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|00000530| 00 00 3c 48 05 00 00 00 | 00 00 24 55 6e 69 71 75 |..<H....|..$Uniqu|
|00000540| 65 5f 49 44 7b 59 52 42 | 30 35 34 30 30 7d 0d 0a |e_ID{YRB|05400}..|
|00000550| 24 54 69 74 6c 65 7b 42 | 6f 6e 65 20 53 61 72 63 |$Title{B|one Sarc|
|00000560| 6f 6d 61 73 20 41 73 73 | 6f 63 69 61 74 65 64 20 |omas Ass|ociated |
|00000570| 57 69 74 68 20 4f 6c 6c | 69 65 72 27 73 20 44 69 |With Oll|ier's Di|
|00000580| 73 65 61 73 65 7d 0d 0a | 24 41 75 74 68 6f 72 7b |sease}..|$Author{|
|00000590| 0d 0a 4c 69 75 2c 20 4a | 0d 0a 48 75 64 6b 69 6e |..Liu, J|..Hudkin|
|000005a0| 73 2c 20 50 47 0d 0a 53 | 77 65 65 2c 20 52 47 0d |s, PG..S|wee, RG.|
|000005b0| 0a 55 6e 6e 69 2c 20 4b | 4b 7d 0d 0a 24 41 66 66 |.Unni, K|K}..$Aff|
|000005c0| 69 6c 69 61 74 69 6f 6e | 7b 4d 61 79 6f 20 43 6c |iliation|{Mayo Cl|
|000005d0| 69 6e 69 63 2c 20 4d 61 | 79 6f 20 46 6f 75 6e 64 |inic, Ma|yo Found|
|000005e0| 7d 0d 0a 24 53 75 62 6a | 65 63 74 7b 53 61 72 63 |}..$Subj|ect{Sarc|
|000005f0| 6f 6d 61 20 62 6f 6e 65 | 2c 20 77 69 74 68 20 4f |oma bone|, with O|
|00000600| 6c 6c 69 65 72 27 73 20 | 64 69 73 65 61 73 65 3b |llier's |disease;|
|00000610| 20 4f 6c 6c 69 65 72 27 | 73 20 64 69 73 65 61 73 | Ollier'|s diseas|
|00000620| 65 20 77 69 74 68 20 62 | 6f 6e 65 0d 0a 73 61 72 |e with b|one..sar|
|00000630| 63 6f 6d 61 3b 20 42 6f | 6e 65 20 73 61 72 63 6f |coma; Bo|ne sarco|
|00000640| 6d 61 20 77 69 74 68 20 | 4f 69 6c 69 65 72 27 73 |ma with |Oilier's|
|00000650| 20 64 69 73 65 61 73 65 | 7d 0d 0a 24 4a 6f 75 72 | disease|}..$Jour|
|00000660| 6e 61 6c 7b 43 61 6e 63 | 65 72 7d 0d 0a 24 56 6f |nal{Canc|er}..$Vo|
|00000670| 6c 75 6d 65 7b 35 39 7d | 0d 0a 24 50 61 67 65 7b |lume{59}|..$Page{|
|00000680| 31 33 37 36 2d 31 33 38 | 35 7d 0d 0a 24 44 61 74 |1376-138|5}..$Dat|
|00000690| 65 7b 41 70 72 69 6c 20 | 31 39 38 37 7d 0d 0a 24 |e{April |1987}..$|
|000006a0| 59 42 56 6f 6c 7b 31 39 | 38 39 20 59 65 61 72 20 |YBVol{19|89 Year |
|000006b0| 42 6f 6f 6b 20 6f 66 20 | 44 69 61 67 6e 6f 73 74 |Book of |Diagnost|
|000006c0| 69 63 20 52 61 64 69 6f | 6c 6f 67 79 7d 0d 0a 24 |ic Radio|logy}..$|
|000006d0| 43 68 61 70 74 65 72 7b | 35 2d 33 37 7d 0d 0a 24 |Chapter{|5-37}..$|
|000006e0| 59 42 45 64 69 74 6f 72 | 7b 44 72 73 2e 20 42 72 |YBEditor|{Drs. Br|
|000006f0| 61 67 67 2c 20 48 65 6e | 64 65 65 2c 20 4b 65 61 |agg, Hen|dee, Kea|
|00000700| 74 73 2c 20 4b 69 72 6b | 70 61 74 72 69 63 6b 2c |ts, Kirk|patrick,|
|00000710| 20 4d 69 6c 6c 65 72 2c | 20 4f 73 62 6f 75 72 6e | Miller,| Osbourn|
|00000720| 65 2c 20 61 6e 64 20 54 | 68 6f 6d 70 73 6f 6e 7d |e, and T|hompson}|
|00000730| 0d 0a 24 54 61 62 6c 65 | 7b 54 61 62 6c 65 20 4f |..$Table|{Table O|
|00000740| 6d 69 74 74 65 64 7d 0d | 0a 24 43 6f 6d 6d 65 6e |mitted}.|.$Commen|
|00000750| 74 61 74 6f 72 7b 54 2e | 45 2e 20 4b 65 61 74 73 |tator{T.|E. Keats|
|00000760| 2c 20 4d 2e 44 2e 7d 0d | 0a 0d 0a 43 6f 70 79 72 |, M.D.}.|...Copyr|
|00000770| 69 67 68 74 20 28 63 29 | 20 59 65 61 72 20 42 6f |ight (c)| Year Bo|
|00000780| 6f 6b 20 4d 65 64 69 63 | 61 6c 20 50 75 62 6c 69 |ok Medic|al Publi|
|00000790| 73 68 65 72 73 2c 20 49 | 6e 63 2e 2c 20 31 39 38 |shers, I|nc., 198|
|000007a0| 39 0d 0a 0d 0a 31 39 38 | 39 20 59 65 61 72 20 42 |9....198|9 Year B|
|000007b0| 6f 6f 6b 20 6f 66 20 44 | 69 61 67 6e 6f 73 74 69 |ook of D|iagnosti|
|000007c0| 63 20 52 61 64 69 6f 6c | 6f 67 79 20 28 52 29 0d |c Radiol|ogy (R).|
|000007d0| 0a 0d 0a 43 68 61 70 74 | 65 72 20 35 2d 2d 54 68 |...Chapt|er 5--Th|
|000007e0| 65 20 4d 75 73 63 75 6c | 6f 73 6b 65 6c 65 74 61 |e Muscul|oskeleta|
|000007f0| 6c 20 53 79 73 74 65 6d | 0d 0a 0d 0a 4e 65 6f 70 |l System|....Neop|
|00000800| 6c 61 73 6d 73 0d 0a 0d | 0a 2d 2d 2d 2d 2d 2d 2d |lasms...|.-------|
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|00000840| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000850| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 0d 0a 42 6f 6e 65 20 |--------|-..Bone |
|00000860| 53 61 72 63 6f 6d 61 73 | 20 41 73 73 6f 63 69 61 |Sarcomas| Associa|
|00000870| 74 65 64 20 57 69 74 68 | 20 4f 6c 6c 69 65 72 27 |ted With| Ollier'|
|00000880| 73 20 44 69 73 65 61 73 | 65 0d 0a 0d 0a 4c 69 75 |s Diseas|e....Liu|
|00000890| 20 4a 2c 20 48 75 64 6b | 69 6e 73 20 50 47 2c 20 | J, Hudk|ins PG, |
|000008a0| 53 77 65 65 20 52 47 2c | 20 55 6e 6e 69 20 4b 4b |Swee RG,| Unni KK|
|000008b0| 0d 0a 28 4d 61 79 6f 20 | 43 6c 69 6e 69 63 2c 20 |..(Mayo |Clinic, |
|000008c0| 4d 61 79 6f 20 46 6f 75 | 6e 64 29 0d 0a 43 61 6e |Mayo Fou|nd)..Can|
|000008d0| 63 65 72 20 35 39 3a 31 | 33 37 36 2d 31 33 38 35 |cer 59:1|376-1385|
|000008e0| 2c 20 41 70 72 69 6c 20 | 31 39 38 37 0d 0a 2d 2d |, April |1987..--|
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|00000930| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|00000940| 0d 0a 41 62 73 74 72 61 | 63 74 0d 0a 0d 0a 20 20 |..Abstra|ct....  |
|00000950| 20 20 20 50 61 74 69 65 | 6e 74 73 20 77 69 74 68 |   Patie|nts with|
|00000960| 20 6d 75 6c 74 69 70 6c | 65 20 65 6e 63 68 6f 6e | multipl|e enchon|
|00000970| 64 72 6f 6d 61 74 6f 73 | 69 73 2c 20 6f 72 20 4f |dromatos|is, or O|
|00000980| 6c 6c 69 65 72 27 73 20 | 64 69 73 65 61 73 65 2c |llier's |disease,|
|00000990| 20 6d 61 79 20 64 65 76 | 65 6c 6f 70 0d 0a 6d 61 | may dev|elop..ma|
|000009a0| 6c 69 67 6e 61 6e 74 20 | 62 6f 6e 65 20 74 75 6d |lignant |bone tum|
