observed that the pattern I was totally non-specific, and the pattern II was found in the three cases of osteosarcoma (100%) and in only one case of Ewing's sarcoma (16.6%). Conclusion: In the present study, pattern II calcifications have shown a 100% sensitivity and 90% specificity for osteosarcoma. However, their importance may be not limited to the radiological diagnosis. Pattern II calcifications indicate probably ideal sites for biopsy. (author)

  3. Computer assisted Objective structured clinical examination versus Objective structured clinical examination in assessment of Dermatology undergraduate students

    Directory of Open Access Journals (Sweden)

    Richa Chaudhary


    Conclusions: Computer assisted objective structured clinical examination was found to be a valid, reliable and effective format for dermatology assessment, being rated as the preferred format by examiners.

  4. Radiotherapy for marginally resected, unresectable or recurrent giant cell tumor of the bone: a rare cancer network study

    Directory of Open Access Journals (Sweden)

    Robert C. Miller


    Full Text Available The role of radiotherapy for local control of marginally resected, unresectable, and recurrent giant cell tumors of bone (GCToB has not been well defined. The number of patients affected by this rare disease is low. We present a series of 58 patients with biopsy proven GCToB who were treated with radiation therapy. A retrospective review of the role of radiotherapy in the treatment of GCToB was conducted in participating institutions of the Rare Cancer Network. Eligibility criteria consisted of the use of radiotherapy for marginally resected, unresectable, and recurrent GCToB. Fifty-eight patients with biopsy proven GCToB were analyzed from 9 participating North American and European institutions. Forty-five patients had a primary tumor and 13 patients had a recurrent tumor. Median radiation dose was 50 Gy in a median of 25 fractions. Indication for radiation therapy was marginal resection in 33 patients, unresectable tumor in 13 patients, recurrence in 9 patients and palliation in 2 patients. Median tumor size was 7.0 cm. A significant proportion of the tumors involved critical structures. Median follow- up was 8.0 years. Five year local control was 85% . Of the 7 local failures, 3 were treated successfully with salvage surgery. All patients who received palliation achieved symptom relief. Five year overall survival was 94%. None of the patients experienced grade 3 or higher acute toxicity. This study reports a large published experience in the treatment of GCToB with radiotherapy. Radiotherapy can provide excellent local control for incompletely resected, unresectable or recurrent GCToB with acceptable morbidity.

  5. Computer-assisted orthopaedic surgery and robotic surgery in total hip arthroplasty. (United States)

    Sugano, Nobuhiko


    Various systems of computer-assisted orthopaedic surgery (CAOS) in total hip arthroplasty (THA) were reviewed. The first clinically applied system was an active robotic system (ROBODOC), which performed femoral implant cavity preparation as programmed preoperatively. Several reports on cementless THA with ROBODOC showed better stem alignment and less variance in limb-length inequality on radiographic evaluation, less incidence of pulmonary embolic events on transesophageal cardioechogram, and less stress shielding on the dual energy X-ray absorptiometry analysis than conventional manual methods. On the other hand, some studies raise issues with active systems, including a steep learning curve, muscle and nerve damage, and technical complications, such as a procedure stop due to a bone motion during cutting, requiring re-registration and registration failure. Semi-active robotic systems, such as Acrobot and Rio, were developed for ease of surgeon acceptance. The drill bit at the tip of the robotic arm is moved by a surgeon's hand, but it does not move outside of a milling path boundary, which is defined according to three-dimensional (3D) image-based preoperative planning. However, there are still few reports on THA with these semi-active systems. Thanks to the advancements in 3D sensor technology, navigation systems were developed. Navigation is a passive system, which does not perform any actions on patients. It only provides information and guidance to the surgeon who still uses conventional tools to perform the surgery. There are three types of navigation: computed tomography (CT)-based navigation, imageless navigation, and fluoro-navigation. CT-based navigation is the most accurate, but the preoperative planning on CT images takes time that increases cost and radiation exposure. Imageless navigation does not use CT images, but its accuracy depends on the technique of landmark pointing, and it does not take into account the individual uniqueness of the anatomy

  6. Global computer-assisted appraisal of osteoporosis risk in Asian women: an innovative study. (United States)

    Chang, Shu F; Hong, Chin M; Yang, Rong S


    To develop a computer-assisted appraisal system of osteoporosis that can predict osteoporosis health risk in community-dwelling women and to use it in an empirical analysis of the risk in Asian women. As the literature indicates, health risk assessment tools are generally applied in clinical practice for patient diagnosis. However, few studies have explored how to assist community-dwelling women to understand the risk of osteoporosis without invasive data. A longitudinal, evidence-based study. The first stage of this study is to establish a system that combines expertise in nursing, medicine and information technology. This part includes information from random samples (n = 700), including data on bone mineral density, osteoporosis risk factors, knowledge, beliefs and behaviour, which are used as the health risk appraisal system database. The second stage is to apply an empirical study. The relative risks of osteoporosis of the participants (n = 300) were determined with the system. The participants that were classified as at-risk were randomly grouped into experimental and control groups. Each group was treated using different nursing intervention methods. The sensitivity and specificity of the analytical tools was 75%. In empirical study, analysis results indicate that the prevalence of osteoporosis was 14.0%. Data indicate that strategic application of multiple nursing interventions can promote osteoporosis prevention knowledge in high-risk women and enhance the effectiveness of preventive action. The system can also provide people in remote areas or with insufficient medical resources a simple and effective means of managing health risk and implement the idea of self-evaluation and self-caring among community-dwelling women at home to achieve the final goal of early detection and early treatment of osteoporosis. This study developed a useful approach for providing Asia women with a reliable, valid, convenient and economical self-health management model. Health

  7. Management of aggressive giant cell tumor of calcaneal bone: A case report

    Directory of Open Access Journals (Sweden)

    Achmad Fauzi Kamal


    Conclusion: Wide excision total calcaneoctomy, bone allograft reconstruction and soft tissue coverage with sural flap is a good option for surgical management in aggressive GCT of calcaneus instead of amputation.

  8. Unusual stafne bone cavity mimicking infected cyst or neural origin tumor

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Kyung Soo; Jung, Yun Hoa; Cho, Bong Hae [Pusan National Univ. College of Dentistry, Pusan (Korea, Republic of)


    The radiographic diagnosis of typical Stafine bone cavity could be done easily with cyst-like round or oval radiolucency near the angle of the mandible, under mandibular canal with or without involving mandibular base, and no symptoms. However there are some atypical cases suggesting possible variations of this entity. We report a quite unusual case, where Stafine bone cavity was lastly included in the differential diagnosis list. Histological examination of salivary gland tissues confirmed the final diagnosis.

  9. BMP7 Induces Dormancy of Prostatic Tumor Stem Cell in Bone (United States)


    and x-ray radiography of bone lesions from representative mice in each group four weeks after inoculation. Osteolytic lesions are indicated by arrow...n = 12) were co-injected with HS5 into tibiae of nude mice. Left panel: BLI and x-ray radiography of representative mice in each group four weeks...dormancy in bone microenvironment” as a Co-I with my mentor. 5. I did oral presentations of this project in the journal club of UMMC cancer

  10. Thalassemia paravertebral tumors and bone marrow scan; Thalassemies, tumeurs paravertebrales et scintigraphie medullaire

    Energy Technology Data Exchange (ETDEWEB)

    Huglo, D.; Rose, C.; Deveaux, M.; Bauters, F.; Marchandise, X. [Centre Hospitalier Universitaire, 59 - Lille (France)


    Two first cousins with thalassemia and with a paravertebral mass had had an indium 111 chloride bone marrow scan. Result of scan influenced therapy: medical treatment in one case where an extramedullary erythropoiesis was confirmed, surgical treatment in the other case. The use of dual-isotope SPECT (indium 111 chloride, HDP{sup -99}Tc) constitutes a contribution to the establishment of diagnosis of extramedullary erythropoiesis, giving to bone marrow scintigraphy a merited importance, avoiding the biopsy. (authors). 15 refs., 5 figs.

  11. The Roles of the Bone Marrow Microenvironment in Controlling Tumor Dormancy (United States)


    culmination of symptoms including extreme weight loss, anorexia, muscle wasting and fatigue .106 Several factors that are enriched in the bone from muscle and tendons to serve as bone samples. Organs were imaged at maximum sensitivity to detect metastatic cancer cells. Tissues were scored...prostatectomy. JAMA . 1999; 281:1591–7. 22. Oktem G, Bilir A, Uslu R, Inan SV, Demiray SB, Atmaca H, Ayla S, Sercan O, Uysal A. Expression profiling of stem

  12. Regulation of tumor progression and metastasis by bone marrow-derived microenvironments

    DEFF Research Database (Denmark)

    El Rayes, Tina; Gao, Dingcheng; Altorki, Nasser K.


    Activating mutations in driver oncogenes and loss-of-function mutations in tumor suppressor genes contribute to tumor progression and metastasis. Accordingly, therapies targeting key tumor cell-intrinsic signaling pathways are being used in clinical trials, and some have met FDA approval. However......, these treatments benefit only a small proportion of patients harboring key driver mutations, and acquired resistance to these therapies presents a major impediment to effective treatment. More recently, the contribution of the tumor microenvironment (TME) has been an area of active investigation and has begun......, extravasation, and outgrowth at the metastatic site. While the tumor-reprogrammed BM cells constitute attractive targets for anticancer therapy, recent studies have also begun to unravel their role as prognostic and predictive molecular markers of the disease....

  13. Using Computer-Assisted Interviewing to Consult with Children with Autism Spectrum Disorders: An Exploratory Study (United States)

    Barrow, Wilma; Hannah, Elizabeth F.


    This article explores the use of computer-assisted interviewing (CAI) as a tool for consulting with children with autism spectrum disorders (ASD). This is considered within the context of a research study which utilized one CAI programme, "In My Shoes", to investigate children and young people's views of provision, support, and participation in…

  14. Promoting Creativity through Assessment: A Formative Computer-Assisted Assessment Tool for Teachers (United States)

    Cropley, David; Cropley, Arthur


    Computer-assisted assessment (CAA) is problematic when it comes to fostering creativity, because in educational thinking the essence of creativity is not finding the correct answer but generating novelty. The idea of "functional" creativity provides rubrics that can serve as the basis for forms of CAA leading to either formative or…

  15. The Instructional Effectiveness of Three Levels of Graphics Displays for Computer-Assisted Instruction. (United States)

    Moore, Martha V.; And Others

    This study compares the effectiveness of three types of computer graphics display for computer-assisted instruction in (1) low level (boxed alphanumerics and schematics), (2) medium level (line drawings), and (3) high level (line drawings plus animations). Three groups of 30 enlisted personnel at the Engineering School and the Defense Mapping…

  16. The Potential of Older Adults for Response to Computer-Assisted Instruction. (United States)

    Flynn, Marilyn L.


    Describes study that examined the general patterns of computer use and response to computer-assisted instruction by older adults age 45 to 70 in programs for jobless men and women to learn skills for labor market re-entry. Socioeconomic characteristics are examined, and the instructor's role in determining student attitudes is explored. (23…

  17. Using Computer-Assisted Instruction to Build Math Fact Fluency: An Implementation Guide (United States)

    Hawkins, Renee O.; Collins, Tai; Hernan, Colleen; Flowers, Emily


    Research findings support the use of computer-assisted instruction (CAI) as a curriculum supplement for improving math skills, including math fact fluency. There are a number of websites and mobile applications (i.e., apps) designed to build students' math fact fluency, but the options can become overwhelming. This article provides implementation…

  18. Incorporating a Computer Assisted Reading Program into an Adult Vocational Basic Skills Lab. (United States)

    Vescial, Ann; And Others

    A computer-assisted reading program was implemented in the VESL (Vocational English as a Second Language) Center at Hacienda La Puente Adult Schools (California), which provides support services to adult special needs vocational students. The purpose of the program was to improve the technical reading skills of the vocational students. The basic…

  19. The pedagogical effectiveness of ASR-based computer assisted pronunciation training

    NARCIS (Netherlands)

    Neri, A.


