ABSTRACT
Cysts of the mesentery, retroperitoneum and omentum are rare. We present a patient with a mucinous cystadenoma in the mesentery of the right hemicolon. The exact aetiology of these cysts at the aforementioned sites is still unclear. Adenocarcinomas can arise in mucinous cystadenomas. Therefore, in our opinion, to prevent spillage the right approach is to primarily perform a laparatomy instead of attempting to remove these lesions laparoscopically, even if clinical and radiological signs of malignancy are absent.
Subject(s)
Colonic Neoplasms/diagnosis , Cystadenocarcinoma, Mucinous/diagnosis , Mesentery , Peritoneal Neoplasms/diagnosis , Adolescent , Colonic Neoplasms/surgery , Cystadenocarcinoma, Mucinous/surgery , Diagnosis, Differential , Female , Humans , Laparotomy/methods , Mesentery/surgery , Peritoneal Neoplasms/surgery , Treatment OutcomeABSTRACT
We re-examined clinically and radiologically 88 patients with a fracture of the lower leg at a mean follow-up of 15 years. Forty-three fractures (49%) had healed with malalignment of at least 5 degrees. More arthritis was found in the knee and ankle adjacent to the fracture than in the comparable joints of the uninjured leg. Malaligned fractures showed significantly more degenerative changes. Eighteen patients (20%) had symptoms in the fractured leg. There was a significant correlation between symptoms in the knee and arthritis but not between symptoms and ankle arthritis or malalignment. We conclude that fractures of the lower leg should be managed so that the possibility of angular deformity and thereby late arthritis is minimised.
Subject(s)
Ankle Joint , Fractures, Malunited/complications , Knee Joint , Osteoarthritis/etiology , Tibial Fractures/complications , Adolescent , Adult , Female , Follow-Up Studies , Fractures, Malunited/classification , Humans , Male , Middle Aged , Osteoarthritis/classification , Osteoarthritis/diagnostic imaging , Radiography , Severity of Illness Index , Tibial Fractures/classificationABSTRACT
The results of conservative (mainly, functional bracing) and operative treatment (mainly, plate fixation) have been compared in a retrospective study of 170 displaced noncomminutive tibial shaft fractures. The characteristics of the fractures in both treatment groups showed no significant differences. The follow-up analysis revealed no statistical differences in outcome between the two methods. However, because of the many factors analyzed and the restricted number of patients studied, it is impossible to compare all factors independently. Surgical treatment resulted in a higher rate of complications (such as implant failure, osteitis, and refracture) and a longer total hospitalization time. Conservative treatment showed a longer duration of fracture healing and a higher rate of malalignment. Malalignments of up to 10 degrees with no adverse effects have been seen so far. In conservative treatment, two fracture types were identified with a higher rate of malalignment: short oblique isolated tibial fractures and fully dislocated transverse crural fractures. Conservative therapy is favored, because there is less discomfort for the patient and the treatment is cost contained.
Subject(s)
Bone Plates , Braces , Tibial Fractures/therapy , Adolescent , Adult , Aged , Humans , Length of Stay , Middle Aged , Postoperative Complications/etiology , Retrospective Studies , Tibial Fractures/classification , Wound HealingABSTRACT
A single-blind prospective study of 99mTc-diethylene triamine penta-acetic acid (DTPA) breast scintigraphy was performed on 160 women who presented at the outpatient clinic with suspected breast tumour. The sensitivity of scintigraphy in establishing the diagnosis of breast cancer was 75 per cent. The specificity of scintigraphy in excluding the presence of breast cancer was 91 per cent. The diagnostic value of DTPA breast scintigraphy is at present too low in comparison with mammography to be clinically useful.
Subject(s)
Breast Neoplasms/diagnostic imaging , Breast/diagnostic imaging , Pentetic Acid , Technetium , Adult , Aged , Female , Humans , Mammography , Middle Aged , Prospective Studies , Radionuclide Imaging , Technetium Tc 99m PentetateABSTRACT
Following a report on the use of Tc-99m-diethylenetriamine pentaacetic acid (Tc-99m-DTPA) for detection of malignant breast tumors we compared this method with other diagnostic aids such as mammography and cytology. Among 160 women referred to our department for diagnosis, 166 examinations were performed (six patients had bilateral lesions); the final diagnosis of the breast lesion was established as malignant in 62 cases and benign in 104 cases. The scintigraphic image was reported malignant if an area of focal uptake observed on the scan 30 minutes after injection of the tracer persisted or became more intense on the 2-hour scintigram. All other uptake patterns were considered benign. For this examination we obtained a sensitivity of 75% and a specificity of 91%. For mammography, sensitivity was 90% and specificity was 82%. The lower false-positive results of scintigraphy may serve to confirm the benignancy of doubtful mammographic findings, for when both examinations suggest a benign lesion, the combined imaging procedure is a useful means of excluding cancer (sensitivity 96%, predictive value 98%). It is concluded that in all other cases Tc-99m-DTPA breast scintigraphy is of limited value.