|000009b0| 6f 72 73 2e 20 20 54 68 | 65 20 63 61 72 74 69 6c |ors.  Th|e cartil|
|000009c0| 61 67 65 20 6d 61 73 73 | 65 73 20 63 68 61 72 61 |age mass|es chara|
|000009d0| 63 74 65 72 69 73 74 69 | 63 20 6f 66 20 74 68 69 |cteristi|c of thi|
|000009e0| 73 20 64 69 73 6f 72 64 | 65 72 20 6d 61 79 0d 0a |s disord|er may..|
|000009f0| 72 65 73 65 6d 62 6c 65 | 20 63 68 6f 6e 64 72 6f |resemble| chondro|
|00000a00| 73 61 72 63 6f 6d 61 20 | 68 69 73 74 6f 6c 6f 67 |sarcoma |histolog|
|00000a10| 69 63 61 6c 6c 79 2e 20 | 20 54 68 65 72 65 66 6f |ically. | Therefo|
|00000a20| 72 65 2c 20 69 74 20 69 | 73 20 69 6d 70 6f 72 74 |re, it i|s import|
|00000a30| 61 6e 74 20 74 6f 20 63 | 6f 6d 70 61 72 65 0d 0a |ant to c|ompare..|
|00000a40| 72 61 64 69 6f 67 72 61 | 70 68 69 63 20 61 6e 64 |radiogra|phic and|
|00000a50| 20 62 69 6f 70 73 79 20 | 66 69 6e 64 69 6e 67 73 | biopsy |findings|
|00000a60| 2e 20 20 53 69 78 74 65 | 65 6e 20 6f 66 20 35 35 |.  Sixte|en of 55|
|00000a70| 20 70 61 74 69 65 6e 74 | 73 20 77 69 74 68 20 4f | patient|s with O|
|00000a80| 6c 6c 69 65 72 27 73 20 | 64 69 73 65 61 73 65 0d |llier's |disease.|
|00000a90| 0a 73 65 65 6e 20 61 74 | 20 4d 61 79 6f 20 43 6c |.seen at| Mayo Cl|
|00000aa0| 69 6e 69 63 20 62 65 74 | 77 65 65 6e 20 31 39 30 |inic bet|ween 190|
|00000ab0| 37 20 61 6e 64 20 31 39 | 38 35 20 68 61 64 20 73 |7 and 19|85 had s|
|00000ac0| 61 72 63 6f 6d 61 73 20 | 28 46 69 67 20 35 2d 33 |arcomas |(Fig 5-3|
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|00000ae0| 74 69 65 6e 74 73 20 77 | 69 74 68 20 73 61 72 63 |tients w|ith sarc|
|00000af0| 6f 6d 61 20 72 61 6e 67 | 65 64 20 69 6e 20 61 67 |oma rang|ed in ag|
|00000b00| 65 20 66 72 6f 6d 20 31 | 33 20 74 6f 20 36 39 20 |e from 1|3 to 69 |
|00000b10| 79 65 61 72 73 2e 20 20 | 54 68 69 72 74 65 65 6e |years.  |Thirteen|
|00000b20| 0d 0a 74 75 6d 6f 72 73 | 20 69 6e 76 6f 6c 76 65 |..tumors| involve|
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|00000b60| 20 74 68 65 20 6b 6e 65 | 65 20 6a 6f 69 6e 74 2e | the kne|e joint.|
|00000b70| 0d 0a 54 68 65 20 70 61 | 74 69 65 6e 74 73 20 75 |..The pa|tients u|
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|00000b90| 20 77 69 74 68 20 69 6e | 63 72 65 61 73 69 6e 67 | with in|creasing|
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|00000ce0| 77 65 72 65 20 64 69 73 | 74 69 6e 67 75 69 73 68 |were dis|tinguish|
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|00000d40| 0d 0a 20 20 20 20 20 53 | 75 72 67 69 63 61 6c 20 |..     S|urgical |
|00000d50| 70 72 6f 63 65 64 75 72 | 65 73 20 76 61 72 69 65 |procedur|es varie|
|00000d60| 64 2e 20 20 46 6f 75 72 | 20 70 61 74 69 65 6e 74 |d.  Four| patient|
|00000d70| 73 20 64 69 65 64 20 6f | 66 20 73 61 72 63 6f 6d |s died o|f sarcom|
|00000d80| 61 2e 20 20 54 68 72 65 | 65 20 64 69 65 64 20 6f |a.  Thre|e died o|
|00000d90| 66 0d 0a 75 6e 72 65 6c | 61 74 65 64 20 63 61 75 |f..unrel|ated cau|
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|00000db0| 20 64 69 73 65 61 73 65 | 20 64 65 76 65 6c 6f 70 | disease| develop|
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|00001bc0| 63 61 6c 6c 79 20 62 65 | 63 61 75 73 65 20 69 74 |cally be|cause it|
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|00001be0| 0a 74 68 61 74 20 6f 6e | 6c 79 20 6f 6e 65 20 68 |.that on|ly one h|
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|00001c10| 73 20 68 61 76 65 20 74 | 68 65 20 63 6c 61 73 73 |s have t|he class|
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|00001c60| 63 69 73 65 20 6c 6f 63 | 61 6c 69 7a 61 74 69 6f |cise loc|alizatio|
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|00001ca0| 20 6c 61 72 67 65 20 65 | 6e 20 62 6c 6f 63 20 65 | large e|n bloc e|
|00001cb0| 78 63 69 73 69 6f 6e 20 | 6f 66 20 73 65 6c 65 63 |xcision |of selec|
|00001cc0| 74 69 76 65 0d 0a 62 6f | 6e 65 2e 2d 2d 54 2e 45 |tive..bo|ne.--T.E|
|00001cd0| 2e 20 4b 65 61 74 73 2c | 20 4d 2e 44 2e 0d 0a 24 |. Keats,| M.D...$|
|00001ce0| 55 6e 69 71 75 65 5f 49 | 44 7b 59 52 42 30 35 34 |Unique_I|D{YRB054|
|00001cf0| 30 32 7d 0d 0a 24 54 69 | 74 6c 65 7b 4f 73 74 65 |02}..$Ti|tle{Oste|
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|00001d20| 61 6e 78 7d 0d 0a 24 41 | 75 74 68 6f 72 7b 0d 0a |anx}..$A|uthor{..|
|00001d30| 42 6f 77 65 6e 2c 20 43 | 56 41 0d 0a 44 7a 75 73 |Bowen, C|VA..Dzus|
|00001d40| 2c 20 41 4b 0d 0a 48 61 | 72 64 79 2c 20 44 41 7d |, AK..Ha|rdy, DA}|
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|00001da0| 65 6f 6d 61 20 6f 66 3b | 20 4f 73 74 65 6f 6d 61 |eoma of;| Osteoma|
|00001db0| 20 6f 73 74 65 6f 69 64 | 20 6f 66 20 70 68 61 6c | osteoid| of phal|
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|00001dd0| 6f 75 72 6e 61 6c 7b 4a | 20 48 61 6e 64 20 53 75 |ournal{J| Hand Su|
|00001de0| 72 67 7d 0d 0a 24 56 6f | 6c 75 6d 65 7b 31 32 42 |rg}..$Vo|lume{12B|
|00001df0| 7d 0d 0a 24 50 61 67 65 | 7b 33 38 37 2d 33 39 30 |}..$Page|{387-390|
|00001e00| 7d 0d 0a 24 44 61 74 65 | 7b 4f 63 74 6f 62 65 72 |}..$Date|{October|
|00001e10| 20 31 39 38 37 7d 0d 0a | 24 59 42 56 6f 6c 7b 31 | 1987}..|$YBVol{1|
|00001e20| 39 38 39 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |989 Year| Book of|
|00001e30| 20 44 69 61 67 6e 6f 73 | 74 69 63 20 52 61 64 69 | Diagnos|tic Radi|
|00001e40| 6f 6c 6f 67 79 7d 0d 0a | 24 43 68 61 70 74 65 72 |ology}..|$Chapter|
