ORCID Profile
0000-0001-5206-9382
Current Organisation
The Chinese University of Hong Kong
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Publisher: Radiological Society of North America (RSNA)
Date: 04-2005
DOI: 10.1148/RADIOL.2351040100
Abstract: To evaluate whether there is a relationship between steroid treatment and risk for osteonecrosis of the hip and knee in patients with severe acute respiratory syndrome (SARS). The hospital ethics committee approved the study, and all patients provided written informed consent. A total of 254 patients with confirmed SARS treated with steroids underwent evaluation with magnetic resonance (MR) imaging for osteonecrosis. Clinical profiles, joint symptoms, relevant past medical and drug history, steroid dose, and radiographic and MR imaging evidence of osteonecrosis and other bone abnormalities were evaluated. Mann-Whitney, Kruskal-Wallis, and Pearson exact chi(2) tests were performed, and univariate and multivariate logistic regression analyses were applied. One hundred thirty-four (53%) of 254 patients had recent onset of large joint pain, but 211 (80%) of 264 painful joints were not associated with abnormality on MR images. MR images in 12 (5%) of 254 patients showed evidence of subchondral osteonecrosis in the proximal femur (n = 9), distal femur (n = 2), and proximal and distal femora and proximal tibiae (n = 1). Additional nonspecific subchondral and intramedullary bone marrow abnormalities were present in 77 (30%) of 254 patients. Results of multiple logistic regression analysis confirmed cumulative prednisolone-equivalent dose to be the most important risk factor for osteonecrosis. The risk of osteonecrosis was 0.6% for patients receiving less than 3 g and 13% for patients receiving more than 3 g prednisolone-equivalent dose. No relationship was found between additional nonspecific bone marrow abnormalities and steroid dose. An appreciable dose-related risk was found for osteonecrosis in patients receiving steroid therapy for SARS. Additional nonspecific bone marrow abnormalities were frequent. Joint pain was common after SARS infection and was not a useful clinical indicator of osteonecrosis.
Publisher: The Korean Society of Radiology
Date: 2021
Publisher: Springer Science and Business Media LLC
Date: 27-02-2011
Publisher: Radiological Society of North America (RSNA)
Date: 07-2004
Publisher: Springer Science and Business Media LLC
Date: 23-06-2010
DOI: 10.1007/S13244-010-0019-6
Abstract: The objective of this study was to describe the sonographic features of deep-seated lipomas. A retrospective review of the sonographic features of 64 deep seated lipomas in 64 patients (43 females, 21 males, mean age 46.5, range 16–77 years) seen over an 8-year period (1998–2006) was undertaken. Features evaluated were location, size, shape, marginal definition, internal echogenicity, including the presence of intermingled muscle fibres and linear internal echoes, acoustic transmission and vascularity. Confirmation was histological in 37 (58%) cases and by typical magnetic resonance imaging (MRI) appearance in 27 (42%) cases. The results show that although the features of deep-seated lipoma are more variable than those reported for subcutaneous lipomas, the presence of thin internal echoes in conjunction with other less specific features should enable a correct diagnosis.
Publisher: Springer Science and Business Media LLC
Date: 26-06-2020
Publisher: Elsevier BV
Date: 04-2004
Publisher: Elsevier BV
Date: 2008
DOI: 10.1016/J.BONE.2007.08.038
Abstract: Giant cell tumor (GCT) of bone is a benign but locally aggressive tumor that is characterized by the presence of mononuclear stromal cells and multinucleated giant cells. Although topical adjuvants have been used in the past, local recurrence following intralesional excision of GCT of bone continues to remain a problem. The use of bisphosphonates as an anti-osteoclastic agent in the management of osteolytic bone metastases is well accepted. Furthermore in vitro studies have shown that bisphosphonates also induce apoptosis in GCT stromal cells. Therefore our clinical study aims to investigate whether the administration of bisphosphonate as an adjuvant can further decrease local recurrence following the surgical treatment of GCT of bone. A retrospective case-control study was performed between 1988 and 2004. Forty-four patients with histological diagnosed appendicular GCT were included. Intralesional curettage or wide excision of the lesions was followed with cementation or biological reconstruction. Additional intravenous and oral bisphosphonates were given peri-operatively to 24 patients who were treated between 1998 and 2004. The average follow-up of the control group was 115 months while that of the treatment group was 48 months. In the bisphosphonate treated group, 1 of 24 patients (4.2%) developed local recurrence. In the control group, 6 of 20 patients (30%) developed local recurrence. The difference in the recurrence rate was statistically significant between the bisphosphonate treatment group and the control group (Log Rank test p=0.056). The effect of reduction of local recurrence was significant in patients with stage III diseases. Patients treated with bisphosphonate did not report any untoward effects. Clinical use of bisphosphonates as an adjuvant therapy for giant cell tumor of bone demonstrated a lower local recurrence rate. The clinical response seems to be more promising in stage III diseases.
