Abstract:
:The mechanism by which a malignant tumor cell establishes a metastatic foci is a complex process requiring the successful completion of a series of steps. If any step cannot be completed, the entire process fails. The tumor cell must separate from the primary tumor, gain access to an efferent channel (lymphatic or vascular), survive transport to a distant capillary bed, exit the vessel at the distant site, and obtain a new blood supply within the distant organ, if successful macrometastases are to develop. As the mysteries of this process are being unraveled, numerous heretofore beliefs have been disproven and new beliefs established. The primary malignant tumor is a heterogenous mixture of malignant cells, each subcell type with unique properties. Both lymphatic and vascular channels offer an efferent pathway for tumor cells, whether they be carcinomatous or sarcomatous. The location of the clinical metastasis is not a haphazard process, but rather a combination of selection by the tumor cell and mechanical trapping of the tumor cell fibrin-platelet clot. Finally, investigations are beginning to demonstrate that the immune process is exceedingly complex and its role in defense against malignancy is far from understood. As more is learned, new treatment methods will become available to combat the metastatic process. If metastasis were to be controlled, cancer would be conquered.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Springfield DSsubject
Has Abstractpub_date
1982-09-01 00:00:00pages
15-9issue
169eissn
0009-921Xissn
1528-1132pub_type
杂志文章abstract::Economics influences how medical care is delivered, organized, and progresses. Fee-for-service payment encourages delivery of services. Fee-for-individual-service, however, offers no incentives for clinicians to efficiently organize the care their patients need. Global capitation provides such incentives; it works wel...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0930-7
更新日期:2009-10-01 00:00:00
abstract::Orthopaedic residency has undergone continual evolution since the early 1900s. Training has evolved from a preceptorship to a highly evolved and structured educational system which largely standardizes training throughout the United States. Approval and accreditation of training programs, as well as content, is now ov...
journal_title:Clinical orthopaedics and related research
pub_type: 历史文章,杂志文章
doi:10.1097/01.blo.0000224022.11282.71
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Grip strength reflects functional status of the upper extremity and has been used in many of the clinical studies regarding upper extremity disease or fracture. However, the smallest difference in grip strength that a patient would notice as an improvement resulting from treatment (defined as the minimum cli...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-3666-y
更新日期:2014-08-01 00:00:00
abstract::Terrorist blasts and landmine injuries have become more common in the past several decades generating thousands of casualties. Preventive and prognostic measures are limited by the lack of knowledge of these complex events. Previous blast research has focused on primary blast injuries that involve the lung, despite mu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:2004-05-01 00:00:00
abstract::Ketorolac and methylprednisolone effects on bone repair were studied. Demineralized bone matrix was used to graft the defects of rabbits' ulnae. Twenty-seven rabbits were divided into 4 groups: Group A (control group; no drug treatment), Group B (treated with ketorolac 2 mg/kg body weight daily), Group C (treated with...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND:Distal radius reconstruction after en bloc tumor resection remains a surgical challenge. Although several surgical techniques, either reconstructing the wrist or achieving a stable arthrodesis, have been described, it is unclear to what degree these restore function. DESCRIPTION OF TECHNIQUE:We describe an ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2555-5
更新日期:2013-03-01 00:00:00
abstract::After a short term of employment in a new job, 3 young heroin addicts became disabled from low back pain due to neisseria gonorrhea prostatitis. Each returned to work after a few weeks of antibiotic therapy without symptoms following proper diagnosis. These patients demonstrate the importance of a careful history and ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::A modified Ilizarov external fixator was used to transfix the stifle joint in 13 dogs. A 1-cm cortical cancellous bone plug was outlined in the intracondylar notch of the femur after excising the anterior (cranial) cruciate ligament (ACL). Hardware attached to the plug allowed controlled distraction of the plug into a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00
abstract::An analysis of the patellofemoral joint based on experimental determinations of pressure distributions on the patellar cartilage and vectorial calculations is presented. The extension torque of all quadriceps muscles is similar. The force transmitted to the patella by the retinacula is small in all knee positions. Bec...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-09-01 00:00:00
abstract::This biographical sketch on Themistocles Gluck corresponds to the historic text, The Classic: Report on the positive results obtained by the modern surgical experiment regarding the suture and replacement of defects of superior tissue, as well as the utilization of re-absorbable and living tamponade in surgery (1891),...