|00001e50| 7b 35 2d 33 39 7d 0d 0a | 24 59 42 45 64 69 74 6f |{5-39}..|$YBEdito|
|00001e60| 72 7b 44 72 73 2e 20 42 | 72 61 67 67 2c 20 48 65 |r{Drs. B|ragg, He|
|00001e70| 6e 64 65 65 2c 20 4b 65 | 61 74 73 2c 20 4b 69 72 |ndee, Ke|ats, Kir|
|00001e80| 6b 70 61 74 72 69 63 6b | 2c 20 4d 69 6c 6c 65 72 |kpatrick|, Miller|
|00001e90| 2c 20 4f 73 62 6f 75 72 | 6e 65 2c 20 61 6e 64 20 |, Osbour|ne, and |
|00001ea0| 54 68 6f 6d 70 73 6f 6e | 7d 0d 0a 24 54 61 62 6c |Thompson|}..$Tabl|
|00001eb0| 65 7b 54 61 62 6c 65 20 | 4f 6d 69 74 74 65 64 7d |e{Table |Omitted}|
|00001ec0| 0d 0a 24 43 6f 6d 6d 65 | 6e 74 61 74 6f 72 7b 54 |..$Comme|ntator{T|
|00001ed0| 2e 45 2e 20 4b 65 61 74 | 73 2c 20 4d 2e 44 2e 7d |.E. Keat|s, M.D.}|
|00001ee0| 0d 0a 0d 0a 43 6f 70 79 | 72 69 67 68 74 20 28 63 |....Copy|right (c|
|00001ef0| 29 20 59 65 61 72 20 42 | 6f 6f 6b 20 4d 65 64 69 |) Year B|ook Medi|
|00001f00| 63 61 6c 20 50 75 62 6c | 69 73 68 65 72 73 2c 20 |cal Publ|ishers, |
|00001f10| 49 6e 63 2e 2c 20 31 39 | 38 39 0d 0a 0d 0a 31 39 |Inc., 19|89....19|
|00001f20| 38 39 20 59 65 61 72 20 | 42 6f 6f 6b 20 6f 66 20 |89 Year |Book of |
|00001f30| 44 69 61 67 6e 6f 73 74 | 69 63 20 52 61 64 69 6f |Diagnost|ic Radio|
|00001f40| 6c 6f 67 79 20 28 52 29 | 0d 0a 0d 0a 43 68 61 70 |logy (R)|....Chap|
|00001f50| 74 65 72 20 35 2d 2d 54 | 68 65 20 4d 75 73 63 75 |ter 5--T|he Muscu|
|00001f60| 6c 6f 73 6b 65 6c 65 74 | 61 6c 20 53 79 73 74 65 |loskelet|al Syste|
|00001f70| 6d 0d 0a 0d 0a 4e 65 6f | 70 6c 61 73 6d 73 0d 0a |m....Neo|plasms..|
|00001f80| 0d 0a 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |..------|--------|
|00001f90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001fa0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001fb0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001fc0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001fd0| 2d 2d 0d 0a 4f 73 74 65 | 6f 69 64 20 4f 73 74 65 |--..Oste|oid Oste|
|00001fe0| 6f 6d 61 74 61 20 6f 66 | 20 74 68 65 20 44 69 73 |omata of| the Dis|
|00001ff0| 74 61 6c 20 50 68 61 6c | 61 6e 78 0d 0a 0d 0a 42 |tal Phal|anx....B|
|00002000| 6f 77 65 6e 20 43 56 41 | 2c 20 44 7a 75 73 20 41 |owen CVA|, Dzus A|
|00002010| 4b 2c 20 48 61 72 64 79 | 20 44 41 0d 0a 28 55 6e |K, Hardy| DA..(Un|
|00002020| 69 76 20 48 6f 73 70 2c | 20 53 61 73 6b 61 74 6f |iv Hosp,| Saskato|
|00002030| 6f 6e 2c 20 53 61 73 6b | 29 0d 0a 4a 20 48 61 6e |on, Sask|)..J Han|
|00002040| 64 20 53 75 72 67 20 31 | 32 42 3a 33 38 37 2d 33 |d Surg 1|2B:387-3|
|00002050| 39 30 2c 20 4f 63 74 6f | 62 65 72 20 31 39 38 37 |90, Octo|ber 1987|
|00002060| 0d 0a 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |..------|--------|
|00002070| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002080| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002090| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000020a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000020b0| 2d 2d 0d 0a 0d 0a 41 62 | 73 74 72 61 63 74 0d 0a |--....Ab|stract..|
|000020c0| 0d 0a 20 20 20 20 20 4f | 73 74 65 6f 69 64 20 6f |..     O|steoid o|
|000020d0| 73 74 65 6f 6d 61 74 61 | 20 61 72 65 20 72 61 72 |steomata| are rar|
|000020e0| 65 20 69 6e 20 74 68 65 | 20 64 69 73 74 61 6c 20 |e in the| distal |
|000020f0| 70 68 61 6c 61 6e 78 2e | 20 20 54 68 65 79 20 63 |phalanx.|  They c|
|00002100| 61 6e 20 61 6c 73 6f 20 | 62 65 0d 0a 64 69 66 66 |an also |be..diff|
|00002110| 69 63 75 6c 74 20 74 6f | 20 64 69 61 67 6e 6f 73 |icult to| diagnos|
|00002120| 65 20 62 65 63 61 75 73 | 65 20 6f 66 20 73 6f 66 |e becaus|e of sof|
|00002130| 74 20 74 69 73 73 75 65 | 20 65 6e 6c 61 72 67 65 |t tissue| enlarge|
|00002140| 6d 65 6e 74 20 61 6e 64 | 20 6e 61 69 6c 20 64 65 |ment and| nail de|
|00002150| 66 6f 72 6d 69 74 79 3b | 20 74 68 65 0d 0a 73 6d |formity;| the..sm|
|00002160| 61 6c 6c 20 73 69 7a 65 | 20 6f 66 20 74 68 65 20 |all size| of the |
|00002170| 64 69 73 74 61 6c 20 70 | 68 61 6c 61 6e 78 20 61 |distal p|halanx a|
|00002180| 6e 64 20 63 6f 6e 73 65 | 71 75 65 6e 74 20 70 72 |nd conse|quent pr|
|00002190| 6f 78 69 6d 69 74 79 20 | 6f 66 20 6c 65 73 69 6f |oximity |of lesio|
|000021a0| 6e 73 20 74 6f 20 74 68 | 65 0d 0a 6e 61 69 6c 2c |ns to th|e..nail,|
|000021b0| 20 67 72 6f 77 74 68 20 | 70 6c 61 74 65 2c 20 61 | growth |plate, a|
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|000021d0| 68 61 6c 61 6e 67 65 61 | 6c 20 6a 6f 69 6e 74 3b |halangea|l joint;|
|000021e0| 20 61 6e 64 20 74 68 65 | 20 61 74 79 70 69 63 61 | and the| atypica|
|000021f0| 6c 0d 0a 72 61 64 69 6f | 6c 6f 67 69 63 20 61 70 |l..radio|logic ap|
|00002200| 70 65 61 72 61 6e 63 65 | 20 6f 66 20 74 68 65 20 |pearance| of the |
|00002210| 6c 65 73 69 6f 6e 73 2e | 20 20 54 77 65 6e 74 79 |lesions.|  Twenty|
|00002220| 2d 74 68 72 65 65 20 63 | 61 73 65 73 2c 20 72 65 |-three c|ases, re|
|00002230| 70 6f 72 74 65 64 20 69 | 6e 20 74 68 65 0d 0a 45 |ported i|n the..E|
|00002240| 6e 67 6c 69 73 68 20 6c | 61 6e 67 75 61 67 65 20 |nglish l|anguage |
|00002250| 6c 69 74 65 72 61 74 75 | 72 65 2c 20 6f 66 20 6f |literatu|re, of o|
|00002260| 73 74 65 6f 69 64 20 6f | 73 74 65 6f 6d 61 74 61 |steoid o|steomata|
|00002270| 20 6f 66 20 74 68 65 20 | 64 69 73 74 61 6c 20 70 | of the |distal p|
|00002280| 68 61 6c 61 6e 78 20 77 | 65 72 65 0d 0a 72 65 76 |halanx w|ere..rev|
|00002290| 69 65 77 65 64 2c 20 61 | 6e 64 20 32 20 6e 65 77 |iewed, a|nd 2 new|