    Computer Assisted Pronunciation Training (CAPT) systems with Automatic Speech Recognition (ASR) technology have become increasingly popular to train pronunciation in the second language (L2). The advantage of these systems is the provision of a self-paced, stress-free type of training with automatic

  20. Why Should I Present a Thesis on Computer Assisted Ndjebbana on DVD? (United States)

    Auld, Glenn

    This paper justifies the presentation of a Ph.D. thesis about computer-assisted Ndjebbana on a digital video disc (DVD). Ndjebbana is a language spoken by 200 Kunibidji, the indigenous landowners of Maningrida on the north coast of Arnhem Land, Australia. Simple digital talking books about the community were created in Ndjebbana and then presented…

  1. Computer Assisted Vocational Math. Written for TRS-80, Model I, Level II, 16K. (United States)

    Daly, Judith; And Others

    This computer-assisted curriculum is intended to be used to enhance a vocational mathematics/applied mathematics course. A total of 32 packets were produced to increase the basic mathematics skills of students in the following vocational programs: automotive trades, beauty culture, building trades, climate control, electrical trades,…

  2. Effectiveness of Using Computer-Assisted Supplementary Instruction for Teaching the Mole Concept. (United States)

    Yalcinalp, Serpil; And Others


    Examines the effect of computer-assisted instruction (CAI) on students' understanding of chemical formulas and mole concept, and their attitudes toward chemistry and CAI. Reports that students who used the CAI accompanied with lectures scored significantly higher and demonstrated significant improvement in attitudes compared to the control group…

  3. Learning to use a word processor with concurrent computer-assisted instruction

    NARCIS (Netherlands)

    Simons, P.R.J.; Biemans, H.J.A.


    In this study the effects of 7embedding regulation questions and regulation hints in a concurrent computer-assisted instruction (CAI) program aimed at learning to use a word processor were examined. This instructional shell WP-DAGOGUE controlled the interaction between the subject and the word

  4. Effect of Tutorial Mode of Computer-Assisted Instruction on Students ...

    African Journals Online (AJOL)

    This study investigated the effect of Tutorial Mode of Computer- Assisted Instruction (CAI) on students' academic performance in practical geography in Nigeria, However, the sample population of eighty (80) Senior Secondary School Two geography students that were randomly selected from two privately owned secondary ...

  5. Ethical Issues Involved with the Use of Computer-Assisted Counseling, Testing, and Guidance Systems. (United States)

    Sampson, James P.; Pyle, K. Richard


    Discusses the growing use of computers in counseling, testing, and guidance. Examines potential ethical problems focusing on confidentiality of client data and the use of computer-assisted testing. Outlines principles for ethical use of computer applications emphasizing the need for counselor intervention. (Author/RC)

  6. The Effects of Computer-assisted and Distance Learning of Geometric Modeling

    Directory of Open Access Journals (Sweden)

    Omer Faruk Sozcu


    Full Text Available The effects of computer-assisted and distance learning of geometric modeling and computer aided geometric design are studied. It was shown that computer algebra systems and dynamic geometric environments can be considered as excellent tools for teaching mathematical concepts of mentioned areas, and distance education technologies would be indispensable for consolidation of successfully passed topics

  7. Algerian EFL University Teachers' Attitudes towards Computer Assisted Language Learning: The Case of Djilali Liabes University (United States)

    Bouchefra, Miloud; Baghoussi, Meriem


    Computer Assisted Language Learning (CALL) is still groping its way into Algerian English as a Foreign Language (EFL) classroom, where Information Communications Technologies (ICTs) are defined in terms of occasional use of computers and data projectors for material presentation in the classroom. Though major issues in the image of the lack of…

  8. Interactive Computer-Assisted Instruction in Acid-Base Physiology for Mobile Computer Platforms (United States)

    Longmuir, Kenneth J.


    In this project, the traditional lecture hall presentation of acid-base physiology in the first-year medical school curriculum was replaced by interactive, computer-assisted instruction designed primarily for the iPad and other mobile computer platforms. Three learning modules were developed, each with ~20 screens of information, on the subjects…

  9. Can Computer-Assisted Discovery Learning Foster First Graders' Fluency with the Most Basic Addition Combinations? (United States)

    Baroody, Arthur J.; Eiland, Michael D.; Purpura, David J.; Reid, Erin E.


    In a 9-month training experiment, 64 first graders with a risk factor were randomly assigned to computer-assisted structured discovery of the add-1 rule (e.g., the sum of 7 + 1 is the number after "seven" when we count), unstructured discovery learning of this regularity, or an active-control group. Planned contrasts revealed that the…

  10. 77 FR 39498 - Guidances for Industry and Food and Drug Administration Staff: Computer-Assisted Detection... (United States)


    ... Applied to Radiology Images and Radiology Device Data--Premarket Notification (510(k)) Submissions'' (CADe... certain computer-assisted detection (CADe)\\1\\ devices applied to radiology images and radiology device...) and Premarket Notification (510(k)) Submissions'' (CADe clinical performance assessment guidance...

  11. Computer-Assisted English Learning System Based on Free Conversation by Topic (United States)

    Choi, Sung-Kwon; Kwon, Oh-Woog; Kim, Young-Kil


    This paper aims to describe a computer-assisted English learning system using chatbots and dialogue systems, which allow free conversation outside the topic without limiting the learner's flow of conversation. The evaluation was conducted by 20 experimenters. The performance of the system based on a free conversation by topic was measured by the…

  12. Effects of Computer Assisted Instruction (CAI) on Secondary School Students' Performance in Biology (United States)

    Yusuf, Mudasiru Olalere; Afolabi, Adedeji Olufemi


    This study investigated the effects of computer assisted instruction (CAI) on secondary school students' performance in biology. Also, the influence of gender on the performance of students exposed to CAI in individualised or cooperative learning settings package was examined. The research was a quasi experimental involving a 3 x 2 factorial…

  13. Ambulatory Computer-Assisted Therapy for Obesity: A New Frontier for Behavior Therapy. (United States)

    Burnett, Kent F.; And Others


    Implemented a behavioral treatment program for obesity using an interactive microcomputer system small enough to be carried by subjects. Subjects receiving the computer-assisted treatment lost approximately 2.5 times as much weight as controls and their rate of weight loss equaled that for more elaborate behavioral treatments. (MCF)

  14. Does Computer-Assisted Femur First THR Improve Musculoskeletal Loading Conditions?

    NARCIS (Netherlands)

    Weber, Tim A.; Dendorfer, Sebastian; Grifka, Joachim; Verkerke, Gijsbertus J.; Renkawitz, Tobias


    We have developed a novel, computer-assisted operation method for minimal-invasive total hip replacement (THR) following the concept of " femur first/combined anteversion," which incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position (CAS FF).

  15. Computer-assisted semen analysis parameters as predictors for fertility of men from the general population

    DEFF Research Database (Denmark)

    Larsen, L; Scheike, Thomas Harder; Jensen, Tina Kold


    The predictive value of sperm motility parameters obtained by computer-assisted semen analysis (CASA) was evaluated for the fertility of men from general population. In a prospective study with couples stopping use of contraception in order to try to conceive, CASA was performed on semen samples...

  16. The Effects of Gender on the Attitudes towards the Computer Assisted Instruction: A Meta-Analysis (United States)

    Cam, Sefika Sumeyye; Yarar, Gokhan; Toraman, Cetin; Erdamar, Gurcu Koc


    The idea that gender factor creates a difference on computer usage and computer-assisted instruction is based upon previous years. At that time, it was thought that some areas like engineering, science and mathematics were for males so it created a difference on the computer usage. Nevertheless, developing technology and females becoming more…

  17. Climate Change Discourse in Mass Media: Application of Computer-Assisted Content Analysis (United States)

    Kirilenko, Andrei P.; Stepchenkova, Svetlana O.


    Content analysis of mass media publications has become a major scientific method used to analyze public discourse on climate change. We propose a computer-assisted content analysis method to extract prevalent themes and analyze discourse changes over an extended period in an objective and quantifiable manner. The method includes the following: (1)…

  18. Pull-Down Menus, Menu Design, and Usage Patterns in Computer-Assisted Instruction. (United States)

    Schuerman, Robert L.; Peck, Kyle L.


    Discussion of menu design strategies for computer-assisted instruction (CAI) focuses on a study that investigated whether menu design would affect undergraduate learners' usage patterns during a CAI lesson. Sequential versus random selection of options is discussed, and new measures for describing usage patterns in CAI are explained. (eight…

  19. Graphic Representation of Musical Concepts: A Computer Assisted Instructional System. Final Report. (United States)

    Heller, Jack J.; And Others

    Computer Assisted Synthesizer System (CASS), a portable music synthesizer system which can produce tones from ordinary paper and pencil graphs, was developed and its usefulness for music instruction evaluated in this study. After completion of a pilot study to determine the feasibility of developing CASS and to run a trail test period, 28 fifth…

  20. Cognitive Models of Students' Language Structure: The View from Intelligent Computer Assisted Instruction. (United States)

    Psotka, Joseph; And Others

    Methods and approaches used at the U.S. Army Research Institute to investigate intelligent computer-assisted foreign language instruction are discussed. The research described explores the use of hypertext and natural language processing for improving language training by articulating student knowledge structures and for providing, incidentally, a…

  1. The View of Science and Technology Teachers about Computer Assisted Instruction (United States)

    Toman, Ufuk; Gurbuz, Fatih; Cimer, Sabiha Odabasi


    The purpose of the study is to present the views of the teachers of Primary Science and Technology course about computer assisted instruction. Qualitative research was used in the study. In qualitative researches, the sampling group is small in order to examine the sampling in-depth. Semi-structured interviews were used in the study as data…

  2. Computer-Assisted Mathematics Instruction for Students with Specific Learning Disability: A Review of the Literature (United States)

    Stultz, Sherry L.


    This review was conducted to evaluate the current body of scholarly research regarding the use of computer-assisted instruction (CAI) to teach mathematics to students with specific learning disability (SLD). For many years, computers are utilized for educational purposes. However, the effectiveness of CAI for teaching mathematics to this specific…

  3. Generative Computer-Assisted Instruction and Artificial Intelligence. Report No. 5. (United States)

    Sinnott, Loraine T.

    This paper reviews the state-of-the-art in generative computer-assisted instruction and artificial intelligence. It divides relevant research into three areas of instructional modeling: models of the subject matter; models of the learner's state of knowledge; and models of teaching strategies. Within these areas, work sponsored by Advanced…

  4. Associations among Teachers' Attitudes towards Computer-Assisted Education and TPACK Competencies (United States)

    Baturay, Meltem Huri; Gökçearslan, Sahin; Sahin, Semsettin


    The current study investigates the attitudes of teachers towards Computer-Assisted Education (CAE) and their knowledge of technology, pedagogy and content via TPACK model that assesses the competencies for developing and implementing successful teaching. There were 280 participants in the study. The results of the study indicate that teachers'…

  5. The Relationship between Second Language Acquisition Theory and Computer-Assisted Language Learning (United States)

    Chapelle, Carol A.


    The point of departure for this article is the contrast between the theoretical landscape within view of language teaching professionals in 1991 and that of today. I argue that the pragmatic goal of computer-assisted language learning (CALL) developers and researchers to create and evaluate learning opportunities pushes them to consider a variety…

  6. Effectiveness of Computer-Assisted Stad Cooperative Learning Strategy on Physics Problem Solving, Achievement

    Directory of Open Access Journals (Sweden)

    Amosa Isiaka Gambari


    Full Text Available This study investigated the effectiveness of computer-assisted Students’ Team Achievement Division (STAD cooperative learning strategy on physics problem solving on students’ achievement and retention. It also examined if the performance of the students would vary with gender. Purposive sampling technique was used to select two senior secondary schools year two physics students (SS II. The schools were assigned into computer-assisted STAD and Individualized Computer Instruction (ICI groups. 84 students from two intact classes participated in the study. Computer-Assisted Learning Package (CALP on physics and Physics Achievement Test (PAT were used as treatment and test instruments respectively. Analysis of Covariance and Scheffe test were used for data analysis. Findings indicated that students taught physics with computer-supported STAD performed and better than their counterparts in ICI group. In addition, they had better retention than those in ICI group. However, gender has no influence on students’ performance. Based on the findings, it was recommended among others that physics teacher should be encouraged to use computer-assisted cooperative instructional to enhance students’ performance.

  7. A Computer-Assisted Multiliteracies Programme as an Alternative Approach to EFL Instruction (United States)

    Lee, Kyungmee; Ardeshiri, Minoo; Cummins, Jim


    The aim of this article is to introduce a computer-assisted multiliteracies programme (CaMP) as an alternative approach to English as a Foreign Language (EFL) instruction in order to overcome the educational limitations that are inherent in most EFL settings. In a number of monolingual societies with a dominant language other than English,…

  8. Effects of Using Simultaneous Prompting and Computer-Assisted Instruction during Small Group Instruction (United States)

    Ozen, Arzu; Ergenekon, Yasemin; Ulke-Kurkcuoglu, Burcu


    The current study investigated the relation between simultaneous prompting (SP), computer-assisted instruction (CAI), and the receptive identification of target pictures (presented on laptop computer) for four preschool students with developmental disabilities. The students' acquisition of nontarget information through observational learning also…

  9. A Computer-Assisted Instruction in Teaching Abstract Statistics to Public Affairs Undergraduates (United States)

    Ozturk, Ali Osman


    This article attempts to demonstrate the applicability of a computer-assisted instruction supported with simulated data in teaching abstract statistical concepts to political science and public affairs students in an introductory research methods course. The software is called the Elaboration Model Computer Exercise (EMCE) in that it takes a great…

  10. Review Question Formats and Web Design Usability in Computer-Assisted Instruction (United States)

    Green, Rebecca S.; Eppler, Marion A.; Ironsmith, Marsha; Wuensch, Karl L.


