Primary treatment of chondroblastoma with percutaneous radio-frequency heat ablation: report of three cases.

Chondroblastomas are benign cartilaginous lesions; however, intervention is necessary to stop progression and alleviate pain. The authors evaluated three patients in whom minimally invasive percutaneous radio-frequency heat ablation was used to treat pathologically proven chondroblastoma to determine whether this treatment demonstrated long-term success. The authors found that this approach may be an effective alternative to surgical intervention in some cases.

Effect of chondrocalcinosis on the MR imaging of knee menisci.

OBJECTIVE: Our goal was to determine the influence of chondrocalcinosis on MR imaging in the detection of meniscal tears. MATERIALS AND METHODS: A retrospective review was performed of knee MR imaging and arthroscopy records from two university hospitals between 1996 and 1998. Seventy individuals had radiographic evidence of chondrocalcinosis and underwent knee MR imaging. Thirty-seven of these individuals had undergone arthroscopy for further evaluation of their symptoms. MR imaging sensitivity and specificity in the detection of medial and lateral meniscal tears were calculated in these 37 patients who had radiographic evidence of chondrocalcinosis and in a control group of 34 patients who underwent MR imaging and arthroscopy but did not have knee chondrocalcinosis. RESULTS: In the chondrocalcinosis group, MR imaging sensitivity, specificity, and accuracy for meniscal tear were 78%, 71%, and 78%, respectively, for the lateral meniscus, and 89%, 72%, and 81% for the medial meniscus. The control group showed sensitivity, specificity, and accuracy of 93%, 100%, and 97%, respectively, for the lateral meniscus and 100% in all cases for the medial meniscus. The MR imaging detection of meniscal tears in both the lateral and medial compartments combined is significantly poorer in the presence of chondrocalcinosis (p < 0.005). CONCLUSION: MR imaging sensitivity and specificity for detection of meniscal tear is decreased in the presence of meniscal chondrocalcinosis. Chondrocalcinosis appeared as a high-signal-intensity region on T1-weighted, intermediate-weighted, and inversion recovery sequences. The high signal of chondrocalcinosis on inversion recovery sequence is an interesting observation that to our knowledge has not been previously reported. Radiographic correlation with the MR imaging examination can help prevent overdiagnosing meniscal tears.

Project Galileo: completing Europa, preparing for Io.

Galileo has completed the Europa leg of the Galileo Europa Mission, and is now pumping down the apojove in each succeeding orbit in preparation for the Io phase. Including three encounters earlier in the primary mission, the total of ten close passes by Europa have provided a wealth of interesting and provocative information about this intriguing body. The results presented include new and exciting information about Europa's interactions with Jupiter's magnetosphere, its interior structure, and its tantalizing surface features, which strongly hint at a watery subsurface layer. Additional data concerning Callisto, and its own outlook for a subsurface ocean are also presented. In addition the engineering aspects of operating the spacecraft during the past year are explored, as well as a brief examination of what will be the challenges to prepare for the Io encounters. The steadily increasing radiation dosage that the spacecraft is experiencing is well beyond the original design parameters, and is contributing to a number of spacecraft problems and concerns. The ability of the flight team to analyze and solve these problems, even at the reduced staffing levels of an extended mission, is a testament to their tenacity and loyalty to the mission. The engineering data being generated by these continuing radiation-induced anomalies will prove invaluable to designers of future spacecraft to Jupiter and its satellites. The lessons learned during this arduous process are presented.

Limbic system abnormalities associated with mesial temporal sclerosis: a model of chronic cerebral changes due to seizures.

In a landmark 1966 study, widespread cerebral abnormalities were discovered at histopathologic examination of autopsied brains from patients with long-standing temporal lobe epilepsy. In the brains diagnosed with mesial temporal sclerosis (MTS), these abnormalities involved not only the hippocampus but also other structures of the limbic system and medial temporal lobe. Many of these changes are evident at magnetic resonance imaging. Because many of these abnormalities are found within limbic structures along a known neuroanatomic pathway (the Papez circuit), they suggest a pattern of cerebral damage related to the physiologic interconnections between the hippocampus and associated limbic structures. It appears that limbic damage associated with MTS more often affects the structures most closely connected to the hippocampus along the Papez circuit. The frequency and widespread distribution of these cerebral abnormalities suggest that MTS is not limited to the medial temporal lobe but instead represents a limbic system disorder.

One-year reduction and longitudinal analysis of carotid intima-media thickness associated with colestipol/niacin therapy.

BACKGROUND AND PURPOSE: The Cholesterol Lowering Atherosclerosis Study has reported significant reduction of coronary artery disease and of carotid arterial intima-media thickness (IMT) at 2 and 4 years with colestipol/niacin therapy. We now report on treatment effects on carotid IMT at 6 months and 1 year. METHODS: One hundred eighty-eight nonsmoking men, aged 40 to 59 years, with prior coronary artery bypass graft surgery were randomized to colestipol/niacin plus diet therapy or placebo plus diet therapy. Computerized image processing of carotid ultrasound films was used to measure IMT in the right common carotid artery. Treatment group comparisons were made at 6 months and 1 year (46 and 33 subjects, respectively, with baseline and 6-month or 1-year ultrasound measures). The time course of the treatment effect on carotid IMT was estimated using the complete sample of 78 subjects with baseline and on-trial data. RESULTS: No significant treatment group differences on carotid IMT were found at 6 months. At 1 year, the treated group showed significant reduction of carotid IMT (P = .01 between groups). The placebo group showed continuing progression of IMT during the 4-year study period (estimated progression rate, 0.018 mm/y). The treated group showed reduction of IMT during the first 3 years and a plateau during the remainder of the study. CONCLUSIONS: Reduction of carotid IMT was found with aggressive lipid-lowering therapy. Ultrasound measures of IMT offer a noninvasive and precise measure of early carotid atherosclerosis that will decrease sample size requirements, potentially decrease dropout rates, and widen the study population of antiatherosclerotic clinical trials.