|000022a0| 20 63 61 73 65 73 20 77 | 65 72 65 20 70 72 65 73 | cases w|ere pres|
|000022b0| 65 6e 74 65 64 2e 0d 0a | 20 20 20 20 20 49 6e 20 |ented...|     In |
|000022c0| 31 20 6f 66 20 74 68 65 | 20 6e 65 77 20 63 61 73 |1 of the| new cas|
|000022d0| 65 73 2c 20 74 68 65 20 | 64 69 73 74 61 6c 20 70 |es, the |distal p|
|000022e0| 61 72 74 20 6f 66 20 74 | 68 65 20 70 61 74 69 65 |art of t|he patie|
|000022f0| 6e 74 27 73 20 72 69 67 | 68 74 20 69 6e 64 65 78 |nt's rig|ht index|
|00002300| 20 66 69 6e 67 65 72 0d | 0a 67 72 61 64 75 61 6c | finger.|.gradual|
|00002310| 6c 79 20 69 6e 63 72 65 | 61 73 65 64 20 69 6e 20 |ly incre|ased in |
|00002320| 73 69 7a 65 20 77 69 74 | 68 6f 75 74 20 6d 61 72 |size wit|hout mar|
|00002330| 6b 65 64 20 70 61 69 6e | 2e 20 20 54 68 65 20 66 |ked pain|.  The f|
|00002340| 69 6e 67 65 72 20 72 65 | 73 65 6d 62 6c 65 64 20 |inger re|sembled |
|00002350| 61 6e 0d 0a 69 73 6f 6c | 61 74 65 64 20 63 6c 75 |an..isol|ated clu|
|00002360| 62 62 65 64 20 64 69 67 | 69 74 20 61 6e 64 20 73 |bbed dig|it and s|
|00002370| 68 6f 77 65 64 20 65 6e | 6c 61 72 67 65 6d 65 6e |howed en|largemen|
|00002380| 74 20 62 65 79 6f 6e 64 | 20 74 68 65 20 64 69 73 |t beyond| the dis|
|00002390| 74 61 6c 20 69 6e 74 65 | 72 70 68 61 6c 61 6e 67 |tal inte|rphalang|
|000023a0| 65 61 6c 0d 0a 6a 6f 69 | 6e 74 2e 20 20 54 68 65 |eal..joi|nt.  The|
|000023b0| 20 73 6b 69 6e 20 61 74 | 20 74 68 65 20 62 61 73 | skin at| the bas|
|000023c0| 65 20 6f 66 20 74 68 65 | 20 6e 61 69 6c 20 70 6c |e of the| nail pl|
|000023d0| 61 74 65 20 77 61 73 20 | 73 68 69 6e 79 20 61 6e |ate was |shiny an|
|000023e0| 64 20 73 77 6f 6c 6c 65 | 6e 2c 20 61 6e 64 0d 0a |d swolle|n, and..|
|000023f0| 73 65 76 65 72 61 6c 20 | 64 69 73 63 72 65 74 65 |several |discrete|
|00002400| 20 61 72 65 61 73 20 75 | 6e 64 65 72 20 74 68 65 | areas u|nder the|
|00002410| 20 6e 61 69 6c 20 70 6c | 61 74 65 20 77 65 72 65 | nail pl|ate were|
|00002420| 20 70 75 72 70 6c 65 2e | 20 20 52 61 64 69 6f 67 | purple.|  Radiog|
|00002430| 72 61 70 68 73 20 73 68 | 6f 77 65 64 0d 0a 73 6f |raphs sh|owed..so|
|00002440| 66 74 20 74 69 73 73 75 | 65 20 73 77 65 6c 6c 69 |ft tissu|e swelli|
|00002450| 6e 67 20 61 6e 64 20 61 | 20 72 61 64 69 6f 6c 75 |ng and a| radiolu|
|00002460| 63 65 6e 74 20 6c 65 73 | 69 6f 6e 20 69 6e 20 74 |cent les|ion in t|
|00002470| 68 65 20 64 6f 72 73 61 | 6c 20 63 6f 72 74 65 78 |he dorsa|l cortex|
|00002480| 20 6f 66 20 74 68 65 20 | 64 69 73 74 61 6c 0d 0a | of the |distal..|
|00002490| 70 68 61 6c 61 6e 78 20 | 28 46 69 67 20 35 2d 33 |phalanx |(Fig 5-3|
|000024a0| 37 29 2e 20 20 54 68 65 | 72 65 20 77 61 73 20 69 |7).  The|re was i|
|000024b0| 6e 74 65 6e 73 65 6c 79 | 20 68 69 67 68 20 75 70 |ntensely| high up|
|000024c0| 74 61 6b 65 20 6f 6e 20 | 74 65 63 68 6e 65 74 69 |take on |techneti|
|000024d0| 75 6d 20 39 39 20 62 6f | 6e 65 20 73 63 61 6e 0d |um 99 bo|ne scan.|
|000024e0| 0a 28 46 69 67 20 35 2d | 33 38 29 2e 20 20 41 20 |.(Fig 5-|38).  A |
|000024f0| 72 65 64 64 69 73 68 2d | 70 75 72 70 6c 65 20 73 |reddish-|purple s|
|00002500| 6f 66 74 20 74 69 73 73 | 75 65 20 6d 61 73 73 20 |oft tiss|ue mass |
|00002510| 77 61 73 20 72 65 6d 6f | 76 65 64 2e 20 20 48 69 |was remo|ved.  Hi|
|00002520| 73 74 6f 6c 6f 67 69 63 | 0d 0a 65 78 61 6d 69 6e |stologic|..examin|
|00002530| 61 74 69 6f 6e 20 72 65 | 76 65 61 6c 65 64 20 63 |ation re|vealed c|
|00002540| 6c 6f 73 65 6c 79 20 73 | 70 61 63 65 64 20 70 61 |losely s|paced pa|
|00002550| 72 74 69 61 6c 6c 79 20 | 63 61 6c 63 69 66 69 65 |rtially |calcifie|
|00002560| 64 20 74 72 61 62 65 63 | 75 6c 61 65 2e 20 20 54 |d trabec|ulae.  T|
|00002570| 68 65 0d 0a 69 6e 74 65 | 72 76 65 6e 69 6e 67 20 |he..inte|rvening |
|00002580| 73 74 72 6f 6d 61 20 63 | 6f 6e 74 61 69 6e 65 64 |stroma c|ontained|
|00002590| 20 73 6f 6d 65 20 6f 73 | 74 65 6f 62 6c 61 73 74 | some os|teoblast|
|000025a0| 73 20 61 6e 64 20 6f 73 | 74 65 6f 63 6c 61 73 74 |s and os|teoclast|
|000025b0| 73 2e 0d 0a 20 20 20 20 | 20 46 6f 75 72 20 6d 6f |s...    | Four mo|
|000025c0| 6e 74 68 73 20 61 66 74 | 65 72 20 73 75 72 67 65 |nths aft|er surge|
|000025d0| 72 79 2c 20 74 68 65 72 | 65 20 77 61 73 20 6e 6f |ry, ther|e was no|
|000025e0| 20 70 61 69 6e 20 61 6e | 64 20 74 68 65 20 63 6c | pain an|d the cl|
|000025f0| 75 62 62 69 6e 67 20 68 | 61 64 20 61 6c 6d 6f 73 |ubbing h|ad almos|
|00002600| 74 0d 0a 72 65 73 6f 6c | 76 65 64 2e 20 20 52 61 |t..resol|ved.  Ra|
|00002610| 64 69 6f 67 72 61 70 68 | 73 20 73 68 6f 77 65 64 |diograph|s showed|
|00002620| 20 74 68 61 74 20 74 68 | 65 20 64 65 66 65 63 74 | that th|e defect|
|00002630| 20 68 61 64 20 66 69 6c | 6c 65 64 20 69 6e 20 77 | had fil|led in w|
|00002640| 69 74 68 20 6e 65 77 20 | 62 6f 6e 65 2e 20 20 41 |ith new |bone.  A|
|00002650| 74 0d 0a 31 2d 79 65 61 | 72 20 66 6f 6c 6c 6f 77 |t..1-yea|r follow|
|00002660| 2d 75 70 2c 20 74 68 65 | 20 70 6f 73 74 6f 70 65 |-up, the| postope|
|00002670| 72 61 74 69 76 65 20 6e | 61 69 6c 20 64 65 66 6f |rative n|ail defo|
|00002680| 72 6d 69 74 79 20 68 61 | 64 20 61 6c 6d 6f 73 74 |rmity ha|d almost|
|00002690| 20 67 72 6f 77 6e 20 6f | 75 74 2e 0d 0a 20 20 20 | grown o|ut...   |
|000026a0| 20 20 41 6c 6d 6f 73 74 | 20 61 6c 6c 20 6f 73 74 |  Almost| all ost|
|000026b0| 65 6f 69 64 20 6f 73 74 | 65 6f 6d 61 74 61 20 61 |eoid ost|eomata a|
|000026c0| 72 65 20 64 69 61 67 6e | 6f 73 65 64 20 61 74 20 |re diagn|osed at |