    We tested the effects of two embedded review question formats and the application of web design guidelines in a computer-assisted mastery learning course in developmental psychology. Students used either a branching review question format that redirected them to relevant portions of the study module after incorrect answers or a linear format that…

  11. Computer Assisted Medical Diagnosis (CAMD) System. Version 1.0. User’s Guide (United States)




    Sperm motility variables from the milt of the common carp Cyprinus carpio were assessed using a computer-assisted sperm analysis (CASA) system across several months (March-August 1992) known to encompass the natural spawning period. Two-year-old pond-raised males obtained each mo...


    Objective evaluation of hyperactivated motility in rat spermatozoa using computer-assisted sperm analysis.Cancel AM, Lobdell D, Mendola P, Perreault SD.Toxicology Program, University of North Carolina, Chapel Hill, NC 27599, USA.The aim of this study was t...

  14. Computer-assisted cognitive remediation therapy: cognition, self-esteem and quality of life in schizophrenia. (United States)

    Garrido, Gemma; Barrios, Maite; Penadés, Rafael; Enríquez, Maria; Garolera, Maite; Aragay, Núria; Pajares, Marta; Vallès, Vicenç; Delgado, Luis; Alberni, Joan; Faixa, Carlota; Vendrell, Josep M


    Quality of life (QoL) is an important outcome in the treatment of schizophrenia. Cognitive deficits have an impact on functional outcomes. Cognitive remediation therapy is emerging as a psychological intervention that targets cognitive impairment, but the effect of computer-assisted cognitive remediation on neuropsychology and social functioning and wellbeing remains unclear. The aim of the current study is to investigate the neurocognitive outcomes of computer-assisted cognitive remediation (CACR) therapy in a sample of schizophrenia patients, and to measure the quality of life and self-esteem as secondary outcomes. Sixty-seven people with schizophrenia were randomly assigned to computer-assisted cognitive remediation or an active control condition. The main outcomes were neuropsychological measures and secondary outcomes (self-esteem and quality of life). Measurements were recorded at baseline and post-treatment. The CACR therapy group improved in speed of processing, working memory and reasoning and problem-solving cognitive domains. QoL and self-esteem measures also showed significant improvements over time in this group. Computer-assisted cognitive remediation therapy for people with schizophrenia achieved improvements in neuropsychological performance and in QoL and self-esteem measurements. © 2013 Elsevier B.V. All rights reserved.

  15. DLI-IBM Joint Feasibility Study in Computer-Assisted Foreign Language Instruction. Final Report. (United States)

    Adams, Edward N.; Rosenbaum, Peter S.

    This document is the final report on a study of the use of computer assisted instruction (CAI). The objective of the study was to evaluate the potential applicability and usefulness of CAI in the instructional environment of the Defense Language Institute (DLI). The operational phases of the study were implemented in the Russian Aural…

  16. Automatization of Mathematics Skills via Computer-Assisted Instruction among Students with Mild Mental Handicaps. (United States)

    Podell, David M.; And Others


    This evaluation study with 94 elementary students (50 with mild mental handicap) compared computer-assisted instruction (CAI) and paper-and-pencil practices in promoting automatization of basic addition and subtraction skills. Findings suggested CAI was more effective but that the students with mental handicap required more practice than…

  17. The Application of Electroencephalography to Computer Assisted Instruction: A Conceptual Framework. (United States)

    Schack, Edna O.

    This paper examines the possibility of developing a conceptual framework on which future research on the application of electroencephalography (EEG) to computer-assisted instruction (CAI) could be based. Consistent associations between EEG and cognitive functions for learning and instruction have the potential for bringing cognitivism into the…

  18. Effect of Computer-Assisted Instruction on Secondary School Students' Achievement in Ecological Concepts (United States)

    Nkemdilim, Egbunonu Roseline; Okeke, Sam O. C.


    This study investigated the effects of computer-assisted instruction (CAI) on students' achievement in ecological concepts. Quasi-experimental design, specifically the pre-test post test non-equivalent control group design was adopted. The sample consisted of sixty-six (66) senior secondary year two (SS II) biology students, drawn from two…

  19. Effects of Computer-Assisted Instruction on Performance of Senior High School Biology Students in Ghana (United States)

    Owusu, K. A.; Monney, K. A.; Appiah, J. Y.; Wilmot, E. M.


    This study investigated the comparative efficiency of computer-assisted instruction (CAI) and conventional teaching method in biology on senior high school students. A science class was selected in each of two randomly selected schools. The pretest-posttest non equivalent quasi experimental design was used. The students in the experimental group…

  20. Effectiveness of Cognitive Skills-Based Computer-Assisted Instruction for Students with Disabilities: A Synthesis (United States)

    Weng, Pei-Lin; Maeda, Yukiko; Bouck, Emily C.


    Computer-assisted instruction (CAI) for students with disabilities can be categorized into the following categories: visual, auditory, mobile, and cognitive skills-based CAI. Cognitive-skills based CAI differs from other types of CAI largely in terms of an emphasis on instructional design features. We conducted both systematic review of…

  1. Effectiveness of a Computer-Assisted Intervention for Young Children with Attention and Reading Problems (United States)

    Walcott, Christy M.; Marett, Katherine; Hessel, Amanda B.


    Children who are significantly inattentive and poor early readers require intervention, and traditional tutoring approaches may not be effective with this group. Using a single-subject, multiple-baseline-across-participants design, Study 1 examines whether a computer-assisted reading intervention increases performance for three first-grade…

  2. Application of computer-assisted semen analysis to explain variations in pig fertility.

    NARCIS (Netherlands)

    Broekhuijse, M.L.W.J.|info:eu-repo/dai/nl/313871728; Sostaric, E.|info:eu-repo/dai/nl/27685408X; Feitsma, H.; Gadella, B.M.|info:eu-repo/dai/nl/115389873


    Sperm quality is often evaluated through computer-assisted semen analysis (CASA) and is an indicator of boar fertility. The aim of this research was to study the relationship between CASA motility parameters and fertility results in pigs. Insemination records and semen parameters from a total of

  3. A Comparison of Computer-Assisted Instruction and Tutorials in Hematology and Oncology. (United States)

    Garrett, T. J.; And Others


    A study comparing the effectiveness of computer-assisted instruction (CAI) and small group instruction found no significant difference in medical student achievement in oncology but higher achievement through small-group instruction in hematology. Students did not view CAI as more effective, but saw it as a supplement to traditional methods. (MSE)

  4. Integrating Online and Active Learning in a Computer-Assisted Translation Workbench

    DEFF Research Database (Denmark)

    Alabau, Vicent; González-Rubio, Jésus; Ortíz-Martínez, Daniel


    This paper describes a pilot study with a computed-assisted translation workbench aiming at testing the integration of online and active learning features. We investigate the effect of these features on translation productivity, using interactive translation prediction (ITP) as a baseline. User...

  5. Brother-Sister Incest: Data from Anonymous Computer-Assisted Self Interviews (United States)

    Stroebel, Sandra S.; O'Keefe, Stephen L.; Beard, Keith W.; Kuo, Shih-Ya; Swindell, Samuel; Stroupe, Walter


    Retrospective data were entered anonymously by 1,521 adult women using computer-assisted self interview. Forty were classified as victims of brother-sister incest, 19 were classified as victims of father-daughter incest, and 232 were classified as victims of sexual abuse by an adult other than their father before reaching 18 years of age. The…

  6. An Evaluation of the Effectiveness of a Computer-Assisted Reading Intervention (United States)

    Messer, David; Nash, Gilly


    Background: A cost-effective method to address reading delays is to use computer-assisted learning, but these techniques are not always effective. Methods: We evaluated a commercially available computer system that uses visual mnemonics, in a randomised controlled trial with 78 English-speaking children (mean age 7 years) who their schools…

  7. Evaluating a Computer-Assisted Pronunciation Training (CAPT) Technique for Efficient Classroom Instruction (United States)

    Luo, Beate


    This study investigates a computer-assisted pronunciation training (CAPT) technique that combines oral reading with peer review to improve pronunciation of Taiwanese English major students. In addition to traditional in-class instruction, students were given a short passage every week along with a recording of the respective text, read by a native…

  8. Teaching Pronunciation with Computer Assisted Pronunciation Instruction in a Technological University (United States)

    Liu, Sze-Chu; Hung, Po-Yi


    The purpose of this study is to evaluate the effectiveness of computer assisted pronunciation instruction in English pronunciation for students in vocational colleges and universities in Taiwan. The participants were fifty-one first-year undergraduate students from a technological university located in central Taiwan. The participants received an…

  9. Improving English Pronunciation through Computer-Assisted Programs in Jordanian Universities (United States)

    Al-Qudah, Fatima Zaki Mohammad


    The purpose of this research is to investigate the effect of using computer- assisted programs for teaching English pronunciation on students' performance in English Language pronunciation in Jordanian universities. To achieve the purpose of the study, a pre/post-test was constructed to measure students' level in English pronunciation. The sample…

  10. Effects of Computer-Assisted Instruction for Struggling Elementary Readers with Disabilities (United States)

    Regan, Kelley; Berkeley, Sheri; Hughes, Melissa; Kirby, Suzanne


    Despite a lack of conclusive evidence, many researchers in the field view computer-assisted instruction (CAI) as an opportunity for improved instruction for students with disabilities. This study examined the effects of a CAI program, Lexia Strategies for Older Students (SOS)™ on the word recognition skills of four, upper elementary students with…

  11. Relationship between Pre-Service Music Teachers' Personality and Motivation for Computer-Assisted Instruction (United States)

    Perkmen, Serkan; Cevik, Beste


    The main purpose of this study was to examine the relationship between pre-service music teachers' personalities and their motivation for computer-assisted music instruction (CAI). The "Big Five" Model of Personality served as the framework. Participants were 83 pre-service music teachers in Turkey. Correlation analysis revealed that three…

  12. Integrated workflow for computer assisted history matching on a channelized reservoir

    NARCIS (Netherlands)

    Peters, E.; Wilschut, F.; Leeuwenburgh, O.; Hooff, P.M.E. van


    Increasingly computer assisted techniques are used for history matching reservoir models. Such methods will become indispensable in view of the increasing amount of information generated by intelligent wells, in which case manual interpretation becomes too time consuming. Also, with the increasing

  13. Computer Assisted Project-Based Instruction: The effects on Science Achievement, Computer Achievement and Portfolio Assessment

    Directory of Open Access Journals (Sweden)

    Yavuz Erdoğan


    Full Text Available The purpose of this study is to compare the effects of computer assisted projectbased instruction on learners’ achievement in a science and technology course, in a computer course and in portfolio development. With this aim in mind, a quasiexperimental design was used and a sample of 70 seventh grade secondary school students from Org. Eşref Bitlis Primary School in Istanbul was selected. The students were randomly assigned to one of the two groups: the control group and experimental group. Instruction to control group was provided by the traditional project-based learning approach, to the experimental group was provided computer assisted project-based learning approach. Both groups were given instruction on the topic of Our Living Conditions in the syllabus of 7th grade Science and Technology course. During the five-week instruction, experimental group was required to prepare the projects with using computer assisted project-based method, while control group used traditional project-based method. At the end of the study, the findings revealed that science and technology and portfolio assessment scores of the experimental group were significantly higher than that of the control group. This result indicates that the learning gains are higher when instruction is provided by computer assisted project-based instruction than by the traditional method

  14. A computer assistant for remote collaborative troubleshooting of domestic medical instruments

    NARCIS (Netherlands)

    Blanson Henkemans, O.A.; Sawirjo, V.M.; Mast, C.A.P.G. van der; Neerincx, M.A.; Lindenberg, J.


