Leg function after radiotherapy for Ewing's sarcoma

Twenty-nine patients with Ewing's sarcoma of the lower extremity who survived for two or more years following therapy (5000 rad locally and systemic chemotherapy) were studied to assess functional status of the affected leg. Twenty-two of twenty-nine were alive and were reexamined; the deceased patients were evaluated by record review. Twenty-two of the twenty-nine had serial radiographs, which were reviewed to assess growth change induced by radiation. The living patients were divided on the basis of clinical examination into four functional groups with Group I comprising patients with minor functional limitations and leg length discrepancy 1.5 cm or less. Group II patients had moderate functional limitations with 2.5-cm leg-length discrepancy or less. Group III patients had severe functional limitations with up to 4-cm leg length discrepancy. Group IV patients had severe complications, sufficient enough to warrant amputation. Thirteen of twenty-two patients were classified as functional Group I, five as Group II, three as Group III, and one as Group IV. Radiographic changes in growing bone did not correlate with functional results. Although a femoral fracture and an age less than 16 years at diagnosis were found to be less favorable prognostic factors for the functional treatment result, these results show that neither femoral location nor young age justify primary amputation for Ewing's sarcoma of the lower leg extremity.     

The North Carolina High School Athletic Injury Study: design and methodology

PURPOSE: Organized interscholastic athletics are an integral part of the educational program at almost every school level. With this growing popularity of sports and their inclusion in more public school programs, it becomes increasingly apparent that additional consideration must be given to the injury problem associated with sport. The North Carolina High School Athletic Injury Study (NCHSAIS) was undertaken to identify patterns of injury among male and female athletes in North Carolina high schools participating in any of 12 sports. Specific aims are to measure the incidence, severity and etiology of injuries; to determine the relationship of demographic factors and protective equipment, exposure to play, and school characteristics to injuries; to study the relationship of coaches' training and experience to injury occurrence; and to compare the incidence and severity of injury among female and male athletes in the same or comparable sports. METHODS: A two-stage cluster sample of 100 high schools in North Carolina was selected for this 4-yr prospective study. RESULTS: Participation by the initial sample or a random replacement was achieved for 91 of the 100 schools. Nonresponse occurred at multiple levels of the sample for this study, and the weekly participation form posed the greatest respondent burden. CONCLUSIONS: The NCHSIAS offers a successful methodology for addressing sports injuries. In this paper we describe the design, methodology, and implementation issues that emerge in conducting a large scale epidemiological study in a population of high school athletes.     

Semitransparent poly(styrene‐r‐maleic anhydride)/alumina nanocomposites for optical applications

This article presents the development and characterization of transparent poly(styrene‐r‐maleic anhydride) (SMA)/alumina nanocomposites for potential use in optical applications. Chemically treated spherical alumina nanoparticles were dispersed in an SMA matrix polymer via the solution and melt‐compounding methods to produce 2 wt % nanocomposites. Field emission scanning electron microscopy was used to examine the nanoparticle dispersion. When the solution method was used, nanoparticle reagglomeration occurred, despite the fairly good polymer wetting. However, through the coating of the alumina nanoparticles with a thin layer (ca. 20 nm) of low‐molecular‐weight SMA, reagglomeration was absent in the melt‐compounded samples, and this resulted in excellent nanoparticle dispersion. The resultant nanocomposites were semitransparent to visible light at a 2‐mm thickness with improved UV‐barrier properties. Their impact strengths, tensile strengths, and strains at break were slightly reduced compared with those of their neat resin counterpart, whereas a small enhancement in their moduli was achieved. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci 2007     

Management of chylothorax

BACKGROUND: Chylothorax is a rare primary or secondary condition the optimum management of which remains uncertain. METHODS: Twenty cases of chylothorax, including ten of primary chylothorax and ten secondary to either malignancy, subclavian vein thrombosis or lymphangioma treated between 1956 and 1986 have been reviewed. RESULTS: Open pleurectomy was the most successful treatment in preventing reaccumulation of the effusion. Three patients had thoracic duct-azygous vein anastomoses, but all anastomoses were probably occluded within a year of surgery. Three patients have been lost to follow-up and five died within 2 years of their treatment, but 12 patients were alive and free from an effusion 3-22 years after treatment. CONCLUSION: Patients with chylothorax should undergo lymphangiography to identify the cause and site of the lymphatic abnormality. Conservative treatment is successful in some patients but should be abandoned if the fluid loss exceeds 1.5 l/day for more than 5-7 days in an adult or more than 100 ml/day in a child. Parietal pleurectomy is the most successful treatment when no distinct chylous leak can be identified. Less commonly, an isolated chylous leak either in the chest or in the abdomen may be identified and this should be treated by direct ligation.     

A8高速路公园

Koog aan de Zaan是阿姆斯特丹附近的个可爱的小村庄，坐落于Zaan河边。20世纪70年代早期，这里新建了条高速路。为了跨过河，A8高速下面由桥墩支撑。这条新路奇妙地穿过镇子，在城市肌理中形成了个粗暴的切口。具有讽刺意义的是，在这里形成了个教会和政府间的根本分离：高架路的一侧是一个小教堂，而另一侧则是原来的市政厅。桥墩大概有7米高。桥下的空间变得非常具有纪念性：成为一个延伸的教堂。