Single-Shot Spinal Anesthesia in an Infant Requiring Magnetic Resonance Imaging and Open Lower-Extremity Surgery: A Case Report.

Spinal anesthesia (SA) is a safe and effective anesthetic technique for lower abdominal and lower extremity surgery in neonates and infants and is associated with an apparent state of sedation. We report the use of single-shot SA in a 6-week-old infant for a combined magnetic resonance imaging and open surgical biopsy of a deep soft tissue lower extremity mass. By leveraging the unique qualities of SA (sedation and surgical blockade), we avoided the need for general anesthesia.

Percutaneous in Situ Fixation of Slipped Capital Femoral Epiphysis.

Slipped capital femoral epiphysis (SCFE), a common cause of adolescent hip pain, is a displacement of the femoral head through the proximal femoral physis. The exact etiology of SCFE is unknown, but both biochemical and biomechanical factors, including obesity, femoral retroversion, increased physeal obliquity, puberty, and endocrinopathies, play a role. Patients often present with hip, groin, or knee pain and an antalgic gait.

Disruption of crosstalk between mesenchymal stromal and tumor cells in bone marrow as a therapeutic target to prevent metastatic bone disease.

Skeletal metastasis is a serious complication of many primary cancers. A common feature of tumor cells that metastasize to the bone marrow microenvironment is that they initiate a cascade of events, recruiting and presumably/potentially altering the phenotype of bone marrow mesenchymal stromal cells (MSC) to produce an environment that allows for tumor growth and in some cases, drug-resistant dormancy of latent cancer cells. Consequently the MSC population can contribute to metastatic disease through several distinct mechanisms by differentiating into cancer-associated fibroblasts (CAFs).

What is the best material for molding casts in children?

Background: Casts are used to treat clubfeet, developmental dysplasia of the hip (DDH), forearm fractures, and femur fractures. The ability of a cast to maintain a desired shape is termed moldability. Clinicians use plaster, fiberglass, and soft casts.

Prognosis of hepatoid yolk sac tumor in women: what's up, Doc?

Ovarian yolk sac tumors are highly malignant germ cell tumors that commonly occur in young women. The hepatoid yolk sac tumor is a variant form of yolk sac tumor in which there has been extensive tumor differentiation to early liver tissue. Hepatoid differentiation is traditionally considered to signify a poor prognosis.

Ultraporous β-tricalcium phosphate alone or combined with bone marrow aspirate for benign cavitary lesions: comparison in a prospective randomized clinical trial.

Background: Ultraporous β-tricalcium phosphate (TCP) synthetic graft material (Vitoss; Orthovita) persists for a year or longer in some cases. In this study, we prospectively examined healing of cavitary defects filled with TCP versus TCP and bone marrow aspirate (TCP/BM) with the hypothesis that bone-marrow aspirate speeds incorporation of bone graft substitute.

Methods: Fifty-five patients with a benign bone lesion undergoing surgical curettage were randomized to receive TCP (N = 26; mean duration of follow-up [and standard deviation], 20.

Physical activity assessment in adolescents with limb salvage.

Objectives: To evaluate ambulatory activity differences between youth with limb salvage procedures and typically developing youth (TDY) and assess differences in self-reported activity levels in the 2 groups, to provide a basis for physical activity assessment in patients who had undergone limb salvage surgery and treatment planning that incorporates regaining normal physical and daily living activities.

Study Design: In this cohort comparison study, we compared ambulatory and self-reported activity levels in 20 youth (aged 11.7-20.

Ankle fractures in children.

Computed tomography is useful for preoperative planning and postreduction assessment for intra-articular pediatric ankle fractures. Nondisplaced pediatric ankle fractures can be effectively managed with cast immobilization and close radiographic follow-up evaluation. Physeal ankle injuries in younger children with considerable growth remaining should be followed closely for at least one year after injury as growth arrest may result in substantial angular deformity.

Measurement of walking activity throughout childhood: influence of leg length.

The aim of this study was to describe walking (stride) activity frequency and intensity in 428 children ages 2-15 years with a single accelerometer-based device. With comparison with published pedometer-determined data, the influence of leg length was examined. Decline in stride frequency and intensity throughout childhood increased with adjustment for leg length.

Kaposiform hemangioendothelioma in multiple spinal levels without skin changes.

Kaposiform hemangioendothelioma is a rare vascular tumor of childhood that is locally aggressive but has little metastatic potential and by itself is not known to be lethal. It most commonly presents as a superficial or deep soft tissue mass with associated cutaneous lesions. Kasabach-Merritt phenomenon, a condition characterized by profound thrombocytopenia and life-threatening hemorrhage, often is associated with kaposiform hemangioendothelioma.

Risk assessment based on FDG-PET imaging in patients with synovial sarcoma.

Unlabelled: Synovial sarcoma generally is associated with poor prognosis. With recent advances in molecular biology, it has become apparent not all synovial sarcomas share the same tumor biology. (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) is useful for risk assessment in several types of sarcomas.

Metastatic osteosarcoma gene expression differs in vitro and in vivo.

An understanding of differential gene expression in highly metastatic osteosarcoma could provide gene targets for treatment of metastases. We compared gene expression profiles of high- (LM7) and low- (LM2) metastatic SaOS2-derived cell lines in an in vitro tissue culture model and examined several differentially regulated genes in vivo in a murine orthotopic xenograft model. We hypothesized an orthotopic inoculation of LM2 and LM7 cells would establish a primary lesion and the gene expression profile of cells grafted in this fashion would resemble the gene expression profile observed in an in vitro model.