    Patients suffering from chronic illness, such as diabetes, use various domestic instruments as part of their selfcare. For older adults, there is a need for assistance to use the instruments adequately and to solve technical failures. Following the eHealth concept, we designed a computer assistant

  15. The Effects of Computer Assisted Instruction Materials on Approximate Number Skills of Students with Dyscalculia (United States)

    Mutlu, Yilmaz; Akgün, Levent


    The aim of this study is to examine the effects of computer assisted instruction materials on approximate number skills of students with mathematics learning difficulties. The study was carried out with pretest-posttest quasi experimental method with a single subject. The participants of the study consist of a girl and two boys who attend 3rd…

  16. A Compilation of Postgraduate Theses Written in Turkey on Computer Assisted Instruction in Chemistry Education (United States)

    Bozdogan, Aykut Emre; Demirbas, Murat


    The purpose of the study conducted is to present in-depth information about the postgraduate theses written within the context of Computer Assisted Instruction in Chemistry Education in Turkey. The theses collected in National Thesis Centre of Turkish Council of Higher Education were examined. As a result of an examination, it was found that about…

  17. Computer Assisted English Language Learning in Costa Rican Elementary Schools: An Experimental Study (United States)

    Alvarez-Marinelli, Horacio; Blanco, Marta; Lara-Alecio, Rafael; Irby, Beverly J.; Tong, Fuhui; Stanley, Katherine; Fan, Yinan


    This study presents first-year findings of a 25-week longitudinal project derived from a two-year longitudinal randomized trial study at the elementary school level in Costa Rica on effective computer-assisted language learning (CALL) approaches in an English as a foreign language (EFL) setting. A pre-test-post-test experimental group design was…

  18. Teacher Training Programs for Computer Education and Computer Assisted Education in Turkey (United States)

    Usun, Salih


    The aim of this descriptive study is to review the applications and problems on the teacher training programs for computer education and computer assisted education (CAE) in Turkey. The study, firstly, introduces some applications and major problems on using instructional media and computers in developing countries and instructional technology…

  19. The Effects of Computer-Assisted Material on Students' Cognitive Levels, Misconceptions and Attitudes Towards Science (United States)

    Cepni, Salih; Tas, Erol; Kose, Sacit


    The purpose of this study was to investigate the effects of a Computer-Assisted Instruction Material (CAIM) related to "photosynthesis" topic on student cognitive development, misconceptions and attitudes. The study conducted in 2002-2003 academic year and was carried out in two different classes taught by the same teacher, in which…

  20. Efficiency of Computer Assisted Cooperative Learning Method on Students' Performance in Using Colors (United States)

    Dikici, Ayhan


    In this study, the effects of computer assisted cooperative learning method on students' performance of using colours in art education were examined. 15 students at the ages between 12 and 15 who owned a personal computer and had access to the internet were selected to form the experimental group. 35 students at the same time age and education…

  1. Generalization of Computer-Assisted Prosody Training: Quantitative and Qualitative Findings (United States)

    Hardison, Debra M.


    Two experiments investigated the effectiveness of computer-assisted prosody training, its generalization to novel sentences and segmental accuracy, and the relationship between prosodic and lexical information in long-term memory. Experiment 1, using a pretest-posttest design, provided native English-speaking learners of French with 3 weeks of…

  2. The Effect of Adaptive Confidence Strategies in Computer-Assisted Instruction on Learning and Learner Confidence (United States)

    Warren, Richard Daniel


    The purpose of this research was to investigate the effects of including adaptive confidence strategies in instructionally sound computer-assisted instruction (CAI) on learning and learner confidence. Seventy-one general educational development (GED) learners recruited from various GED learning centers at community colleges in the southeast United…

  3. Effect of Different Types of Computer-Assisted Feedback Strategies on Achievement and Response Confidence. (United States)

    Clark, Kevin; Dwyer, Francis M.


    This study examined the effects of different types of computer-assisted feedback strategies (knowledge of correct response, knowledge of response, and elaborative) and different types of information (facts, concepts, and principles) on student achievement and response confidence. Findings indicated a positive correlation between achievement and…

  4. Computer-assisted instruction before colonoscopy is as effective as nurse counselling, a clinical pilot trial

    NARCIS (Netherlands)

    Veldhuijzen, G.; Klemt-Kropp, M.; Noomen, C.; Esch, A.A.J. van; Tjwa, E.T.; Drenth, J.P.


    BACKGROUND AND STUDY AIMS: Better patient education prior to colonoscopy improves adherence to instructions for bowel preparation and leads to cleaner colons. We reasoned that computer assisted instruction (CAI) using video and 3 D animations followed by nurse contact maximizes the effectiveness of

  5. A Computer Assisted Application in Preschool Education: Seasons and Their Characteristics (United States)

    Akçay, Nilufer Okur


    In this study, it is aimed to determine the effect of computer-assisted instruction while teaching the subject seasons to preschool students on the academic success. The sample of the study consists of 86 children from the nursery classes of private and official schools in Agri city center. As data collecting tools General Achievement Test used as…

  6. Effects of Computer-Assisted Instruction with Conceptual Change Texts on Removing the Misconceptions of Radioactivity

    Directory of Open Access Journals (Sweden)

    Ahmet YUMUŞAK


    Full Text Available Training young scientists, enabling conceptual understanding in science education is quite important. Misconception is one of the important indications for whether the concepts are understood or not. The most important educational tools to remove misconceptions are conceptual change texts. In addition, one of the important methods to remove misconceptions is computer-assisted instruction. The goal of this study is to research the effects of the use of computer-assisted instruction (CAI, conceptual change texts (CCT, computer-assisted instruction with conceptual change texts (CAI+CCT, and use of traditional teaching method (TTM on removing the misconceptions of science teacher candidates on the subject of radioactivity. Research sample was made of totally 92 students studying at four different groups of senior students in Celal Bayar University, Faculty of Education, Department of Science Education in 2011-2012 academic year. A different teaching method was used in each group. Experimental groups were randomly determined; in the first experimental group, computer-assisted instruction was used (23 students; in the second experimental group, conceptual change texts were used (23 students; in the third experimental group, computer-assisted instruction with conceptual change texts were used (23 students; and the fourth group, on which traditional education method was used, was called control group (23 students. Two-tier misconception diagnostic instrument, which was developed by the researcher, was used as data collection tool of the research. “Nonequivalent Control Groups Experimental Design” was used in this research in order to determine the efficiency of different teaching methods. Obtained data were analyzed by using SPSS 21.0. As a result of the research, it was determined that methods used on experimental groups were more successful than traditional teaching method practiced on control group in terms of removing misconceptions on

  7. Applications of Computer-Assisted Navigation for the Minimally Invasive Reduction of Isolated Zygomatic Arch Fractures. (United States)

    Li, Zhi; Yang, Rong-Tao; Li, Zu-Bing


    Computer-assisted navigation has been widely used in oral and maxillofacial surgery. The purpose of this study was to describe the applications of computer-assisted navigation for the minimally invasive reduction of isolated zygomatic arch fractures. All patients identified as having isolated zygomatic arch fractures presenting to the authors' department from April 2013 through November 2014 were included in this prospective study. Minimally invasive reductions of isolated zygomatic arch fractures were performed on these patients under the guidance of computer-assisted navigation. The reduction status was evaluated by postoperative computed tomography (CT) 1 week after the operation. Postoperative complications and facial contours were evaluated during follow-up. Functional recovery was evaluated by the difference between the preoperative maximum interincisal mouth opening and that at the final follow-up. Twenty-three patients were included in this case series. The operation proceeded well in all patients. Postoperatively, all patients displayed uneventful healing without postoperative complication. Postoperative CT showed exact reduction in all cases. Satisfactory facial contour and functional recovery were observed in all patients. The preoperative maximal mouth opening ranged from 8 to 25 mm, and the maximal mouth opening at the final follow-up ranged from 36 to 42 mm. Computer-assisted navigation can be used not only for guiding zygomatic arch fracture reduction, but also for assessing reduction. Computer-assisted navigation is an effective and minimally invasive technique that can be applied in the reduction of isolated zygomatic arch fractures. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Gene expression markers in circulating tumor cells may predict bone metastasis and response to hormonal treatment in breast cancer. (United States)

    Wang, Haiying; Molina, Julian; Jiang, John; Ferber, Matthew; Pruthi, Sandhya; Jatkoe, Timothy; Derecho, Carlo; Rajpurohit, Yashoda; Zheng, Jian; Wang, Yixin


    Circulating tumor cells (CTCs) have recently attracted attention due to their potential as prognostic and predictive markers for the clinical management of metastatic breast cancer patients. The isolation of CTCs from patients may enable the molecular characterization of these cells, which may help establish a minimally invasive assay for the prediction of metastasis and further optimization of treatment. Molecular markers of proven clinical value may therefore be useful in predicting disease aggressiveness and response to treatment. In our earlier study, we identified a gene signature in breast cancer that appears to be significantly associated with bone metastasis. Among the genes that constitute this signature, trefoil factor 1 (TFF1) was identified as the most differentially expressed gene associated with bone metastasis. In this study, we investigated 25 candidate gene markers in the CTCs of metastatic breast cancer patients with different metastatic sites. The panel of the 25 markers was investigated in 80 baseline samples (first blood draw of CTCs) and 30 follow-up samples. In addition, 40 healthy blood donors (HBDs) were analyzed as controls. The assay was performed using quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) with RNA extracted from CTCs captured by the CellSearch system. Our study indicated that 12 of the genes were uniquely expressed in CTCs and 10 were highly expressed in the CTCs obtained from patients compared to those obtained from HBDs. Among these genes, the expression of keratin 19 was highly correlated with the CTC count. The TFF1 expression in CTCs was a strong predictor of bone metastasis and the patients with a high expression of estrogen receptor β in CTCs exhibited a better response to hormonal treatment. Molecular characterization of these genes in CTCs may provide a better understanding of the mechanism underlying tumor metastasis and identify gene markers in CTCs for predicting disease progression and

  9. Validation of the Brazilian version of the musculoskeletal tumor society rating scale for lower extremity bone sarcoma. (United States)

    Rebolledo, Daniel Cesar Seguel; Vissoci, João Ricardo Nickenig; Pietrobon, Ricardo; de Camargo, Olavo Pires; Baptista, Andre Mathias


    The Musculoskeletal Tumor Society (MSTS) rating scale is an English-language instrument used worldwide to assess functional evaluation of patients with musculoskeletal cancer. Despite its use in several studies in English-speaking countries, its validity for assessing patients in other languages is unknown. The translation and validation of widely used scales can facilitate the comparison across international patient samples. The objectives of this study were (1) to translate and culturally adapt the MSTS rating scale for functional evaluation in patients with lower extremity bone sarcomas to Brazilian Portuguese; (2) analyze its factor structure; and (3) test the reliability and (4) validity of this instrument. The MSTS rating scale for lower limbs was translated from English into Brazilian Portuguese. Translations were synthesized, translated back into English, and reviewed by a multidisciplinary committee for further implementation. The questionnaire was administered to 67 patients treated for malignant lower extremity bone tumors who were submitted to limb salvage surgery or amputation. They also completed a Brazilian version of the Toronto Extremity Salvage Score (TESS). Psychometric properties were analyzed including factor structure analysis, internal consistency, interobserver reliability, test-retest reliability, and construct validity (by comparing the adapted MSTS with TESS and discriminant validity). The MSTS rating scale for lower limbs was translated and culturally adapted to Brazilian Portuguese. The MSTS-BR proved to be adequate with only one latent dimension. The scale was also found to be reliable in a population that speaks Brazilian Portuguese showing good internal consistency (Cronbach's alpha = 0.84) and reliability (test-retest reliability and interobserver agreement of 0.92 and 0.98, respectively). Validity of the Brazilian MSTS rating scale was proved by moderate with TESS and good discriminant validity. The Brazilian version of the MSTS

  10. Evaluation of mandibular bone involvement by oral malignant tumors using scintigraphy of Tc-99m MDP and Ga-67 citrate. Intensely invaded cases

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    Katada, Yoshiaki; Tsuchimochi, Makoto; Kato, Joji


    Ten patients with intensely invaded malignant tumors at the mandibles were studied with bone scintigraphy (Tc-99m MDP) and Ga-67 citrate scintigraphy. All patients were classified by type of accumulation of both radionuclide pharmaceuticals. In almost all patients with invaded malignant tumors, bone scintigraphy revealed decreasing uptake in the center of the lesion and increasing uptake in the peripheral region. Ga-67 citrate scintigram showed increasing concentrated accumulation which was smaller than the area of Tc-99m MDP uptake in almost all cases. These types of accumulation were compared with those of other oral and maxillo-facial diseases. The patterns of accumulation of both radionuclide pharmaceuticals in ameloblastoma (3 cases), radicular cyst (3 cases), bone fracture (2 cases), diffuse sclerosing osteomyelitis (2 cases), and one sagittal ramus osteotomy case were different from that of bone involvement of malignant tumor cases. From the types of accumulation, we may be able to differentiate the oral and maxillo-facial diseases to some extent. In addition, the intensity of accumulation of Tc-99m MDP was measured by using bone to soft tissue ratio (4 hrB/St ratio). The mean 4 hrB/St ratio was higher in moth-eaten absorbed type than in permeated type of resorption in roentgenogram. However, we could not obtain a definitive conclusion because of too few cases. The mean 4 hrB/St ratio in the bone involvement by malignant tumor was higher than that in radicular cyst, and lower than that of diffuse sclerosing osteomyelitis. Unfortunately, we could not differentiate each disease of the involved malignant tumor, ameloblastoma, or bone fracture by only the 4 hrB/St ratio. The Tc-99m MDP accumulated beyond the region where the radiolucencies exist in roentgenograms. We consider that both scintigraphies have a great role in planning surgical treatment, especially in selecting osteotomy.

