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  • 1
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 49, No. 13 ( 2021-11), p. 3544-3550
    Abstract: The microvascular anatomy of the meniscus of the human knee is regarded as a crucial factor in the injury response. Previous studies have investigated the zone-dependent distribution pattern, but no quantitative data exist on vascular density and its age-related changes. Hypothesis/Purpose: The aim of the present study was to histologically analyze the vascular anatomy of the meniscus as a function of age. It was hypothesized that vascular density would decrease with increasing age. Study Design: Descriptive laboratory study. Methods: Human menisci were retrieved from patients who underwent tumor resection or who received total knee replacement because of osteoarthritis. A total of 51 menisci were collected from 28 patients over 9 years (mean age, 25.6 ± 20.4 years; range 3-79 years). Immunohistological staining (alpha–smooth muscle actin) in combination with serial sections and standardized software-based contrast detection were used for the quantitative analysis. Data were analyzed using multiple t tests and the analysis of variance for trends, with a statistical significance level of P 〈 .05. Results: The overall vascular density in the meniscus was lower in the 61- to 80-year age group than in the age groups of 0 to 10, 11 to 20, and 21 to 30 years ( P 〈 .01). A negative linear trend was detected with increasing age (slope, -0.007; P = .016). Within the red-white (RW) zone, a low vessel density was detected for the age groups of 0 to 10 and 11 to 20 years. Beyond these age groups, no vasculature was found in the RW zone. For the white-white (WW) zone, no vessel formations were noted in any age group. Almost 95% of the vessels in the meniscus were located in the capsule. Conclusion: This study reports quantitative histological data for microvascular anatomy as a function of age in a broad cohort of human knee menisci. The overall vascular density decreased with increasing age. No vessel formations were detected in the RW and WW zones after adolescence. Additionally, the capsule is far more densely vascularized than any other part of the meniscus. Clinical Relevance: Vascular density might be an additional factor to consider, along with tear location and patient age, for future treatment options.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2063945-4
    SSG: 31
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  • 2
    In: HAND, SAGE Publications, Vol. 18, No. 6 ( 2023-09), p. 1037-1043
    Abstract: The classic type of epithelioid sarcoma (ES) is a rare, aggressive soft tissue neoplasm that most commonly affects the distal upper extremities of young patients. This study aimed to assess clinical features and provide a long-term report of the oncological outcome. Methods: We retrospectively analyzed our clinical database for patients with ES of the distal upper extremities. Results: Twenty-three patients with ES of the distal upper extremity were treated surgically between January 1990 and August 2018. ES affected most commonly the palmar side of young patients. The most common site affected by a sarcoma was the wrist in 47.8% of cases, followed by metacarpals and fingers with 34.8% and 17.4%, respectively. Most of the patients were treated according to the protocols of interdisciplinary tumor boards with multimodal therapy. A local recurrence was observed in 7 patients (30.4%). The 5 - and 10-year recurrence-free survival was 80.4% (95% confidence interval [CI]: 68.6-76.8) and 60.9% (95% CI: 53.5-68.3), respectively. The 5- and 10-years disease-specific survival was 89.9% (95% CI: 87-92.8) and 61.9% (95% CI: 56.5-67.3), respectively. Five patients (21.7%) had metastasis in regional lymph nodes. Conclusion: The classic type of ES represents a group of high-grade sarcomas, which affect the dominantly distal upper extremity. Specific clinical, diagnostic, and oncological characteristics make it difficult to diagnose and therapy. Wide tumor resection as a part of multimodal therapy remains a more viable and common treatment option for patients with ES on distal extremities. High rates of lymph node metastasis are typical for ES.
    Type of Medium: Online Resource
    ISSN: 1558-9447 , 1558-9455
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2316440-2
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