journal_title:Clinical orthopaedics and related research
pub_type: 传,历史文章
doi:10.1007/s11999-011-1836-8
更新日期:2011-06-01 00:00:00
abstract::Reconstructive procedures were investigated in meniscal lesions in 14 dogs. Large wedge-shaped lesions were repaired with a graft containing carbon fibers and an organic polymer, prepared from physical mixtures of poly(L-lactide) and a segmented polyurethane. Four and eight weeks postoperation, arthroscopy was perform...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::The Rhodococcus species rarely cause musculoskeletal infections, with only two cases reported in the literature. We report the case of a 53-year-old woman who had an infection develop after first metatarsophalangeal joint fusion. A year after surgery, she continued to have pain and swelling with nonunion. She underwen...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0901-z
更新日期:2009-11-01 00:00:00
abstract::Despite the implication that mechanical overload is fundamental to the development of plantar fasciitis, gait analysis has revealed inconsistent findings regarding its effect on lower limb loading. The aim of the current study was to evaluate the regional vertical ground reaction force in patients with and without pla...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000057989.41099.d8
更新日期:2003-04-01 00:00:00
abstract::Between March 1991 and December 1992 the authors surgically treated 55 acetabular fractures using a modified Stoppa anterior intrapelvic extensile approach. Indications for utilization of this approach included displaced anterior column or wall fractures, transverse fractures, T shaped fractures, both column fractures...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract::Failure of bone grafting in scaphoid nonunion presents the hand surgeon a perplexing set of problems. Controversy remains as to the best course of treatment in this difficult situation. The authors have retrospectively reviewed during a 5-year period the patients treated at the Mayo Clinic who have gone on to a second...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199606000-00015
更新日期:1996-06-01 00:00:00
abstract::Recent studies have generated considerable information that reveals substantial support for major change in the understanding of total hip arthroplasty and its current state. Although some of these observations appear unrelated at first glance, they can be drawn together to support the thesis that osteolysis is the do...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1995-02-01 00:00:00
abstract::In three patients with cryptococcal bone infection, skeletal involvement was sometimes occult, localized (offering a clinically accessible area for the diagnosis of disseminated) or part of a disseminated disease. Cryptococcal bone infection may clinically imitate neoplastic disease. Cryptococcal antigen determination...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1981-07-01 00:00:00
abstract::A ball-and-socket joint is an unusual disturbance of normal ankle development. Previous reports have noted good function and the absence of osteoarthritic change in ankles with this configuration. A 50-year-old man with no history of injury developed an osteoarthritic ball-and-socket deformity of the ankle joint. Asso...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-02-01 00:00:00
abstract::The purpose of this investigation was to determine the effects of continuous passive motion (CPM) on the chondrogenic potential of autogenous osteoperiosteal grafts to repair major osteochondral defects. A 3.5-mm-wide circular full-thickness defect was drilled in one medial femoral condyle of 55 adolescent New Zealand...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-07-01 00:00:00
abstract::Exogenous steroids are known to induce aseptic necrosis in the femoral head of adults. This case report of a 9-year-old girl with corticosteroid induced femoral head necrosis demonstrates effective treatment with an abduction device in a manner similar to that prescribed for the treatment of Legg-Calve-Perthes disease...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-06-01 00:00:00
abstract::Six patients with systemic lupus erythematosus and avascular necrosis of the femoral head were treated by total hip arthroplasty (THA). The primary indication for surgery was persistent hip pain despite conservative therapy. Postoperatively, pain was relieved with corresponding improvement in range of motion in all si...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1981-11-01 00:00:00
abstract::Forty-nine knees with osteochondritis dissecans were evaluated and in many cases, treated by arthroscopic means. The lesions were classified as to location and degree of separation. Arthroscopic treatment involved drilling, pinning, reduction of fragments, removal and replacement of fragments, and bone grafting. Of th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-07-01 00:00:00
abstract::Polycentric total knee arthroplasty has been performed at the Mayo Clinic on more than 1,600 knees since July 1970. Two groups of 106 and 101 knee arthroplasties performed between July 1970 and July 1971 and June 1971 and January 1972, respectively, were compared at 5 and 7 years. The technique used exposed the joint ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1979-11-01 00:00:00
abstract:BACKGROUND:Low-cost indigenous megaprostheses used in the developing world are prone to mechanical failure but the frequency and causes are not well established. QUESTIONS/PURPOSES:We retrospectively analyzed the causes of failure, particularly design, and suggest changes to reduce the breakage. We also report our exp...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1409-2
更新日期:2010-11-01 00:00:00
abstract::Long-term effects (104 weeks) of 2 extremes of gap size on the mechanical behavior of the rabbit medial collateral ligament were examined. In the midsubstance of each right medial collateral ligament, either an 8 mm gap injury was created or a 4 mm Z plasty injury was created and repaired. Each group was subdivided in...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199704000-00031
更新日期:1997-04-01 00:00:00
abstract:UNLABELLED:The iliopsoas and adductor tendons are often soft tissue barriers obstructing relocation of the femoral head into the acetabulum and are frequently released to obtain reduction. We assessed whether posteromedial soft tissue release including sectioning of the adductor longus and iliopsoas tendons would lead ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0146-2
更新日期:2008-04-01 00:00:00
abstract::Chondrocytes are the single cellular component of hyaline cartilage. Under physiologic conditions, they show steady-state equilibrium between anabolic and catabolic activities that maintains the structural and functional integrity of the cartilage extracellular matrix. Implicit in the loss of cartilage matrix that is ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000144854.66565.8f
更新日期:2004-10-01 00:00:00
abstract::One hundred four patients with rheumatoid arthritis of the wrist were evaluated a minimum of 12 months post-operatively (average of 34 months). Seventy patients had 87 arthroplasties and 34 patients had 41 arthrodeses performed on the Arthritis Service of Rancho Los Amigos Hospital (Downey, California), from 1962 to 1...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract::A 4-year-old boy with congenital pseudarthrosis of the tibia had two unsuccessful operative attempts for union. After these procedures the patient had a 6-cm leg length discrepancy and an equinovalgus foot deformity. Because of these deformities he underwent Syme amputation at the ankle and was fitted with a total con...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1998-06-01 00:00:00
abstract::Eleven intraoperative femur fractures occurred during 605 total hip replacements at Rancho Los Amigos Hospital, an incidence of 1.8%. Fractures occur more often in women, are usually located in the proximal femur, and mostly occur during femoral reaming. The main predisposing factors were osteoporosis and previous hip...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-11-01 00:00:00