  11. Metastatic Neuroendocrine Tumor with Extensive Bone Marrow Involvement at Diagnosis: Evaluation of Response and Hematological Toxicity Profile of PRRT with 177Lu-DOTATATE


    Basu, Sandip; Ranade, Rohit; Thapa, Pradeep


    The aim of this study was to evaluate the response and hematological toxicity in peptide receptor radionuclide therapy (PRRT) with lutetium (177Lu)-DOTA-octreotate (DOTATATE) in metastatic neuroendocrine tumor (NET) with extensive bone marrow metastasis at the initial diagnosis. A retrospective evaluation was undertaken for this purpose: Patients with NET with extensive diffuse bone marrow involvement at diagnosis who had received at least three cycles of PRRT with 177Lu-DOTATATE were conside...

  12. Effect of intravenous zoledronic acid on histopathology and recurrence after extended curettage in giant cell tumors of bone: A comparative prospective study


    Zile Singh Kundu; Rajeev Sen; Ankur Dhiman; Pankaj Sharma; Ramchander Siwach; Parveen Rana


    Background: Giant cell tumor (GCT) of the bone is known for its locally aggressive behavior and tendency to recur. It is an admixture of rounded or spindle-shaped mononuclear neoplastic stromal cells and multinucleated osteoclast-like giant cells with their proportionate dispersion among the former. Zoledronic acid (a bisphosphonate) is being used in various cancers such as myelomas and metastasis, for osteoporosis with an aim to reduce the resorption of bone, and as an adjuvant treatment for...

  13. Effects of a Computer-Assisted Concept Mapping Learning Strategy on EFL College Students' English Reading Comprehension (United States)

    Liu, Pei-Lin; Chen, Chiu-Jung; Chang, Yu-Ju


    The purpose of this research was to investigate the effects of a computer-assisted concept mapping learning strategy on EFL college learners' English reading comprehension. The research questions were: (1) what was the influence of the computer-assisted concept mapping learning strategy on different learners' English reading comprehension? (2) did…

  14. Equivalency of Computer-Assisted and Paper-and-Pencil Administered Versions of the Minnesota Multiphasic Personality Inventory-2. (United States)

    Pinsoneault, Terry B.


    Computer-assisted and paper-and-pencil-administered formats for the Minnesota Multiphasic Personality Inventories were investigated. Subjects were 32 master's and doctoral-level counseling students. Findings indicated that the two formats were comparable and that students preferred the computer-assisted format. (AEF)

  15. Tumor (United States)

    ... peanut plants (aflatoxins) Excessive sunlight exposure Genetic problems Obesity Radiation exposure Viruses Types of tumors known to be caused by or linked with viruses are: Cervical cancer (human papillomavirus) Most anal cancers (human papillomavirus) Some ...

  16. [Health technology assessment report: Computer-assisted Pap test for cervical cancer screening]. (United States)

    Della Palma, Paolo; Moresco, Luca; Giorgi Rossi, Paolo


    HEALTH PROBLEM: Cervical cancer is a disease which is highly preventable by means of Pap test screening for the precancerous lesions, which can be easily treated. Furthermore, in the near future, control of the disease will be enhanced by the vaccination which prevents the infection of those human papillomavirus types that cause the vast majority of cervical cancers. The effectiveness of screening in drastically reducing cervical cancer incidence has been clearly demonstrated. The epidemiology of cervical cancer in industrialised countries is now determined mostly by the Pap test coverage of the female population and by the ability of health systems to assure appropriate follow up after an abnormal Pap test. Today there are two fully automated systems for computer-assisted Pap test: the BD FocalPoint and the Hologic Imager. Recently, the Hologic Integrated Imager, a semi-automated system, was launched. The two fully automated systems are composed of a central scanner, where the machine examines the cytologic slide, and of one or more review stations, where the cytologists analyze the slides previously centrally scanned. The softwares used by the two systems identify the fields of interest so that the cytologists can look only at those points, automatically pointed out by the review station. Furthermore, the FocalPoint system classifies the slides according to their level of risk of containing signs of relevant lesions. Those in the upper classes--about one fifth of the slides--are labelled as « further review », while those in the lower level of risk, i.e. slides that have such a low level of risk that they can be considered as negative with no human review, are labelled as « no further review ». The aim of computer-assisted Pap test is to reduce the time of slide examination and to increase productivity. Furthermore, the number of errors due to lack of attention may decrease. Both the systems can be applied to liquidbased cytology, while only the BD Focal

  17. Does the presence of tumor-induced cortical bone destruction at CT have any prognostic value in newly diagnosed diffuse large B-cell lymphoma?

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    Adams, Hugo J.A.; Nievelstein, Rutger A.J.; Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Klerk, John M.H. de [Meander Medical Center, Department of Nuclear Medicine, Amersfoort (Netherlands); Fijnheer, Rob [Meander Medical Center, Department of Hematology, Amersfoort (Netherlands); Heggelman, Ben G.F. [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Dubois, Stefan V. [Meander Medical Center, Department of Pathology, Amersfoort (Netherlands)


    To determine the prognostic value of tumor-induced cortical bone destruction at computed tomography (CT) in newly diagnosed diffuse large B-cell lymphoma (DLBCL). This retrospective study included 105 patients with newly diagnosed DLBCL who had undergone CT and bone marrow biopsy (BMB) before R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, Oncovin, and prednisolone) chemo-immunotherapy. Cox regression analyses were used to determine the associations of cortical bone status at CT (absence vs. presence of tumor-induced cortical bone destruction), BMB findings (negative vs. positive for lymphomatous involvement), and dichotomized National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) strata (low risk vs. high risk) with progression-free survival (PFS) and overall survival (OS). Univariate Cox regression analysis indicated that cortical bone status at CT was no significant predictor of either PFS or OS (p = 0.358 and p = 0.560, respectively), whereas BMB findings (p = 0.002 and p = 0.013, respectively) and dichotomized NCCN-IPI risk strata (p = 0.002 and p = 0.003, respectively) were significant predictors of both PFS and OS. In the multivariate Cox proportional hazards model, only the dichotomized NCCN-IPI score was an independent predictive factor of PFS and OS (p = 0.004 and p = 0.003, respectively). The presence of tumor-induced cortical bone destruction at CT was not found to have any prognostic implications in newly diagnosed DLBCL. (orig.)

  18. [The role of the psychologist with children or adolescents with a bone tumor]. (United States)

    Dubois, Caroline


    The psychologist practising both in a paediatric orthopaedic surgery department and a paediatric oncology department provides continuity for children and teenagers suffering from a malignant bone tumour, as well as for their family. Psychological support aims to help these young patients face the somatic and psychological upheavals with which they will be confronted throughout their treatment.

  19. Perspectives of family physicians on computer-assisted health-risk assessments. (United States)

    Ahmad, Farah; Skinner, Harvey A; Stewart, Donna E; Levinson, Wendy


    The firsthand experience of physicians using computer-assisted health-risk assessment is salient for designing practical eHealth solutions. The aim of this study was to enhance understanding about computer-assisted health-risk assessments from physicians' perspectives after completion of a trial at a Canadian, urban, multi-doctor, hospital-affiliated family practice clinic. A qualitative approach of face-to-face, in-depth, semi-structured interviews was used. All interviews were audio recorded and field notes taken. Analytic induction and constant comparative techniques were used for coding and analyses. Interpretation was facilitated by peer audit and insights gained from the social exchange theoretical perspective. Ten physicians (seven female and three male) participated in the interviews. Three overarching themes emerged in relation to computer-assisted health-risk assessments: (1) perceived benefits, (2) perceived concerns or challenges, and (3) feasibility. Physicians unanimously acknowledged the potential of computer-assisted health-risk assessments to open dialogue on psychosocial health risks. They also appreciated the general facilitative roles of the tool, such as improving time-efficiency by asking questions on health risks prior to the consultation and triggering patients' self-reflections on the risks. However, in the context of ongoing physician-patient relationships, physicians expressed concerns about the impact of the computer-assisted health-risk assessment tool on visit time, patient readiness to talk about psychosocial issues when the purpose of the visit was different, and the suitability of such risk assessment for all visits to detect new risk information. In terms of feasibility, physicians displayed general acceptance of the risk assessment tool but considered it most feasible for periodic health exams and follow-up visits based on their perceived concerns or challenges and the resources needed to implement such programs. These included

  20. Bone Marrow Suppression by c-Kit Blockade Enhances Tumor Growth of Colorectal Metastases through the Action of Stromal Cell-Derived Factor-1

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    Kathrin Rupertus


    Full Text Available Background. Mobilization of c-Kit+ hematopoietic cells (HCs contributes to tumor vascularization. Whereas survival and proliferation of HCs are regulated by binding of the stem cell factor to its receptor c-Kit, migration of HCs is directed by stromal cell-derived factor (SDF-1. Therefore, targeting migration of HCs provides a promising new strategy of anti-tumor therapy. Methods. BALB/c mice (=16 were pretreated with an anti-c-Kit antibody followed by implantation of CT26.WT-GFP colorectal cancer cells into dorsal skinfold chambers. Animals (=8 additionally received a neutralizing anti-SDF-1 antibody. Animals (=8 treated with a control antibody served as controls. Investigations were performed using intravital fluorescence microscopy, immunohistochemistry, flow cytometry and western blot analysis. Results. Blockade of c-Kit significantly enhanced tumor cell engraftment compared to controls due to stimulation of tumor cell proliferation and invasion without markedly affecting tumor vascularization. C-Kit blockade significantly increased VEGF and CXCR4 expression within the growing tumors. Neutralization of SDF-1 completely antagonized this anti-c-Kit-associated tumor growth by suppression of tumor neovascularization, inhibition of tumor cell proliferation and reduction of muscular infiltration. Conclusion. Our study indicates that bone marrow suppression via anti-c-Kit pretreatment enhances tumor cell engraftment of colorectal metastases due to interaction with the SDF-1/CXCR4 pathway which is involved in HC-mediated tumor angiogenesis.

  1. Intraperitoneal injection of thalidomide attenuates bone cancer pain and decreases spinal tumor necrosis factor-α expression in a mouse model (United States)


    Background Tumor necrosis factor α (TNF-α) may have a pivotal role in the genesis of mechanical allodynia and thermal hyperalgesia during inflammatory and neuropathic pain. Thalidomide has been shown to selectively inhibit TNF-α production. Previous studies have suggested that thalidomide exerts anti-nociceptive effects in various pain models, but its effects on bone cancer pain have not previously been studied. Therefore, in the present study, we investigated the effect of thalidomide on bone cancer-induced hyperalgesia and up-regulated expression of spinal TNF-α in a mouse model. Results Osteosarcoma NCTC 2472 cells were implanted into the intramedullary space of the right femurs of C3H/HeJ mice to induce ongoing bone cancer related pain behaviors. At day 5, 7, 10 and 14 after operation, the expression of TNF-α in the spinal cord was higher in tumor-bearing mice compared to the sham mice. Intraperitoneal injection of thalidomide (50 mg/kg), started at day 1 after surgery and once daily thereafter until day 7, attenuated bone cancer-evoked mechanical allodynia and thermal hyperalgesia as well as the up-regulation of TNF-α in the spinal cord. Conclusions These results suggest that thalidomide can efficiently alleviate bone cancer pain and it may be a useful alternative or adjunct therapy for bone cancer pain. Our data also suggest a role of spinal TNF-α in the development of bone cancer pain. PMID:20923560

  2. Ceacam1 separates graft-versus-host-disease from graft-versus-tumor activity after experimental allogeneic bone marrow transplantation.