|000026d0| 65 78 63 69 73 69 6f 6e | 2e 20 20 41 20 62 6f 6e |excision|.  A bon|
|000026e0| 65 20 73 63 61 6e 20 69 | 73 0d 0a 75 73 65 66 75 |e scan i|s..usefu|
|000026f0| 6c 20 66 6f 72 20 64 69 | 61 67 6e 6f 73 69 73 2c |l for di|agnosis,|
|00002700| 20 62 75 74 20 63 6f 6e | 66 69 72 6d 61 74 69 6f | but con|firmatio|
|00002710| 6e 20 6d 75 73 74 20 62 | 65 20 6d 61 64 65 20 77 |n must b|e made w|
|00002720| 69 74 68 20 61 20 62 69 | 6f 70 73 79 2e 0d 0a 0d |ith a bi|opsy....|
|00002730| 0a 50 6f 73 74 2d 43 6f | 6d 6d 65 6e 74 0d 0a 0d |.Post-Co|mment...|
|00002740| 0a 20 20 20 20 20 54 68 | 69 73 20 70 61 70 65 72 |.     Th|is paper|
|00002750| 20 61 6e 64 20 74 68 65 | 20 66 6f 6c 6c 6f 77 69 | and the| followi|
|00002760| 6e 67 20 70 61 70 65 72 | 20 69 6e 20 74 68 65 20 |ng paper| in the |
|00002770| 73 61 6d 65 20 6a 6f 75 | 72 6e 61 6c 20 28 46 6f |same jou|rnal (Fo|
|00002780| 75 63 68 65 72 20 47 20 | 65 74 20 61 6c 3a 0d 0a |ucher G |et al:..|
|00002790| 4f 73 74 65 6f 69 64 20 | 6f 73 74 65 6f 6d 61 20 |Osteoid |osteoma |
|000027a0| 6f 66 20 74 68 65 20 64 | 69 73 74 61 6c 20 70 68 |of the d|istal ph|
|000027b0| 61 6c 61 6e 78 3a 20 20 | 41 20 72 65 70 6f 72 74 |alanx:  |A report|
|000027c0| 20 6f 66 20 66 6f 75 72 | 20 63 61 73 65 73 20 61 | of four| cases a|
|000027d0| 6e 64 20 72 65 76 69 65 | 77 20 6f 66 20 74 68 65 |nd revie|w of the|
|000027e0| 0d 0a 6c 69 74 65 72 61 | 74 75 72 65 29 20 74 6f |..litera|ture) to|
|000027f0| 67 65 74 68 65 72 20 72 | 65 70 6f 72 74 20 61 20 |gether r|eport a |
|00002800| 74 6f 74 61 6c 20 6f 66 | 20 36 20 6e 65 77 20 63 |total of| 6 new c|
|00002810| 61 73 65 73 20 6f 66 20 | 6f 73 74 65 6f 69 64 20 |ases of |osteoid |
|00002820| 6f 73 74 65 6f 6d 61 20 | 61 6e 64 20 72 65 76 69 |osteoma |and revi|
|00002830| 65 77 0d 0a 61 6e 20 61 | 64 64 69 74 69 6f 6e 61 |ew..an a|dditiona|
|00002840| 6c 20 32 33 20 63 61 73 | 65 73 20 66 72 6f 6d 20 |l 23 cas|es from |
|00002850| 74 68 65 20 6c 69 74 65 | 72 61 74 75 72 65 2e 20 |the lite|rature. |
|00002860| 20 49 20 64 6f 6e 27 74 | 20 62 65 6c 69 65 76 65 | I don't| believe|
|00002870| 20 49 27 76 65 20 65 76 | 65 72 20 73 65 65 6e 20 | I've ev|er seen |
|00002880| 6f 6e 65 0d 0a 69 6e 20 | 74 68 65 20 64 69 73 74 |one..in |the dist|
|00002890| 61 6c 20 70 68 61 6c 61 | 6e 78 2e 20 20 48 6f 77 |al phala|nx.  How|
|000028a0| 65 76 65 72 2c 20 68 65 | 72 65 20 74 68 65 79 20 |ever, he|re they |
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|000035e0| 6b 70 61 74 72 69 63 6b | 2c 20 4a 72 2e 2c 20 4d |kpatrick|, Jr., M|
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|00003600| 74 20 28 63 29 20 59 65 | 61 72 20 42 6f 6f 6b 20 |t (c) Ye|ar Book |
|00003610| 4d 65 64 69 63 61 6c 20 | 50 75 62 6c 69 73 68 65 |Medical |Publishe|
|00003620| 72 73 2c 20 49 6e 63 2e | 2c 20 31 39 38 39 0d 0a |rs, Inc.|, 1989..|
|00003630| 0d 0a 31 39 38 39 20 59 | 65 61 72 20 42 6f 6f 6b |..1989 Y|ear Book|
|00003640| 20 6f 66 20 44 69 61 67 | 6e 6f 73 74 69 63 20 52 | of Diag|nostic R|
|00003650| 61 64 69 6f 6c 6f 67 79 | 20 28 52 29 0d 0a 0d 0a |adiology| (R)....|
|00003660| 43 68 61 70 74 65 72 20 | 36 2d 2d 50 65 64 69 61 |Chapter |6--Pedia|
|00003670| 74 72 69 63 20 52 61 64 | 69 6f 6c 6f 67 79 0d 0a |tric Rad|iology..|
|00003680| 0d 0a 49 6d 61 67 69 6e | 67 20 61 6e 64 20 49 6e |..Imagin|g and In|
|00003690| 74 65 72 76 65 6e 74 69 | 6f 6e 61 6c 20 54 65 63 |terventi|onal Tec|
|000036a0| 68 6e 69 71 75 65 73 0d | 0a 0d 0a 2d 2d 2d 2d 2d |hniques.|...-----|
|000036b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000036c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000036d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000036e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000036f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 4f 75 74 |--------|---..Out|
|00003700| 70 61 74 69 65 6e 74 20 | 50 65 72 66 6f 72 6d 61 |patient |Performa|
|00003710| 6e 63 65 20 6f 66 20 49 | 6e 76 61 73 69 76 65 20 |nce of I|nvasive |
|00003720| 52 61 64 69 6f 6c 6f 67 | 69 63 20 50 72 6f 63 65 |Radiolog|ic Proce|
|00003730| 64 75 72 65 73 20 69 6e | 20 50 65 64 69 61 74 72 |dures in| Pediatr|
|00003740| 69 63 20 50 61 74 69 65 | 6e 74 73 0d 0a 0d 0a 44 |ic Patie|nts....D|
|00003750| 69 61 6d 65 6e 74 20 4d | 4a 2c 20 42 69 72 64 20 |iament M|J, Bird |
|00003760| 43 52 2c 20 53 74 61 6e | 6c 65 79 20 50 0d 0a 28 |CR, Stan|ley P..(|
|00003770| 43 68 69 6c 64 72 65 6e | 73 20 48 6f 73 70 20 6f |Children|s Hosp o|
|00003780| 66 20 4c 6f 73 20 41 6e | 67 65 6c 65 73 29 0d 0a |f Los An|geles)..|
|00003790| 52 61 64 69 6f 6c 6f 67 | 79 20 31 36 36 3a 34 30 |Radiolog|y 166:40|
|000037a0| 31 2d 34 30 33 2c 20 46 | 65 62 72 75 61 72 79 20 |1-403, F|ebruary |
|000037b0| 31 39 38 38 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |1988..--|--------|
|000037c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000037d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000037e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000037f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003800| 2d 2d 2d 2d 2d 2d 0d 0a | 0d 0a 41 62 73 74 72 61 |------..|..Abstra|
|00003810| 63 74 0d 0a 0d 0a 20 20 | 20 20 20 4d 61 6e 79 20 |ct....  |   Many |
|00003820| 69 6e 76 61 73 69 76 65 | 20 72 61 64 69 6f 6c 6f |invasive| radiolo|
|00003830| 67 69 63 20 70 72 6f 63 | 65 64 75 72 65 73 20 74 |gic proc|edures t|