Publisher: Wiley
Date: 24-07-2015
DOI: 10.1002/JBMR.2542
Abstract: Vascular hyperpermeability and highly upregulated bone resorption in the destructive repair progress of steroid-associated osteonecrosis (SAON) are associated with a high expression of VEGF and high Src activity (Src is encoded by the cellular sarcoma [c-src] gene). This study was designed to prove our hypothesis that blocking the VEGF-Src signaling pathway by specific Src siRNA is able to prevent destructive repair in a SAON rabbit model. Destructive repair in SAON was induced in rabbits. At 2, 4, and 6 weeks after SAON induction, VEGF, anti-VEGF, Src siRNA, Src siRNA+VEGF, control siRNA, and saline were introduced via intramedullary injection into proximal femora for each group, respectively. Vascularization and permeability were quantified by dynamic contrast-enhanced (DCE) MRI. At week 6 after SAON induction, proximal femurs were dissected for micro-computed tomography (μCT)-based trabecular architecture with finite element analysis (FEA), μCT-based angiography, and histological analysis. Histological evaluation revealed that VEGF enhanced destructive repair, whereas anti-VEGF prevented destructive repair and Src siRNA and Src siRNA+VEGF prevented destructive repair and enhanced reparative osteogenesis. Findings of angiography and histomorphometry were consistent with those determined by DCE MRI. Src siRNA inhibited VEGF-mediated vascular hyperpermeability but preserved VEGF-induced neovascularization. Bone resorption was enhanced in the VEGF group and inhibited in the anti-VEGF, Src siRNA, Src siRNA+VEGF groups as determined by both 3D μCT and 2D histomorphometry. FEA showed higher estimated failure load in the Src siRNA and Src siRNA+VEGF groups when compared to the vehicle control group. Blockage of VEGF-Src signaling pathway by specific Src siRNA was able to prevent steroid-associated destructive repair while improving reconstructive repair in SAON, which might become a novel therapeutic strategy.
Publisher: Elsevier BV
Date: 06-2006
Publisher: Wiley
Date: 26-05-2009
DOI: 10.1002/JMRI.21765
Abstract: To determine the reproducibility of proton ((1)H) magnetic resonance (MR) spectroscopy and dynamic contrast-enhanced MR imaging in a clinical setting for the assessment of marrow fat fraction and marrow perfusion in longitudinal studies. In all, 36 subjects (17 females, 19 males, mean age 72.9 +/- 2.9 years) who underwent MR spectroscopy and/or dynamic contrast-enhanced perfusion imaging of the proximal femur were asked to return after 1 week for a repeat MR examination. Reproducibility of (1)H MR spectroscopy in all bone areas tested was high, ranging from 0.78-0.85, with the highest reproducibility being in the femoral head and lowest in the femoral neck. Reproducibility of paired perfusion measurements ranged from 0.59 (enhancement slope femoral head) to 0.98 (enhancement maximum acetabulum). Overall reproducibility of (1)H MR spectroscopy and dynamic contrast-enhanced imaging tended to be best in areas with the highest inherent fat fraction or perfusion. Reproducibility of (1)H MR spectroscopy or perfusion imaging is sufficiently high to warrant these techniques being applied to the longitudinal study of bone diseases.
Publisher: Wiley
Date: 07-2002
DOI: 10.1002/ART.10385
Abstract: Sonographic examination of the median nerve has been suggested as a useful alternative to electrophysiologic study in the diagnosis of carpal tunnel syndrome. To determine its usefulness and the best diagnostic criterion, sonograms of patients with the disease were compared with sonograms of healthy subjects in a case-control study. Patients with carpal tunnel syndrome and asymptomatic controls who were matched for age and sex were enrolled and underwent sonography of the wrists. Eight separate sonographic criteria were analyzed in each wrist. Data from the patient group and the control group were compared to establish optimal diagnostic criteria for carpal tunnel syndrome, using receiver operating characteristic analytic techniques. Thirty-five patients with carpal tunnel syndrome and 35 asymptomatic controls were examined. Increased cross-sectional area of the median nerve was found to be the most predictive measure of carpal tunnel syndrome, proximal to the tunnel inlet, at the tunnel inlet, and at the tunnel outlet, with significant differences between patients and controls. Using a receiver operating characteristic curve, a cut-off value >0.098 cm(2) at the tunnel inlet provided a diagnostic sensitivity of 89% and a specificity of 83%. Sonographic measurement of the median nerve cross-sectional area is both sensitive and specific for the diagnosis of carpal tunnel syndrome.
Publisher: Springer Science and Business Media LLC
Date: 12-01-2002
DOI: 10.1007/S00264-001-0307-3
Abstract: We treated 19 patients with 21 pathological humeral fractures secondary to metastatic disease. All patients were stabilized using retrograde Ender's nails. Open reduction was required in one patient and mean operative time was 40 min (range 30-65 min). All patients retained satisfactory elbow and shoulder function while 16 patients reported good pain relief. Functional recovery was rated as good in 15 patients, fair in three, and poor in one. In our experience the retrograde technique using Ender's nails provides secure stabilization with minimal morbidity, minimal blood loss, and short operative time, and is well suited for this category of patients.
No related grants have been discovered for James Griffith.