    Directory of Open Access Journals (Sweden)

    Sydney X Lu

    Full Text Available Allogeneic bone marrow transplantation (allo-BMT is a potentially curative therapy for a variety of hematologic diseases, but benefits, including graft-versus-tumor (GVT activity are limited by graft-versus-host-disease (GVHD. Carcinoembryonic antigen related cell adhesion molecule 1 (Ceacam1 is a transmembrane glycoprotein found on epithelium, T cells, and many tumors. It regulates a variety of physiologic and pathological processes such as tumor biology, leukocyte activation, and energy homeostasis. Previous studies suggest that Ceacam1 negatively regulates inflammation in inflammatory bowel disease models.We studied Ceacam1 as a regulator of GVHD and GVT after allogeneic bone marrow transplantation (allo-BMT in mouse models. In vivo, Ceacam1(-/- T cells caused increased GVHD mortality and GVHD of the colon, and greater numbers of donor T cells were positive for activation markers (CD25(hi, CD62L(lo. Additionally, Ceacam1(-/- CD8 T cells had greater expression of the gut-trafficking integrin α(4β(7, though both CD4 and CD8 T cells were found increased numbers in the gut post-transplant. Ceacam1(-/- recipients also experienced increased GVHD mortality and GVHD of the colon, and alloreactive T cells displayed increased activation. Additionally, Ceacam1(-/- mice had increased mortality and decreased numbers of regenerating small intestinal crypts upon radiation exposure. Conversely, Ceacam1-overexpressing T cells caused attenuated target-organ and systemic GVHD, which correlated with decreased donor T cell numbers in target tissues, and mortality. Finally, graft-versus-tumor survival in a Ceacam1(+ lymphoma model was improved in animals receiving Ceacam1(-/- vs. control T cells.We conclude that Ceacam1 regulates T cell activation, GVHD target organ damage, and numbers of donor T cells in lymphoid organs and GVHD target tissues. In recipients of allo-BMT, Ceacam1 may also regulate tissue radiosensitivity. Because of its expression on both the

  3. Computer-aided resection and endoprosthesis design for the management of malignant bone tumors around the knee: outcomes of 12 cases. (United States)

    Ding, Huan-wen; Yu, Guang-wen; Tu, Qiang; Liu, Bao; Shen, Jian-jian; Wang, Hong; Wang, Ying-jun


    To report the outcomes of computer-aided resection and endoprosthesis design for the management of malignant bone tumors around the knee. Computed tomography (CT) and magnetic resonance imaging (MRI) data were input into computer software to produce three-dimensional (3D) models of the tumor extent. Imaging data was then used to create a template for surgical resection, and development of an individualized combined allogeneic bone/endoprosthesis. Surgical simulations were performed prior to the actual surgery. This study included 9 males and 3 females with a mean age of 25.3 years (range, 13 to 40 years). There were 9 tumors in the distal femur and 3 in the proximal tibia. There were no surgical complications. In all cases pathologically confirmed clear surgical margins were obtained. Postoperative radiographs showed the range of tumor resection was in accordance with the preoperative design, and the morphological reconstruction of the bone defect was satisfactory with complete bilateral symmetry. The mean follow-up time was 26.5 months. Two patients died of their disease and the remaining are alive and well without evidence of recurrence. All patients are able to ambulate freely without restrictions. At the last follow-up, the average International Society of Limb Salvage score was 25.8 (range, 18 to 27), and was excellent in 8 cases and good in 4 cases. Computer-aided design and modeling for the surgical management of bone tumors and subsequent limb reconstruction provides accurate tumor removal with the salvage of a maximal amount of unaffected bone and precise endoprosthesis reconstruction.


    Directory of Open Access Journals (Sweden)

    R. TOMAN


    Full Text Available The aim of this study was to reveal the effect of diazinon on the rat spermatozoa motility characteristics using the computer-assisted semen analysis (CASA. Motility, progressive motility, DAP, DCL, DSL, VAP, VCL, VSL, STR, LIN, WOB, ALH, and BCF after the diazinon i.p. administration of 20 mg/kg b.w. were evaluated. 36 hours after the diazinon administration, only slight decrease in VCL, DCL and increase in percentage of progressive motility in the diazinon-treated group. Significant decrease (P<0.01 was only observed in BCF in diazinon-treated group. Computer-assisted semen analysis (CASA of rat sperm motility showed that acute diazinon administration slightly affected the rat sperm motility which can be the first step in the decreased fertilization capacity caused by pesticides. Further investigation of reproductive effects of diazinon is needed.

  5. Personalized, relevance-based Multimodal Robotic Imaging and augmented reality for Computer Assisted Interventions. (United States)

    Navab, Nassir; Fellow, Miccai; Hennersperger, Christoph; Frisch, Benjamin; Fürst, Bernhard


    In the last decade, many researchers in medical image computing and computer assisted interventions across the world focused on the development of the Virtual Physiological Human (VPH), aiming at changing the practice of medicine from classification and treatment of diseases to that of modeling and treating patients. These projects resulted in major advancements in segmentation, registration, morphological, physiological and biomechanical modeling based on state of art medical imaging as well as other sensory data. However, a major issue which has not yet come into the focus is personalizing intra-operative imaging, allowing for optimal treatment. In this paper, we discuss the personalization of imaging and visualization process with particular focus on satisfying the challenging requirements of computer assisted interventions. We discuss such requirements and review a series of scientific contributions made by our research team to tackle some of these major challenges. Copyright © 2016. Published by Elsevier B.V.

  6. Clinician attitudes, social norms and intentions to use a computer-assisted intervention. (United States)

    Buti, Allison L; Eakins, Danielle; Fussell, Holly; Kunkel, Lynn E; Kudura, Aisha; McCarty, Dennis


    The National Drug Abuse Treatment Clinical Trials Network (CTN) works to bridge the gap between research and practice and tested a Web-delivered psychosocial intervention (the Therapeutic Education System, TES) in 10 community treatment centers. Computer-assisted therapies, such as Web-delivered interventions, may improve the consistency and efficiency of treatment for alcohol and drug use disorders. Prior to the start of the study, we surveyed counselors (N=96) in participating treatment centers and assessed counselor attitudes, perceived social norms and intentions to use a Web-delivered intervention. Analysis of the intention to adopt a Web-delivered intervention assessed the influence of attitudes and perceived social norms. Perceived social norms were a significant contributor to clinician intention to adopt Web-based interventions while attitude was not. To promote successful implementation, it may be helpful to create social norms supportive of computer-assisted therapies. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Image-guided ablation of painful metastatic bone tumors: a new and effective approach to a difficult problem

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    Callstrom, Matthew R.; Charboneau, J. William; Atwell, Thomas D.; Farrell, Michael A.; Welch, Timothy J.; Maus, Timothy P. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Goetz, Matthew P.; Rubin, Joseph [Mayo Clinic, Department of Oncology, Rochester, MN (United States)


    Painful skeletal metastases are a common problem in cancer patients. Although external beam radiation therapy is the current standard of care for cancer patients who present with localized bone pain, 20-30% of patients treated with this modality do not experience pain relief, and few further options exist for these patients. For many patients with painful metastatic skeletal disease, analgesics remain the only alternative treatment option. Recently, image-guided percutaneous methods of tumor destruction have proven effective for treatment of this difficult problem. This review describes the application, limitations, and effectiveness of percutaneous ablative methods including ethanol, methyl methacrylate, laser-induced interstitial thermotherapy (LITT), cryoablation, and percutaneous radiofrequency ablation (RFA) for palliation of painful skeletal metastases. (orig.)

  8. The Roles of the Bone Marrow Microenvironment in Controlling Tumor Dormancy (United States)


    project? Name: Yusuke Shiozawa Project Role: PI Researcher Identifier (e.g. ORCID ID): Nearest person month worked... Org : Wake Forest School of Medicine Award Amount: $225,000 Study/Product Aim(s) • Aim1: Determine the mechanisms whereby disseminated tumor cells

  9. Pamidronate Disodium for Palliative Therapy of Feline Bone-Invasive Tumors

    Directory of Open Access Journals (Sweden)

    Jackie M. Wypij


    Full Text Available This study sought to quantify in vitro antiproliferative effects of pamidronate in feline cancer cells and assess feasibility of use of pamidronate in cats by assessing short-term toxicity and dosing schedule in cats with bone-invasive cancer. A retrospective pilot study included eight cats with bone invasive cancer treated with intravenous pamidronate. In vitro, pamidronate reduced proliferation in feline cancer cells (P<0.05. One cat treated with pamidronate in combination with chemotherapy and two cats treated with pamidronate as a single agent after failing prior therapy had subjective clinically stable disease; median progression free interval in these cats from initial pamidronate treatment was 81 days. Three cats developed azotemia while undergoing various treatment modalities including nonsteroidal anti-inflammatory drugs and pamidronate. Median overall survival was 116.5 days for all cats and 170 days for cats with oral squamous cell carcinoma. Median progression free survival was 55 days for all cats and 71 days for cats with oral squamous cell carcinoma. Pamidronate therapy appears feasible for administration in cancer bearing cats with aggressive bone lesions in the dose range of 1-2 mg/kg every 21–28 days for multiple treatments. No acute or short-term toxicity was directly attributable to pamidronate.

  10. Effectiveness of a computer assisted learning (CAL) package to raise awareness of autism


    diMambro Benedict; Chuthapisith Jariya; Doody Gillian


    Abstract Background Promoting awareness of autism in populations who work with children may result in an earlier diagnosis of the condition. In this study, a computer assisted learning (CAL) package, containing educationally appropriate knowledge about autism was developed; and the effectiveness of this CAL package was evaluated. Methods The CAL package was developed using computer software, "Xerte" and "Flash Macromedia". The effectiveness of the CAL package was evaluated in 32 childcare stu...

  11. Auditors’ Usage of Computer Assisted Audit Tools and Techniques: Empirical Evidence from Nigeria


    Appah Ebimobowei; G.N. Ogbonna; Zuokemefa P. Enebraye


    This study examines use of computer assisted audit tool and techniques in audit practice in the Niger Delta of Nigeria. To achieve this objective, data was collected from primary and secondary sources. The secondary sources were from scholarly books and journals while the primary source involved a well structured questionnaire of three sections of thirty seven items with an average reliability of 0.838. The data collected from the questionnaire were analyzed using relevant descriptive statist...

  12. Students Computer Literacy: Covariate For Assessing The Efficacy Of Computer Assisted Learning Tools


    Ronald R. Tidd; Richard Fenzl


    The purpose of this paper is to focus attention on the need to more rigorously measure computer-specific student characteristics when assessing the efficacy of computer assisted learning tools and benchmarking a curriculum's impact. It accomplishes this by first modeling learning outcomes assessment, identifying appropriate instruments, and discussing the absence of such measures in accounting education research. Then, the measurement process employed by the authors is discussed. The unsurpri...

  13. Effect of Integrating Computer-Assisted Language Learning in the TOEFL Performance of Nursing Students


    Marlene R. Castillo


    The study aimed to determine the relationship between the use of a computer-assisted language learning (CALL) software and the TOEFL performance of nursing students. This descriptive study used a pre-test and post-test and a survey questionnaire to gather data. Interviews and observations were also conducted to gain further insights in the use of the software. Results indicate that for the three areas of the TOEFL model practice test, there is a statistically significant increase in the gain ...

  14. Computer-Assisted Adjuncts for Aneurysmal Morphologic Assessment: Toward More Precise and Accurate Approaches (United States)

    Rajabzadeh-Oghaz, Hamidreza; Varble, Nicole; Davies, Jason M.; Mowla, Ashkan; Shakir, Hakeem J.; Sonig, Ashish; Shallwani, Hussain; Snyder, Kenneth V.; Levy, Elad I.; Siddiqui, Adnan H.; Meng, Hui


    Neurosurgeons currently base most of their treatment decisions for intracranial aneurysms (IAs) on morphological measurements made manually from 2D angiographic images. These measurements tend to be inaccurate because 2D measurements cannot capture the complex geometry of IAs and because manual measurements are variable depending on the clinician's experience and opinion. Incorrect morphological measurements may lead to inappropriate treatment strategies. In order to improve the accuracy and consistency of morphological analysis of IAs, we have developed an image-based computational tool, AView. In this study, we quantified the accuracy of computer-assisted adjuncts of AView for aneurysmal morphologic assessment by performing measurement on spheres of known size and anatomical IA models. AView has an average morphological error of 0.56% in size and 2.1% in volume measurement. We also investigate the clinical utility of this tool on a retrospective clinical dataset and compare size and neck diameter measurement between 2D manual and 3D computer-assisted measurement. The average error was 22% and 30% in the manual measurement of size and aneurysm neck diameter, respectively. Inaccuracies due to manual measurements could therefore lead to wrong treatment decisions in 44% and inappropriate treatment strategies in 33% of the IAs. Furthermore, computer-assisted analysis of IAs improves the consistency in measurement among clinicians by 62% in size and 82% in neck diameter measurement. We conclude that AView dramatically improves accuracy for morphological analysis. These results illustrate the necessity of a computer-assisted approach for the morphological analysis of IAs. PMID:28867867

  15. Interactive computer-assisted approach for evaluation of ultrastructural cilia abnormalities (United States)

    Palm, Christoph; Siegmund, Heiko; Semmelmann, Matthias; Grafe, Claudia; Evert, Matthias; Schroeder, Josef A.