|00003840| 68 61 74 20 70 72 65 76 | 69 6f 75 73 6c 79 20 72 |hat prev|iously r|
|00003850| 65 71 75 69 72 65 64 0d | 0a 68 6f 73 70 69 74 61 |equired.|.hospita|
|00003860| 6c 69 7a 61 74 69 6f 6e | 20 61 72 65 20 6e 6f 77 |lization| are now|
|00003870| 20 70 65 72 66 6f 72 6d | 65 64 20 6f 6e 20 61 6e | perform|ed on an|
|00003880| 20 6f 75 74 70 61 74 69 | 65 6e 74 20 62 61 73 69 | outpati|ent basi|
|00003890| 73 2e 20 20 4d 61 6e 79 | 20 69 6e 76 61 73 69 76 |s.  Many| invasiv|
|000038a0| 65 0d 0a 65 78 61 6d 69 | 6e 61 74 69 6f 6e 73 2c |e..exami|nations,|
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|00003900| 74 70 61 74 69 65 6e 74 | 73 2c 20 77 65 72 65 20 |tpatient|s, were |
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|00003930| 20 74 68 69 73 20 70 6f | 6c 69 63 79 2e 0d 0a 20 | this po|licy... |
|00003940| 20 20 20 20 44 61 74 61 | 20 6f 6e 20 31 30 32 20 |    Data| on 102 |
|00003950| 63 6f 6e 73 65 63 75 74 | 69 76 65 20 69 6e 76 61 |consecut|ive inva|
|00003960| 73 69 76 65 20 70 72 6f | 63 65 64 75 72 65 73 20 |sive pro|cedures |
|00003970| 64 6f 6e 65 20 6f 6e 20 | 39 34 20 63 68 69 6c 64 |done on |94 child|
|00003980| 72 65 6e 2c 20 61 67 65 | 64 20 32 0d 0a 6d 6f 6e |ren, age|d 2..mon|
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|000039a0| 20 77 65 72 65 20 72 65 | 74 72 6f 73 70 65 63 74 | were re|trospect|
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|000039c0| 20 41 6c 6c 20 77 65 72 | 65 20 64 6f 6e 65 20 6f | All wer|e done o|
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|000039e0| 20 62 61 73 69 73 20 62 | 65 74 77 65 65 6e 20 31 | basis b|etween 1|
|000039f0| 39 38 34 20 61 6e 64 20 | 31 39 38 37 20 28 46 69 |984 and |1987 (Fi|
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|00003a10| 54 68 65 20 6d 6f 73 74 | 20 63 6f 6d 6d 6f 6e 0d |The most| common.|
|00003a20| 0a 63 6f 6d 70 6c 69 63 | 61 74 69 6f 6e 73 20 77 |.complic|ations w|
|00003a30| 65 72 65 20 68 65 61 64 | 61 63 68 65 2c 20 69 72 |ere head|ache, ir|
|00003a40| 72 69 74 61 62 69 6c 69 | 74 79 2c 20 61 6e 64 20 |ritabili|ty, and |
|00003a50| 6e 61 75 73 65 61 20 6f | 72 20 76 6f 6d 69 74 69 |nausea o|r vomiti|
|00003a60| 6e 67 20 61 66 74 65 72 | 0d 0a 6d 79 65 6c 6f 67 |ng after|..myelog|
|00003a70| 72 61 70 68 79 3b 20 61 | 74 20 6c 65 61 73 74 20 |raphy; a|t least |
|00003a80| 31 20 6f 66 20 74 68 65 | 73 65 20 63 6f 6d 70 6c |1 of the|se compl|
|00003a90| 61 69 6e 74 73 20 77 61 | 73 20 72 65 70 6f 72 74 |aints wa|s report|
|00003aa0| 65 64 20 62 79 20 31 37 | 20 6f 66 20 34 34 20 63 |ed by 17| of 44 c|
|00003ab0| 68 69 6c 64 72 65 6e 2e | 0d 0a 49 6e 20 32 20 63 |hildren.|..In 2 c|
|00003ac0| 68 69 6c 64 72 65 6e 2c | 20 61 67 65 64 20 38 20 |hildren,| aged 8 |
|00003ad0| 6d 6f 6e 74 68 73 20 61 | 6e 64 20 32 20 79 65 61 |months a|nd 2 yea|
|00003ae0| 72 73 2c 20 72 65 73 70 | 65 63 74 69 76 65 6c 79 |rs, resp|ectively|
|00003af0| 2c 20 61 6e 20 61 73 65 | 70 74 69 63 0d 0a 6d 65 |, an ase|ptic..me|
|00003b00| 6e 69 6e 67 69 74 69 73 | 6c 69 6b 65 20 73 79 6e |ningitis|like syn|
|00003b10| 64 72 6f 6d 65 20 63 6f | 6e 73 69 73 74 69 6e 67 |drome co|nsisting|
|00003b20| 20 6f 66 20 66 65 76 65 | 72 20 61 6e 64 20 76 6f | of feve|r and vo|
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|00003b40| 20 61 66 74 65 72 0d 0a | 63 6f 6d 70 6c 65 74 65 | after..|complete|
|00003b50| 20 6d 65 74 72 69 7a 61 | 6d 69 64 65 20 6d 79 65 | metriza|mide mye|
|00003b60| 6c 6f 67 72 61 70 68 79 | 2e 0d 0a 20 20 20 20 20 |lography|...     |
|00003b70| 54 77 6f 20 69 6e 66 61 | 6e 74 73 20 65 78 70 65 |Two infa|nts expe|
|00003b80| 72 69 65 6e 63 65 64 20 | 66 65 76 65 72 20 61 6e |rienced |fever an|
|00003b90| 64 20 6c 69 6d 69 74 61 | 74 69 6f 6e 20 6f 66 20 |d limita|tion of |
|00003ba0| 6d 6f 74 69 6f 6e 20 61 | 66 74 65 72 20 68 69 70 |motion a|fter hip|
|00003bb0| 0d 0a 61 72 74 68 72 6f | 67 72 61 70 68 79 2e 20 |..arthro|graphy. |
|00003bc0| 20 48 65 6d 61 74 6f 6d | 61 20 64 65 76 65 6c 6f | Hematom|a develo|
|00003bd0| 70 65 64 20 61 74 20 74 | 68 65 20 70 75 6e 63 74 |ped at t|he punct|
|00003be0| 75 72 65 20 73 69 74 65 | 20 69 6e 20 61 20 67 69 |ure site| in a gi|
|00003bf0| 72 6c 2c 20 61 67 65 64 | 20 31 34 20 79 65 61 72 |rl, aged| 14 year|
|00003c00| 73 2c 0d 0a 77 68 6f 20 | 75 6e 64 65 72 77 65 6e |s,..who |underwen|
|00003c10| 74 20 72 65 6e 61 6c 20 | 74 72 61 6e 73 70 6c 61 |t renal |transpla|
|00003c20| 6e 74 20 61 72 74 65 72 | 69 6f 67 72 61 70 68 79 |nt arter|iography|
|00003c30| 20 66 6f 72 20 6d 65 64 | 69 63 61 6c 6c 79 20 63 | for med|ically c|
|00003c40| 6f 6e 74 72 6f 6c 6c 65 | 64 0d 0a 68 79 70 65 72 |ontrolle|d..hyper|
|00003c50| 74 65 6e 73 69 6f 6e 2e | 20 20 46 6f 75 72 20 63 |tension.|  Four c|
|00003c60| 68 69 6c 64 72 65 6e 20 | 68 61 64 20 63 6f 6d 70 |hildren |had comp|
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|00003c90| 65 69 72 0d 0a 70 68 79 | 73 69 63 69 61 6e 73 2c |eir..phy|sicians,|
|00003ca0| 20 62 75 74 20 6e 6f 6e | 65 20 72 65 71 75 69 72 | but non|e requir|
|00003cb0| 65 64 20 68 6f 73 70 69 | 74 61 6c 69 7a 61 74 69 |ed hospi|talizati|
|00003cc0| 6f 6e 20 61 66 74 65 72 | 20 74 68 65 20 6f 75 74 |on after| the out|
|00003cd0| 70 61 74 69 65 6e 74 20 | 70 72 6f 63 65 64 75 72 |patient |procedur|
|00003ce0| 65 2e 0d 0a 54 68 65 73 | 65 20 66 69 6e 64 69 6e |e...Thes|e findin|
