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Two-branch 3D convolutional nerve organs network regarding motor symbolism EEG decoding.
der the curve 69.2% [range 62.8%-75.6%]). CONCLUSIONS We found that age, BMI, tumor location, and timing of radiation are associated with the risk of wound complications. Based on these factors, a validated nomogram has been established that can provide an individualized prediction of wound complications in patients with a resected soft-tissue sarcoma of the extremity. This may allow for proactive management with nutrition and surgical techniques, and help determine the delivery of radiation in patients with a high risk of having these complications. LEVEL OF EVIDENCE Level III, therapeutic study.BACKGROUND The femur is the most common site of metastasis in the appendicular skeleton, and metastatic bone disease negatively influences quality of life. Orthopaedic surgeons are often faced with deciding whether to prophylactically stabilize an impending fracture, and it is unclear if prophylactic fixation increases the likelihood of survival. QUESTIONS/PURPOSES Is prophylactic femur stabilization in patients with metastatic disease associated with different overall survival than fixation of a complete pathologic fracture? METHODS We performed a retrospective, comparative study using the national Veterans Administration database. All patient records from September 30, 2010 to October 1, 2015 were queried. Only nonarthroplasty procedures were included. The final study sample included 950 patients (94% males); 362 (38%) received prophylactic stabilization of a femoral lesion, and 588 patients (62%) underwent fixation of a pathologic femur fracture. Mean followup duration was 2 years (range, 0-7 years). We cr not determine the cause of this association, and it is possible, if not likely, that patients treated for fracture had more aggressive disease causing the fracture than did those undergoing prophylactic stabilization. Proteasome inhibitor Currently, most orthopaedic surgeons who treat pathological fractures stabilize the fracture prophylactically when reasonable to do so. We may be improving survival in addition to preventing a pathological fracture; further study is needed to determine whether the association is cause-and-effect and whether additional efforts to identify and treat at-risk lesions improves patient outcomes. LEVEL OF EVIDENCE Level III, therapeutic study.BACKGROUND Massive bone allografts have been used for limb salvage in patients undergoing bone tumor resections as an alternative to endoprostheses. Although several studies on massive allograft reconstructions for bone tumors reported that most complications occur in the first 3 years after surgery, there are no long-term reports on complications to substantiate this contention. We believe such information is important so that surgeons and patients can make more informed decisions when choosing a reconstructive method after tumor resection. QUESTIONS/PURPOSES (1) What is the survival of allografts free from removal, amputation, or joint replacement in patients treated for bone tumors in the lower limb with a minimum of 10 years of followup? (2) What complications occur after 10 or more years of followup? (3) Are there factors associated with allograft survival, such as age, sex, the affected bone, reconstruction type (intercalary or osteoarticular allograft), tumor type (malignant or benign), failure type, aOF EVIDENCE Level III, therapeutic study.High-grade serous carcinoma has a variety of different growth patterns, but is typically easily recognizable to pathologists and rarely confused with serous borderline tumors. We report a case of a 71-yr-old woman with a unilateral 5.1 cm ovarian cyst with small papillary projections on contrast-enhanced magnetic resonance imaging of the pelvis. Histologic examination showed a noninvasive papillary neoplasm with hierarchical branching and epithelial proliferation, and thus, at low magnification, bearing a striking resemblance to a serous borderline tumor. However, a more careful examination demonstrated high-grade cytologic features, nuclear pleomorphism, and abundant mitotic activity, suggestive of high-grade serous carcinoma. The morphology and immunohistochemical profile of this lesion is consistent with a rare, purely noninvasive growth pattern of high-grade serous carcinoma. This lesion represents the "far left" of the high-grade ovarian serous carcinoma morphologic spectrum and can mimic a serous borderline tumor.OBJECTIVES Standard titanium nails (TN) or carbon fiber reinforced-PEEK nails (CFN) were compared to evaluate impact of material on fracture union, healing time, knee/ankle, and barometric pain. DESIGN Longitudinal cohort evaluated retrospectively comparing two time-periods using two implant types. SETTING Single surgeon series at one Level II Trauma Center. PATIENTS Standardized treatment protocol. 56 tibial fracture patients suitable for intramedullary nailing over 5-year period. INTERVENTION First time period-TN; second time period-CFN. MAIN OUTCOME MEASUREMENTS Standard demographic data OTA fracture classification, fracture location, nail type. OUTCOME PARAMETERS cumulative healing at standard time intervals, infection/non-union, associated injuries, knee/ankle, barometric pain, hardware removal. Statistical analysis comparing incident healing. RESULTS Patient populations were not statistically different regarding demographics, fracture type/location although there was a trend toward greater fracture severity/more associated injuries in CFN group. In 56 patients, 26 received CFN; 30 received TN. Healing rates reported at each time interval. 8 weeks TN-0%, CFN-19%; 12 weeks TN-17%, CFN-69%; 16 weeks TN-57%, CFN-92%; 20 weeks TN-87%, CFN-96%; 24 weeks TN-97% CFN-96% (p less then 0.0001 every interval except 24 weeks). Each group had one infected non-union in an open fracture that healed with subsequent treatment. There was a trend towards less barometric pain with CFN that did not reach statistical significance (p=0.065). No statistical differences with knee/ankle pain (p=0.109)/removal of hardware (p=0.269) potentially due to low power of pilot study. CONCLUSION In this pilot study evaluating CFR-PEEK intramedullary nail for tibial shaft fractures, there was a demonstrated accelerated healing times compared to titanium with a potential for less barometric pain. LEVEL OF EVIDENCE Therapeutic Level III.
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