Clinical Application of Artificial Intelligence: Auto-Discerning the Effectiveness of Lidocaine Concentration Levels in Osteosarcoma Femoral Tumor Segment Resection.

Adolescents and children worldwide are threatened by osteosarcoma, a tumor that predominantly affects the long bone epiphysis. Osteosarcoma is the most common and highly malignant bone tumor in youngsters. Early tumor detection is the key to effective treatment of this disease. The discovery of biomarkers and the growing understanding of molecules and their complex interactions have improved the outcome of clinical trials in osteosarcoma. This article describes biomarkers of osteosarcoma with the aim of positively influencing the progress of clinical treatment of osteosarcoma. Femoral bone tumor is a typical condition of osteosarcoma. Due to the wide range of femoral stem types, complexities in the distal femur, and tumors in the rotor part of femur, physicians following the traditional clinical approach face difficulties in removing the lesion and fixing the femur with resection of the tumor segment. In this paper, the effect of small doses of different concentrations of lidocaine anesthesia in patients undergoing lumpectomy for osteosarcoma femoral tumor segments is investigated. A computer-based artificial intelligence method for automated determination of different concentration levels of lidocaine anesthesia and amputation of osteosarcoma femoral tumor segment is proposed. Statistical analysis is carried on the empirical data including intraoperative bleeding, intraoperative and postoperative pain scores, surgical operation time, postoperative complications, patient satisfaction, and local anesthetic dose. The results showed that the patients in the study group had low intraoperative bleeding, short operation time, low postoperative hematoma formation rate, high patient satisfaction, higher dosage of anesthetic solution, and low dosage of lidocaine. Results revealed that mean arterial pressure and heart rate in extubating and intubating were significantly lower in the observation group than in the control group, and a significant difference (P < 0.05) was observed between the two groups. This proves that the proposed algorithm can adequately reduce bleeding, alleviate postoperative pain, shorten operation time, reduce complications, accelerate recovery, and ensure better treatment results.

Metal-associated angiosarcoma of bone: report of two cases and review of the literature.

Angiosarcoma is an extremely rare bone tumor. The authors report two cases of patients with angiosarcoma that developed adjacent to a stainless steel plate used for fixation of a femur fracture. In both patients, the interval between fracture treatment and the development of the neoplasm was more than 40 years. A review of the literature found 36 previously reported cases of malignancy arising adjacent to an orthopaedic implant. Despite any evidence directly linking these implants to the development of cancer, continued vigilance is warranted.

Metal-induced sarcoma. A case report and literature review.

The overall biocompatibility characteristics of metallic implants are important considerations in orthopedic surgery. A review of the literature shows very few reports of neoplasms in association with metallic implants. This case report demonstrates osteogenic sarcoma at the site of a Smith-Petersen nail that had been implanted for nine years in a 65-year-old woman for fixation of a femoral neck fracture. Gross examination revealed debris at the tumor site, with a concentration of 14 ppm of nickel within the tumor tissue. Experimental investigations support the possibility of neoplastic induction by heavy metals, particularly cobalt, cadmium, and nickel. Circumstantial evidence shows osteogenic sarcoma that developed at the site of this device, possibly in response to metal or factors at the site of metal.

[Localization and invasion of the femur in the rat by a soft tissue tumor induced by pellets made of hydroxypropylcellulose mixed with 20-methylcholanthrene: special reference to effects of the periosteum].

Pellets made of a carcinogenic substance, methylcholanthrene admixed with a high molecular substance, hydroxypropycellulose were implanted into the thigh of 90 Wistar white female rats of 5 weeks of age (3 groups, 30 rats each). Ten control rats did not receive the pellets. In group 1, the pellets were placed at the window made at the cortex of the right femur; in group 2, into the space between the cortex and the periosteum; in group 3, into the pouch created outside of the periosteum. Twenty weeks after implantation, spindle cell sarcoma developed in 28 rats of group 1, 27 of group 2, and 21 of group 3. Tumor invasions into the bone marrow of the femur were seen in 14 rats in group 1 (46.7%), 5 in group 2 (18.5%). In group 3, however, tumor invasion was not observed. There were significant differences in the frequency of tumor invasion between group 1 and 2 (p less than 0.01) as well as between group 2 and 3 (p less than 0.05). At implant sites, group 2 showed thinning out of periosteum, while group 3 exhibited thickening of both cortex and periosteum. This experimental results suggested that periosteum provides an important barrier in the bone against tumor invasion.

Induction of gastric carcinomas in nonhuman primates by N-ethyl-N'-nitro-N-nitrosoguanidine.

N-Ethyl-N'-nitro-N-nitrosoguanidine [(ENNG) CAS: 63885-23-4] was administered to 5 Macaca monkeys (Macaca mulatta and M. irus) at a concentration of 200 or 300 micrograms/ml for 11-26 months in their drinking water. Gastric carcinomas in the pyloric region were observed in all 5 monkeys between experimental months 11 and 38. Histologically, these carcinomas were mainly poorly differentiated adenocarcinomas and signet-ring cell carcinomas, and a few moderately and well-differentiated adenocarcinomas were also found. The macroscopic and histologic appearances of these carcinomas were similar to those in humans.

Difference in the induction of osteosarcoma in rabbit bone with single administration of three kinds of chemical carcinogens.

A single intramedullary administration of each dose (15 approximately 20 mg) of 4-nitroquinoline 1-oxide, 3-methylcholanthrene, or 7,12-dimethylbenz[alpha]anthracene was applied to the mandible, diaphysis, or distal metaphysis of the femur of rabbits. The highest incidence in production of osteosarcoma was obtained from the group in which 4-nitroquinoline 1-oxide was applied to the distal metaphysis (75%, including one case of chondrosarcoma). Tumors hardly appeared in any of the groups when given 3-methylcholanthrene or 7,12-dimethylbenz[alpha]anthracene. Histologically, three kinds of entities were recognized from the quantitative difference of the reactive tissues which appeared around carcinogens. It is estimated that the condition of entity III induces the highest incidence of osteosarcoma if chemical carcinogens are given into the bone marrow of experimental animals.