|00003cf0| 67 73 20 73 68 6f 77 20 | 74 68 61 74 2c 20 77 69 |gs show |that, wi|
|00003d00| 74 68 20 61 70 70 72 6f | 70 72 69 61 74 65 20 70 |th appro|priate p|
|00003d10| 61 74 69 65 6e 74 20 73 | 65 6c 65 63 74 69 6f 6e |atient s|election|
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|00003d30| 65 64 75 72 65 73 20 70 | 65 72 66 6f 72 6d 65 64 |edures p|erformed|
|00003d40| 20 6f 6e 20 61 6e 20 6f | 75 74 70 61 74 69 65 6e | on an o|utpatien|
|00003d50| 74 20 62 61 73 69 73 20 | 69 6e 20 69 6e 66 61 6e |t basis |in infan|
|00003d60| 74 73 2c 20 63 68 69 6c | 64 72 65 6e 2c 20 61 6e |ts, chil|dren, an|
|00003d70| 64 0d 0a 61 64 6f 6c 65 | 73 63 65 6e 74 73 20 61 |d..adole|scents a|
|00003d80| 72 65 20 73 61 66 65 2e | 0d 0a 0d 0a 50 6f 73 74 |re safe.|....Post|
|00003d90| 2d 43 6f 6d 6d 65 6e 74 | 0d 0a 0d 0a 20 20 20 20 |-Comment|....    |
|00003da0| 20 54 68 65 20 61 75 74 | 68 6f 72 73 20 72 65 70 | The aut|hors rep|
|00003db0| 6f 72 74 20 61 20 6c 61 | 72 67 65 20 6e 75 6d 62 |ort a la|rge numb|
|00003dc0| 65 72 20 6f 66 20 70 72 | 6f 63 65 64 75 72 65 73 |er of pr|ocedures|
|00003dd0| 20 69 6e 20 63 68 69 6c | 64 72 65 6e 20 61 6e 64 | in chil|dren and|
|00003de0| 20 64 65 73 63 72 69 62 | 65 0d 0a 74 68 65 69 72 | describ|e..their|
|00003df0| 20 6d 61 74 65 72 69 61 | 6c 73 20 61 6e 64 20 6d | materia|ls and m|
|00003e00| 65 74 68 6f 64 73 2e 20 | 20 41 6c 6c 20 6f 66 20 |ethods. | All of |
|00003e10| 75 73 20 6d 75 73 74 20 | 62 65 63 6f 6d 65 20 61 |us must |become a|
|00003e20| 77 61 72 65 20 6f 66 20 | 74 68 65 20 6e 65 65 64 |ware of |the need|
|00003e30| 20 74 6f 20 70 65 72 66 | 6f 72 6d 0d 0a 6d 6f 72 | to perf|orm..mor|
|00003e40| 65 20 61 6e 64 20 6d 6f | 72 65 20 70 72 6f 63 65 |e and mo|re proce|
|00003e50| 64 75 72 65 73 20 6f 6e | 20 61 6e 20 6f 75 74 70 |dures on| an outp|
|00003e60| 61 74 69 65 6e 74 20 62 | 61 73 69 73 2e 20 20 4f |atient b|asis.  O|
|00003e70| 6e 65 20 63 61 6e 6e 6f | 74 20 68 65 6c 70 20 62 |ne canno|t help b|
|00003e80| 75 74 20 62 65 0d 0a 69 | 6d 70 72 65 73 73 65 64 |ut be..i|mpressed|
|00003e90| 20 77 69 74 68 20 74 68 | 65 20 66 61 63 74 20 74 | with th|e fact t|
|00003ea0| 68 61 74 20 74 68 65 72 | 65 20 77 65 72 65 20 6e |hat ther|e were n|
|00003eb0| 6f 20 73 65 64 61 74 69 | 6f 6e 20 66 61 69 6c 75 |o sedati|on failu|
|00003ec0| 72 65 73 20 61 6e 64 20 | 74 68 61 74 20 74 68 65 |res and |that the|
|00003ed0| 0d 0a 66 72 65 71 75 65 | 6e 63 79 20 6f 66 20 63 |..freque|ncy of c|
|00003ee0| 6f 6d 70 6c 69 63 61 74 | 69 6f 6e 73 20 77 61 73 |omplicat|ions was|
|00003ef0| 20 22 67 72 61 74 69 66 | 79 69 6e 67 6c 79 20 6c | "gratif|yingly l|
|00003f00| 6f 77 2e 22 2d 2d 4a 2e | 41 2e 20 4b 69 72 6b 70 |ow."--J.|A. Kirkp|
|00003f10| 61 74 72 69 63 6b 2c 20 | 4a 72 2e 2c 0d 0a 4d 2e |atrick, |Jr.,..M.|
|00003f20| 44 2e 0d 0a 24 55 6e 69 | 71 75 65 5f 49 44 7b 59 |D...$Uni|que_ID{Y|
|00003f30| 52 42 30 35 34 30 35 7d | 0d 0a 24 54 69 74 6c 65 |RB05405}|..$Title|
|00003f40| 7b 42 61 6c 6c 6f 6f 6e | 20 44 69 6c 61 74 69 6f |{Balloon| Dilatio|
|00003f50| 6e 20 41 6e 67 69 6f 70 | 6c 61 73 74 79 20 6f 66 |n Angiop|lasty of|
|00003f60| 20 50 6f 73 74 6f 70 65 | 72 61 74 69 76 65 20 41 | Postope|rative A|
|00003f70| 6f 72 74 69 63 20 4f 62 | 73 74 72 75 63 74 69 6f |ortic Ob|structio|
|00003f80| 6e 73 7d 0d 0a 24 41 75 | 74 68 6f 72 7b 0d 0a 53 |ns}..$Au|thor{..S|
|00003f90| 61 75 6c 2c 20 4a 50 0d | 0a 4b 65 61 6e 65 2c 20 |aul, JP.|.Keane, |
|00003fa0| 4a 46 0d 0a 46 65 6c 6c | 6f 77 73 2c 20 4b 45 0d |JF..Fell|ows, KE.|
|00003fb0| 0a 4c 6f 63 6b 2c 20 4a | 45 7d 0d 0a 24 41 66 66 |.Lock, J|E}..$Aff|
|00003fc0| 69 6c 69 61 74 69 6f 6e | 7b 43 68 69 6c 64 72 65 |iliation|{Childre|
|00003fd0| 6e 27 73 20 48 6f 73 70 | 2c 20 42 6f 73 74 6f 6e |n's Hosp|, Boston|
|00003fe0| 3b 20 48 61 72 76 61 72 | 64 20 4d 65 64 20 53 63 |; Harvar|d Med Sc|
|00003ff0| 68 6f 6f 6c 7d 0d 0a 24 | 53 75 62 6a 65 63 74 7b |hool}..$|Subject{|
|00004000| 42 61 6c 6c 6f 6f 6e 20 | 64 69 6c 61 74 69 6f 6e |Balloon |dilation|
|00004010| 20 61 6e 67 69 6f 70 6c | 61 73 74 79 20 6f 66 20 | angiopl|asty of |
|00004020| 70 6f 73 74 6f 70 65 72 | 61 74 69 76 65 20 61 6f |postoper|ative ao|
|00004030| 72 74 69 63 20 6f 62 73 | 74 72 75 63 74 69 6f 6e |rtic obs|truction|
|00004040| 73 3b 0d 0a 41 6f 72 74 | 69 63 20 6f 62 73 74 72 |s;..Aort|ic obstr|
|00004050| 75 63 74 69 6f 6e 73 2c | 20 70 6f 73 74 6f 70 65 |uctions,| postope|
|00004060| 72 61 74 69 76 65 2c 20 | 62 61 6c 6c 6f 6f 6e 20 |rative, |balloon |
|00004070| 61 6e 67 69 6f 70 6c 61 | 73 74 79 20 6f 66 3b 20 |angiopla|sty of; |
|00004080| 41 6e 67 69 6f 70 6c 61 | 73 74 79 20 62 61 6c 6c |Angiopla|sty ball|
|00004090| 6f 6f 6e 0d 0a 64 69 6c | 61 74 69 6f 6e 2c 20 6f |oon..dil|ation, o|
|000040a0| 66 20 70 6f 73 74 6f 70 | 65 72 61 74 69 76 65 20 |f postop|erative |
|000040b0| 61 6f 72 74 69 63 20 6f | 62 73 74 72 75 63 74 69 |aortic o|bstructi|
|000040c0| 6f 6e 73 7d 0d 0a 24 4a | 6f 75 72 6e 61 6c 7b 41 |ons}..$J|ournal{A|
|000040d0| 6d 20 4a 20 43 61 72 64 | 69 6f 6c 7d 0d 0a 24 56 |m J Card|iol}..$V|
|000040e0| 6f 6c 75 6d 65 7b 35 39 | 7d 0d 0a 24 50 61 67 65 |olume{59|}..$Page|
|000040f0| 7b 39 34 33 2d 39 34 38 | 7d 0d 0a 24 44 61 74 65 |{943-948|}..$Date|
|00004100| 7b 41 70 72 69 6c 20 31 | 35 2c 20 31 39 38 37 7d |{April 1|5, 1987}|
|00004110| 0d 0a 24 59 42 56 6f 6c | 7b 31 39 38 39 20 59 65 |..$YBVol|{1989 Ye|