    Introduction - Diagnosis of abnormal cilia function is based on ultrastructural analysis of axoneme defects, especialy the features of inner and outer dynein arms which are the motors of ciliar motility. Sub-optimal biopsy material, methodical, and intrinsic electron microscopy factors pose difficulty in ciliary defects evaluation. We present a computer-assisted approach based on state-of-the-art image analysis and object recognition methods yielding a time-saving and efficient diagnosis of cilia dysfunction. Method - The presented approach is based on a pipeline of basal image processing methods like smoothing, thresholding and ellipse fitting. However, integration of application specific knowledge results in robust segmentations even in cases of image artifacts. The method is build hierarchically starting with the detection of cilia within the image, followed by the detection of nine doublets within each analyzable cilium, and ending with the detection of dynein arms of each doublet. The process is concluded by a rough classification of the dynein arms as basis for a computer-assisted diagnosis. Additionally, the interaction possibilities are designed in a way, that the results are still reproducible given the completion report. Results - A qualitative evaluation showed reasonable detection results for cilia, doublets and dynein arms. However, since a ground truth is missing, the variation of the computer-assisted diagnosis should be within the subjective bias of human diagnosticians. The results of a first quantitative evaluation with five human experts and six images with 12 analyzable cilia showed, that with default parameterization 91.6% of the cilia and 98% of the doublets were found. The computer-assisted approach rated 66% of those inner and outer dynein arms correct, where all human experts agree. However, especially the quality of the dynein arm classification may be improved in future work.

  16. Computer Assisted Semen Analysis of Epididymal Spermatozoa after an Interperitoneal Administration of Diazinon and Cadmium


    Maria Adamkovicova; Robert Toman; Michal Cabaj; Svatoslav Hluchy; Peter Massanyi; Norbert Lukac; Monika Martiniaková


    The effects of cadmium and diazinon administration on rat sperm motility parameters were performed using a Computer Assisted Semen Analyzer (CASA) system. CASA was made on semen samples collected 36 h following an intraperitoneal injection of physiological solution (control group), diazinon (20 mg/kg body wt), cadmium (2 mg/kg body wt), separately and in combination. Sperm kinematic measurements revealed significant decline in the percentage of motile spermatozoa (P<0.05), significant high...

  17. Learning Performance Enhancement Using Computer-Assisted Language Learning by Collaborative Learning Groups


    Ya-huei Wang; Hung-Chang Liao


    This study attempted to test whether the use of computer-assisted language learning (CALL) and innovative collaborative learning could be more effective than the use of traditional collaborative learning in improving students’ English proficiencies. A true experimental design was used in the study. Four randomly-assigned groups participated in the study: a traditional collaborative learning group (TCLG, 34 students), an innovative collaborative learning group (ICLG, 31 students), a CALL tradi...

  18. Review Essay: Guidance in the World of Computer-Assisted Qualitative Data Analysis Software (CAQDAS) Programs


    Áine Humble


    This review discusses Christina SILVER and Ann Lewins' book, "Using Software in Qualitative Research: A Step-by-Step Guide" (2nd ed.). This book is an impressive undertaking, with online supplemental material in the form of three data sets consisting of many different types of data, detailed instructions for seven CAQDAS (Computer-Assisted Qualitative Data Analysis Software) programs, and full-color reproductions of illustrations from the book. The 14 chapters in the book cover a wide range o...

  19. Computer-assisted total knee arthroplasty using mini midvastus or medial parapatellar approach technique


    Feczko, Peter; Engelmann, Lutz; Arts, Jacobus J.; Campbell, David


    Background Despite the growing evidence in the literature there is still a lack of consensus regarding the use of minimally invasive surgical technique (MIS) in total knee arthroplasty (TKA). Methods A prospective, randomized, international multicentre trial including 69 patients was performed to compare computer-assisted TKA (CAS-TKA) using either mini-midvastus (MIS group) or standard medial parapatellar approach (conventional group). Patients from 3 centers (Maastricht, Zwickau, Adelaide) ...

  20. The Design and Application of Computer Assisted Language Learning System in Business English Writing course

    Directory of Open Access Journals (Sweden)

    Zhang Xi Wen


    Full Text Available The CALL (Computer Assisted Language Learning system is an effective method in business English writing teaching, particularly for students which are non-speaking countries. The CALLS is suited to self-learning because of the Rich scenario module design. Application results are examined by using the methods of group experiments, questionnaires, examinations and others. The CALLS is especially suited to creating a better studying atmosphere among students in the process of business English writing teaching than other methods.

  1. A computer-assisted verification of hyperchaos in the Saito hysteresis chaos generator

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    Li Qingdu [Institute for Nonlinear Systems, Chongqing University of Posts and Telecomm., Chongqing 400065 (China); Yang Xiaosong [Department of Mathematics, Huazhong University of Science and Technology, Wuhan 430074 (China)


    This paper presents a computer-assisted verification of hyperchaos in the well-known Saito hysteresis chaos generator (SHCG) by virtue of topological horseshoe theory. By means of interval analysis we find two disjoint compact subsets in a carefully chosen 3D cross section that can guarantee the existence of a topological horseshoe for the corresponding third-return Poincare map. Numerical studies show that the Poincare map expands in two directions. It justifiably indicates that there exists hyperchaos in the SHCG.

  2. An evaluation of the effectiveness of a computer-assisted reading intervention


    Messer, D. J.; Nash, Gilly


    Background. A cost-effective method to address reading delays is to use computer-assisted learning, but these are not always effective. \\ud Methods. We evaluated a commercially available computer system which uses visual mnemonics, in a randomised controlled trial with 78 English speaking children (mean age 7;7 years) who their schools identified as needing reading support. School based individual tutorials usually took place 2-3 times/week. Only the experimental group received the interventi...

  3. Computer-Assisted Diagnosis of the Sleep Apnea-Hypopnea Syndrome: A Review


    Diego Alvarez-Estevez; Vicente Moret-Bonillo


    Automatic diagnosis of the Sleep Apnea-Hypopnea Syndrome (SAHS) has become an important area of research due to the growing interest in the field of sleep medicine and the costs associated with its manual diagnosis. The increment and heterogeneity of the different techniques, however, make it somewhat difficult to adequately follow the recent developments. A literature review within the area of computer-assisted diagnosis of SAHS has been performed comprising the last 15 years of research in ...

  4. Factors affecting the use of computer assisted learning by further education biology teachers


    Barnard, Jane


    The UK educational system is currently under pressure from many quarters to increase its use of educational technology. Within this context, this thesis investigates the nature of a range of factors which influence teachers' use of computer assisted learning (CAL), focusing on biology teachers in Further Education (FE). The factors were identified from the literature, and include aspects such as resourcing, and the teachers' classroom practice and educational philosophies.\\ud \\ud There were t...

  5. New endoprosthesis suspension method with polypropylene monofilament knitted mesh after resection of bone tumors in proximal humerus. (United States)

    Fujibuchi, Taketsugu; Matsumoto, Seiichi; Shimoji, Takashi; Ae, Keisuke; Tanizawa, Taisuke; Gokita, Tabu; Hayakawa, Keiko


    Endoprosthetic reconstruction of the proximal humerus is one of the standard procedures after resection of tumors of the proximal humerus and has been considered a reliable method to reconstruct the proximal humerus in recent reports. However, instability of the shoulder joint caused by loss of the rotator cuff and deltoid muscle function is often observed after such an endoprosthetic reconstruction. We performed the endoprosthesis suspension method with polypropylene monofilament knitted mesh. This suspension method, by which the endoprosthesis is suspended from the bone structure, was used after resection of tumors in 9 patients. We assessed postoperative stability of the shoulder joint by comparing these patients with 12 patients who underwent the conventional surgical technique, by which the mesh-wrapped endoprosthesis is attached only to soft tissue. In radiographic and physical evaluation, 4 of the 12 patients in the soft tissue reconstruction group showed shoulder joint instability. No patient in the suspension method group showed subluxation of the humeral prosthesis. The mean shoulder flexion was 35° and 65° and the mean shoulder abduction was 40° and 40° for the soft tissue reconstruction group and the suspension method group, respectively. Shoulder joint subluxation sometimes occurs because of elongation of the attached soft tissue in the conventional reconstruction with mesh, whereas no shoulder joint subluxation occurs after endoprosthetic reconstruction in the suspension method because the bone structure has no leeway for elongation. Excellent stability of our new method enables exercise of the surgical shoulder at an early stage, leading to improved range of shoulder joint motion. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  6. Anti-angiogenesis therapy based on the bone marrow-derived stromal cells genetically engineered to express sFlt-1 in mouse tumor model

    Directory of Open Access Journals (Sweden)

    Chen X-C


    Full Text Available Abstract Background Bone marrow-derived stromal cells (BMSCs are important for development, tissue cell replenishment, and wound healing in physiological and pathological conditions. BMSCs were found to preferably reach sites undergoing the process of cell proliferation, such as wound and tumor, suggesting that BMSCs may be used as a vehicle for gene therapy of tumor. Methods Mouse BMSCs were loaded with recombinant adenoviruses which express soluble Vascular Endothelial Growth Factor Receptor-1 (sFlt-1. The anti-angiogenesis of sFlt-1 in BMSCs was determined using endothelial cells proliferation inhibition assay and alginate encapsulation assay. The anti-tumor effects of BMSCs expressing sFlt-1 through tail-vein infusion were evaluated in two mouse tumor metastases models. Results BMSCs genetically modified with Adv-GFP-sFlt-1 could effectively express and secret sFlt-1. BMSCs loaded with sFlt-1 gene could preferentially home to tumor loci and decrease lung metastases and prolong lifespan in mouse tumor model through inducing anti-angiogenesis and apoptosis in tumors. Conclusion We demonstrated that BMSCs might be employed as a promising vehicle for tumor gene therapy which can effectively not only improve the concentration of anticancer therapeutics in tumors, but also modify the tumor microenvironment.

  7. Squalene Selectively Protects Mouse Bone Marrow Progenitors Against Cisplatin and Carboplatin-Induced Cytotoxicity In Vivo Without Protecting Tumor Growth

    Directory of Open Access Journals (Sweden)

    Bikul Das


    Full Text Available Squalene, an isoprenoid antioxidant is a potential cytoprotective agent against chemotherapy-induced toxicity. We have previously published that squalene protects light-density bone marrow cells against cis-diamminedichloroplatinum( II (cisplatin-induced toxicity without protecting tumor cells in vitro. Here, we developed an in vivo mouse model of cisplatin and cis-diammine (cyclobutane-1,1-dicarboxylato platinum(II (carboplatin-induced toxicity to further investigate squalene-mediated LD-BM cytoprotection including the molecular mechanism behind selective cytoprotection. We found that squalene significantly reduced the body weight loss of cisplatin and carboplatin-treated mice. Light-density bone marrow cells from squalene-treated mice exhibited improved formation of hematopoietic colonies (colony-forming unit-granulocyte macrophage. Furthermore, squalene also protected mesenchymal stem cell colonies (colony-forming unit-fibroblast from cisplatin and carboplatin-induced toxicity. Squalene-induced protection was associated with decreased reactive oxygen species and increased levels of glutathione and glutathione peroxidase/glutathione-S-transferase. Importantly, squalene did not protect neuroblastoma, small cell carcinoma, or medulloblastoma xenografts against cisplatin-induced toxicity. These results suggest that squalene is a potential candidate for future development as a cytoprotective agent against chemotherapeutic toxicity.

  8. Diagnostic Value of Ex-Vivo Three-Dimensional Micro-Computed Tomography Imaging of Primary Nonhematopoietic Human Bone Tumors: Osteosarcoma versus Chondrosarcoma

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    Langheinrich, A. C.; Stolle, C.; Kampschulte, M.; Lommel, D.; Rau, W. S.; Bassaly, B. (Depts. of Radiology and Pathology, Univ. of Giessen, Giessen (Germany))


    Background: Osteosarcoma and chondrosarcoma are the most common nonhematopoietic primary malignancies of bone. However, unusual radiographic appearances can lead to delay in diagnosis and confusion with benign diseases. Purpose: To evaluate the feasibility of micro-computed tomography (CT) for the analysis of primary, nonhematopoietic human bone tumors ex vivo. Material and Methods: Samples from 12 human bone specimens (osteosarcoma, n=6; chondrosarcoma, n=6) obtained for diagnostic purposes were scanned using industrial X-ray film without amplifier foil and scanned with micro-CT (7- and 12-mum-cubic voxels). Trabecular bone CT 'density' and tumor matrix CT 'density' were determined, and results were compared with those obtained from a detailed conventional histopathologic analysis of corresponding cross-sections. The significance of differences in grayscale measurements was tested with analysis of variance. Results: Micro-CT provided quantitative information on bone morphology equivalent to histopathological analysis. We established grayscale measurements by which tumor matrices of chondrosarcoma and osteosarcoma could be radiographically categorized following histological classifications (P<0.001). Conclusion: Micro-CT is feasible for the analysis and differentiation of human osteosarcoma and chondrosarcoma

  9. The Bt-DUX: development of a subjective measure of health-related quality of life in patients who underwent surgery for lower extremity malignant bone tumor.

