Evaluation of soft tissue sarcomas response to preoperative treatment: Assessment by angiography, thallium scintigraphy, and dynamic MRI
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Digital subtraction angiography
Thallium
Abstract Background and Objectives The incidence of soft tissue complications following sarcoma surgery in the upper extremity is reportedly high. Therefore, this study assessed the National Surgical Quality Improvement Program (NSQIP) database to identify independent risk factors, while also reporting the incidence of soft tissue complications in the first 30 days after surgery. Methods A total of 620 patients that underwent surgical treatment for upper extremity sarcoma were included from the NSQIP database. Soft tissue complications were defined as surgical site infection, wound dehiscence, or soft‐tissue related reoperations. Clinically relevant patient and treatment characteristics were selected and analyzed. Results The 30‐day soft tissue complication rate was 4.7%. In the multivariable analysis, higher body mass index ( p = .047) and longer operative times ( p = .002) were independently associated with soft tissue complications. Conclusions Higher body mass index and longer operative times are risk factors for soft tissue complications following upper extremity sarcoma surgery. The soft‐tissue complication rate following resection of upper extremity tumors is low in this national cohort, possibly due to the relatively small tumor size and low prevalence of radiotherapy.
Wound dehiscence
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Bone Sarcoma
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Abstract Thallium and thallium compounds are produced by roasting zinc, copper, and lead ores. Demand and production of thallium and its compounds are small because of the element's high toxicity. Thallium(I) oxide, thallium(III) acetate, and thallium(III) nitrate are unstable. Other thallium(I) and thallium(III) compounds are stable. Certain alloys of thallium are used in bearings, contact points, as well as equipment for extreme conditions such as in polar regions or in space.
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History, Production, and Uses of Thallium (J. Nriagu). Aqueous Geochemistry of Thallium (D. Kaplan & S. Mattigod). Speciation of Thallium in Natural Waters (T. Lin & J. Nriagu). Thallium in the (Sub)Surface Environment: Its Mobility in Terms of Eh and pH (B. Vink). Thallium in Agricultural Practice (M. Sager). Determination of Thallium by Electroanalytical Techniques (M. Esteban, et al.). Determination of Thallium and Its Species in Aquatic Environmental Samples (C. Chou & J. Moffatt). Analysis of Thallium in Biological Samples (C. Rios & S. Galvan-Arzate). Human Thallium Toxicity (G. Repetto, et al.). Reproductive and Developmental Toxicity of Thallium (C. Gregotti & E. Faustman). Age-Dependent Differences in the Nephrotoxicity of Thallium (I) Sulfate in Rats (D. Appenroth & S. Gambaryan). Thallium Transport in Cellular Membranes (T. Brismar). Effect of Thallium Toxicity on the Visual System (H. Tabandeh). Index.
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Purpose or Learning Objective: Soft tissue palpable lesions are a frequent concern for patients. Although rare, soft tissue sarcoma can be highly aggressive, with resectability and overall survival rates correlated with early recognition and diagnosis. The appearance of soft tissue lesions can vary on ultrasonography (US) and magnetic resonance imaging (MRI). Histologic analysis is the gold-standard investigation. We present the imaging findings of the most common benign and malignant soft tissue lesions collected from a regional soft tissue sarcoma diagnostic center.
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We analyzed the management of all the patients with soft tissue sarcoma located in the trunk and extremities in Sweden in 1982. The total fraction of patients referred to musculoskeletal tumor centers for definitive treatment was 0.6. In more than four fifths of the patients operated on at the centers, surgery was performed with a wide or radical margin compared with one fifth of the patients treated at other hospitals.In our center specifically, 10 patients with soft tissue lesions that turned out to be benign were referred per every unoperated on sarcoma patient. The treatment of soft tissue sarcomas outside tumor centers is less than optimal, and centralization is associated with substantially increased referral of patients with benign tumors to catch the majority of soft tissue sarcomas in the virgin state. Information to peripheral hospitals about indications for referral of patients with soft tissue lesions has been effective in our region.
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Penicillamine
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