    NARCIS (Netherlands)

    Bekkering, W.P.; Vlieland, T.P.; Koopman, H.M.; Schaap, G.R.; Schreuder, H.W.B.; Beishuizen, A.; Tissing, W.J.; Hoogerbrugge, P.M.; Anninga, J.K.; Taminiau, A.H.M.


    BACKGROUND: To examine the practical applicability, internal consistency, and validity of the Bt-DUX, a disease-specific Health Related Quality of Life (HRQoL) instrument. The Bt-Dux was developed to examine patients' individual values of their life after a malignant bone tumor of the lower

  10. The Bt-DUX : Development of a Subjective Measure of Health-Related Quality of Life in Patients Who Underwent Surgery for Lower Extremity Malignant Bone Tumor

    NARCIS (Netherlands)

    Bekkering, W. Peter; Vlieland, Theodora P. M. Vliet; Koopman, Hendrik M.; Schaap, Gerard R.; Schreuder, H. W. Bart; Beishuizen, Auke; Tissing, Wim J. E.; Hoogerbrugge, Peter M.; Anninga, Jacob K.; Taminiau, Antonie H. M.

    Background To examine the practical applicability, internal consistency, and validity of the Bt-DUX, a disease-specific Health Related Quality of Life (HRQoL) instrument. The Bt-Dux was developed to examine patients' individual values of their life after a malignant bone tumor of the lower extremity

  11. Functional ability and physical activity in children and young adults after limb-salvage or ablative surgery for lower extremity bone tumors

    NARCIS (Netherlands)

    Bekkering, W. Peter; Vliet Vlieland, Theodora P. M.; Koopman, Hendrik M.; Schaap, Gerard R.; Bart Schreuder, H. W.; Beishuizen, Auke; Jutte, Paul C.; Hoogerbrugge, Peter M.; Anninga, Jacob K.; Nelissen, Rob G. H. H.; Taminiau, Antonie H. M.


    Aim of our study was to compare functional ability and physical activity in children and young adults who underwent surgery for a malignant bone tumor that was located around the knee. This cross-sectional study included 82 patients aged 8-25 years with a follow-up of 1-5 years. The functional

  12. Functional ability and physical activity in children and young adults after limb-salvage or ablative surgery for lower extremity bone tumors

    NARCIS (Netherlands)

    Bekkering, W.P.; Vliet Vlieland, T.P.M.; Koopman, H.M.; Schaap, G.R.; Schreuder, H.W.B.; Beishuizen, A.; Jutte, P.C.; Hoogerbrugge, P.M.; Anninga, J.K.; Nelissen, R.G.; Taminiau, A.H.M.


    BACKGROUND: Aim of our study was to compare functional ability and physical activity in children and young adults who underwent surgery for a malignant bone tumor that was located around the knee. METHODS: This cross-sectional study included 82 patients aged 8-25 years with a follow-up of 1-5 years.

  13. Functional Ability and Physical Activity in Children and Young Adults After Limb-Salvage or Ablative Surgery for Lower Extremity Bone Tumors

    NARCIS (Netherlands)

    Bekkering, W. Peter; Vlieland, Theodora P. M. Vliet; Koopman, Hendrik M.; Schaap, Gerard R.; Schreuder, H. W. Bart; Beishuizen, Auke; Jutte, Paul C.; Hoogerbrugge, Peter M.; Anninga, Jacob K.; Nelissen, Rob G. H. H.; Taminiau, Antonie H. M.


    Background: Aim of our study was to compare functional ability and physical activity in children and young adults who underwent surgery for a malignant bone tumor that was located around the knee. Methods: This cross-sectional study included 82 patients aged 8-25 years with a follow-up of 1-5 years.

  14. Gene recombinant bone marrow mesenchymal stem cells as a tumor-targeted suicide gene delivery vehicle in pulmonary metastasis therapy using non-viral transfection. (United States)

    Zhang, Tian-Yuan; Huang, Bing; Yuan, Zhong-Yue; Hu, Yu-Lan; Tabata, Yasuhiko; Gao, Jian-Qing


    One of the main limitations of anti-tumor gene therapy is the lack of an effective way to deliver therapeutic genes to tumor sites. Bone marrow mesenchymal stem cells (BMSCs) have been proposed as cellular delivery vehicles to tumor sites in tumor-targeted cancer gene therapy. Here, we investigated the therapeutic effects of cytomegalovirus-thymidine kinase expressing BMSCs (TK-BMSCs) on pulmonary melanoma metastasis combined with prodrug ganciclovir. BMSCs were successfully engineered through a non-viral gene vector. The gene recombinant BMSCs migrated to the pulmonary area and were found to have the tendency to target tumor nodules after systemic delivery. In vitro results demonstrate that the engineered BMSCs have significant suicide effects in the presence of ganciclovir in a dose-dependent manner and can exert a sufficient bystander effect on B16F10 tumor cells in co-culture experiments. In vivo studies confirmed the therapeutic effects of TK-BMSCs/ganciclovir on the metastasis tumor model. This study investigates the possibility of gene transfer via bone marrow mesenchymal stem cells in anti-cancer gene therapy using a metastatic melanoma model and cytomegalovirus-thymidine kinase expressing stem cells, demonstrating clear therapeutic effects. © 2013.

  15. Predictive factors of acute skin reactions to carbon ion radiotherapy for the treatment of malignant bone and soft tissue tumors. (United States)

    Takakusagi, Yosuke; Saitoh, Jun-Ichi; Kiyohara, Hiroki; Oike, Takahiro; Noda, Shin-Ei; Ohno, Tatsuya; Nakano, Takashi


    The skin is considered a critical organ at risk in carbon ion radiotherapy (CIRT) for locally advanced malignant bone and soft tissue tumors (MBSTs). The predictive factors for acute skin reactions after CIRT have not been investigated. The present study aimed to identify these factors and evaluate the correlation between the severity of acute skin reactions and skin dose parameters. CIRT with total doses of 64.0-70.4 Gy (relative biological effectiveness [RBE]) was administered to 22 patients with MBSTs. The skin-tumor distance (STD), maximum skin total dose (Dmax), and area of the skin receiving a total dose of X Gy (RBE) were evaluated. All patients developed acute skin reactions after CIRT, including Grades 1 and 2 dermatitis in 15 (71%) and 6 (29%) patients, respectively. There was a significant difference in the STD between the two groups (P = 0.007), and the cut-off value of STD for predicting Grade 2 acute skin reactions was 11 mm. There was a significant difference in Dmax between the groups (P reactions.

  16. Celecoxib enhances radiation response of secondary bone tumors of a human non-small cell lung cancer via antiangiogenesis in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Klenke, Frank Michael [Bern Univ. (Switzerland). Dept. of Orthopedic Surgery; Abdollahi, Amir [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Dept. of Radiation Oncology; Tufts Univ. School of Medicine, Boston, MA (United States). Center of Cancer Systems Biology; Bischof, Marc; Huber, Peter E. [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Dept. of Radiation Oncology; Gebhard, Martha-Maria [Heidelberg Univ. (Germany). Dept. of Experimental Surgery; Ewerbeck, Volker [Heidelberg Univ. (Germany). Dept. of Orthopedic Surgery; Sckell, Axel [Charite Univ. Medical Center, Berlin (Germany). Dept. of Orthopedic, Trauma and Reconstructive Surgery


    Purpose: Cyclooxygenase-2 (COX-2) inhibitors mediate a systemic antitumor activity via antiangiogenesis and seem to enhance the response of primary tumors to radiation. Radiosensitizing effects of COX-2 inhibition have not been reported for bone metastases. Therefore, the aim of this study was the investigation of the radiosensitizing effects of the selective COX-2 inhibitor celecoxib in secondary bone tumors of a non-small cell lung carcinoma in vivo. Materials and Methods: Human A549 lung carcinomas were implanted into a cranial window preparation in male SCID mice (n = 24). Animals were treated with either celecoxib or radiation (7 Gy single photon dose) alone or a combination of celecoxib and radiation, respectively. Untreated animals served as controls. The impact of radiation and COX-2 inhibition on angiogenesis, microcirculation, and tumor growth was analyzed over 28 days by means of intravital microscopy and histological methods. Results: Monotherapies with radiation as well as celecoxib had significant antitumor effects compared to untreated controls. Both therapies reduced tumor growth and vascularization to a similar extent. The simultaneous administration of celecoxib and radiation further enhanced the antitumor and antiangiogenic effects of single-beam radiation. With the combined treatment approach, tumor vascularization and tumor size were decreased by 57% and 51%, respectively, as compared to monotherapy with radiation. Conclusion: The combined application of radiation therapy and COX-2 inhibition showed synergistic effects concerning the inhibition of tumor growth and tumor angiogenesis. Therefore, the combination of radiation with COX-2 inhibitor therapy represents a promising approach to improve the therapeutic efficacy of radiotherapy of bone metastases. (orig.)

  17. InterviewStreamliner, a minimalist, free, open source, relational approach to computer-assisted qualitative data analysis software

    NARCIS (Netherlands)

    H.D. Pruijt (Hans)


    textabstractInterviewStreamliner is a free, open source, minimalist alternative to complex computer-assisted qualitative data analysis packages. It builds on the flexibility of relational database management technology.

  18. Total knee arthroplasty with computer-assisted navigation more closely replicates normal knee biomechanics than conventional surgery. (United States)

    McClelland, Jodie A; Webster, Kate E; Ramteke, Alankar A; Feller, Julian A


    Computer-assisted navigation in total knee arthroplasty (TKA) reduces variability and may improve accuracy in the postoperative static alignment. The effect of navigation on alignment and biomechanics during more dynamic movements has not been investigated. This study compared knee biomechanics during level walking of 121 participants: 39 with conventional TKA, 42 with computer-assisted navigation TKA and 40 unimpaired control participants. Standing lower-limb alignment was significantly closer to ideal in participants with navigation TKA. During gait, when differences in walking speed were accounted for, participants with conventional TKA had less knee flexion during stance and swing than controls (Pbiomechanics of computer-assisted navigation TKA patients compared to controls than for patients with conventional TKA. Computer-assisted navigation TKA may restore biomechanics during walking that are closer to normal than conventional TKA. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Conference report: 18th conference on computer-assisted qualitative data analysis (CAQD) 2016: MAXQDA user conference


    Galan-Diaz, Carlos


    During the first week of March 2016, 120 researchers from 12 different countries, including Syria, Japan, the USA and Turkey, met in Berlin (Germany) to learn more about their computer-assisted qualitative data analysis skills. The 18th Conference on Computer-Assisted Qualitative Data Analysis (CAQD) offered several workshops, a research methods poster session, and the opportunity to share and discuss best practice between attendees, trainers and speakers (informally and through the user foru...

  20. Enhanced cephalomedullary nail lag screw placement and intraoperative tip-apex distance measurement with a novel computer assisted surgery system. (United States)

    Kuhl, Mitchell; Beimel, Claudia


    The goal of this study was to evaluate the ability of a novel computer assisted surgery system to guide ideal placement of a lag screw during cephalomedullary nailing and then accurately measure the tip-apex distance (TAD) measurement intraoperatively. Retrospective case review. Level II trauma hospital. The initial 98 consecutive clinical cases treated with a cephalomedullary nail in conjunction with a novel computer assisted surgery system were retrospectively reviewed. A novel computer assisted surgery system was utilized to enhance lag screw placement during cephalomedullary nailing procedures. The computer assisted surgery system calculates the TAD intraoperatively after final lag screw placement. The ideal TAD was considered to be within a range of 5mm-20mm. The ability of the computer assisted surgery system (CASS) to assist in placement of a lag screw within the ideal TAD was evaluated. Intraoperative TAD measurements provided by the computer assisted surgery system were then compared to standard postoperative TAD measurements on PACS (picture archiving and communication system) images to determine whether these measurements are equivalent. 79 cases (80.6%) were available with complete information for a retrospective review. All cases had CASS TAD and PACS TAD measurements >5mm and<20mm. In addition, no significant difference could be detected between the intraoperative CASS TAD and the postoperative PACS TAD (p=0.374, Wilcoxon Test; p=0.174, paired T-Test). A cut-out rate of 0% was observed in all patients who were treated with CASS in this case series (95% CI: 0 - 3.01%). The novel computer assisted surgery system tested here is an effective and reliable adjunct that can be utilized for optimal lag screw placement in cephalomedullary nailing procedures. The computer assisted surgery system provides an accurate intraoperative TAD measurement that is equivalent to the standard postoperative measurement utilizing PACS images. Therapeutic Level IV. Copyright