|00004120| 61 72 20 42 6f 6f 6b 20 | 6f 66 20 44 69 61 67 6e |ar Book |of Diagn|
|00004130| 6f 73 74 69 63 20 52 61 | 64 69 6f 6c 6f 67 79 7d |ostic Ra|diology}|
|00004140| 0d 0a 24 43 68 61 70 74 | 65 72 7b 36 2d 32 7d 0d |..$Chapt|er{6-2}.|
|00004150| 0a 24 59 42 45 64 69 74 | 6f 72 7b 44 72 73 2e 20 |.$YBEdit|or{Drs. |
|00004160| 42 72 61 67 67 2c 20 48 | 65 6e 64 65 65 2c 20 4b |Bragg, H|endee, K|
|00004170| 65 61 74 73 2c 20 4b 69 | 72 6b 70 61 74 72 69 63 |eats, Ki|rkpatric|
|00004180| 6b 2c 20 4d 69 6c 6c 65 | 72 2c 20 4f 73 62 6f 75 |k, Mille|r, Osbou|
|00004190| 72 6e 65 2c 20 61 6e 64 | 20 54 68 6f 6d 70 73 6f |rne, and| Thompso|
|000041a0| 6e 7d 0d 0a 24 54 61 62 | 6c 65 7b 54 61 62 6c 65 |n}..$Tab|le{Table|
|000041b0| 20 4f 6d 69 74 74 65 64 | 7d 0d 0a 24 43 6f 6d 6d | Omitted|}..$Comm|
|000041c0| 65 6e 74 61 74 6f 72 7b | 7d 0d 0a 0d 0a 43 6f 70 |entator{|}....Cop|
|000041d0| 79 72 69 67 68 74 20 28 | 63 29 20 59 65 61 72 20 |yright (|c) Year |
|000041e0| 42 6f 6f 6b 20 4d 65 64 | 69 63 61 6c 20 50 75 62 |Book Med|ical Pub|
|000041f0| 6c 69 73 68 65 72 73 2c | 20 49 6e 63 2e 2c 20 31 |lishers,| Inc., 1|
|00004200| 39 38 39 0d 0a 0d 0a 31 | 39 38 39 20 59 65 61 72 |989....1|989 Year|
|00004210| 20 42 6f 6f 6b 20 6f 66 | 20 44 69 61 67 6e 6f 73 | Book of| Diagnos|
|00004220| 74 69 63 20 52 61 64 69 | 6f 6c 6f 67 79 20 28 52 |tic Radi|ology (R|
|00004230| 29 0d 0a 0d 0a 43 68 61 | 70 74 65 72 20 36 2d 2d |)....Cha|pter 6--|
|00004240| 50 65 64 69 61 74 72 69 | 63 20 52 61 64 69 6f 6c |Pediatri|c Radiol|
|00004250| 6f 67 79 0d 0a 0d 0a 49 | 6d 61 67 69 6e 67 20 61 |ogy....I|maging a|
|00004260| 6e 64 20 49 6e 74 65 72 | 76 65 6e 74 69 6f 6e 61 |nd Inter|ventiona|
|00004270| 6c 20 54 65 63 68 6e 69 | 71 75 65 73 0d 0a 0d 0a |l Techni|ques....|
|00004280| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004290| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000042a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000042b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000042c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000042d0| 0d 0a 42 61 6c 6c 6f 6f | 6e 20 44 69 6c 61 74 69 |..Balloo|n Dilati|
|000042e0| 6f 6e 20 41 6e 67 69 6f | 70 6c 61 73 74 79 20 6f |on Angio|plasty o|
|000042f0| 66 20 50 6f 73 74 6f 70 | 65 72 61 74 69 76 65 20 |f Postop|erative |
|00004300| 41 6f 72 74 69 63 20 4f | 62 73 74 72 75 63 74 69 |Aortic O|bstructi|
|00004310| 6f 6e 73 0d 0a 0d 0a 53 | 61 75 6c 20 4a 50 2c 20 |ons....S|aul JP, |
|00004320| 4b 65 61 6e 65 20 4a 46 | 2c 20 46 65 6c 6c 6f 77 |Keane JF|, Fellow|
|00004330| 73 20 4b 45 2c 20 4c 6f | 63 6b 20 4a 45 0d 0a 28 |s KE, Lo|ck JE..(|
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|00005100| 42 6f 73 74 6f 6e 3b 20 | 48 61 72 76 61 72 64 20 |Boston; |Harvard |
|00005110| 4d 65 64 20 53 63 68 6f | 6f 6c 7d 0d 0a 24 53 75 |Med Scho|ol}..$Su|
|00005120| 62 6a 65 63 74 7b 45 73 | 6f 70 68 61 67 75 73 20 |bject{Es|ophagus |
|00005130| 61 74 72 65 73 69 61 20 | 72 65 70 61 69 72 2c 20 |atresia |repair, |
|00005140| 70 6f 73 74 6f 70 65 72 | 61 74 69 76 65 20 61 6e |postoper|ative an|
|00005150| 64 20 70 65 70 74 69 63 | 20 65 73 6f 70 68 61 67 |d peptic| esophag|
|00005160| 65 61 6c 0d 0a 73 74 72 | 69 63 74 75 72 65 73 20 |eal..str|ictures |
|00005170| 61 66 74 65 72 3b 20 43 | 61 74 68 65 74 65 72 20 |after; C|atheter |
|00005180| 62 61 6c 6c 6f 6f 6e 2c | 20 66 6f 72 20 70 6f 73 |balloon,| for pos|
|00005190| 74 6f 70 65 72 61 74 69 | 76 65 20 61 6e 64 20 70 |toperati|ve and p|
|000051a0| 65 70 74 69 63 20 65 73 | 6f 70 68 61 67 65 61 6c |eptic es|ophageal|
|000051b0| 0d 0a 73 74 72 69 63 74 | 75 72 65 73 3b 20 42 61 |..strict|ures; Ba|
|000051c0| 6c 6c 6f 6f 6e 20 63 61 | 74 68 65 74 65 72 73 20 |lloon ca|theters |
|000051d0| 66 6f 72 20 70 6f 73 74 | 6f 70 65 72 61 74 69 76 |for post|operativ|
|000051e0| 65 20 61 6e 64 20 70 65 | 70 74 69 63 20 65 73 6f |e and pe|ptic eso|
|000051f0| 70 68 61 67 65 61 6c 0d | 0a 73 74 72 69 63 74 75 |phageal.|.strictu|
|00005200| 72 65 73 3b 20 41 74 72 | 65 73 69 61 20 65 73 6f |res; Atr|esia eso|
|00005210| 70 68 61 67 65 61 6c 2c | 20 72 65 70 61 69 72 2c |phageal,| repair,|
|00005220| 20 70 6f 73 74 6f 70 65 | 72 61 74 69 76 65 20 61 | postope|rative a|
|00005230| 6e 64 20 70 65 70 74 69 | 63 20 65 73 6f 70 68 61 |nd pepti|c esopha|
|00005240| 67 65 61 6c 0d 0a 73 74 | 72 69 63 74 75 72 65 73 |geal..st|rictures|
|00005250| 20 61 66 74 65 72 7d 0d | 0a 24 4a 6f 75 72 6e 61 | after}.|.$Journa|
|00005260| 6c 7b 50 65 64 69 61 74 | 72 20 52 61 64 69 6f 6c |l{Pediat|r Radiol|
|00005270| 7d 0d 0a 24 56 6f 6c 75 | 6d 65 7b 31 37 7d 0d 0a |}..$Volu|me{17}..|
|00005280| 24 50 61 67 65 7b 34 35 | 34 2d 34 35 38 7d 0d 0a |$Page{45|4-458}..|
|00005290| 24 44 61 74 65 7b 31 39 | 38 37 7d 0d 0a 24 59 42 |$Date{19|87}..$YB|
|000052a0| 56 6f 6c 7b 31 39 38 39 | 20 59 65 61 72 20 42 6f |Vol{1989| Year Bo|
|000052b0| 6f 6b 20 6f 66 20 44 69 | 61 67 6e 6f 73 74 69 63 |ok of Di|agnostic|
|000052c0| 20 52 61 64 69 6f 6c 6f | 67 79 7d 0d 0a 24 43 68 | Radiolo|gy}..$Ch|
|000052d0| 61 70 74 65 72 7b 36 2d | 33 7d 0d 0a 24 59 42 45 |apter{6-|3}..$YBE|
|000052e0| 64 69 74 6f 72 7b 44 72 | 73 2e 20 42 72 61 67 67 |ditor{Dr|s. Bragg|
|000052f0| 2c 20 48 65 6e 64 65 65 | 2c 20 4b 65 61 74 73 2c |, Hendee|, Keats,|
|00005300| 20 4b 69 72 6b 70 61 74 | 72 69 63 6b 2c 20 4d 69 | Kirkpat|rick, Mi|
|00005310| 6c 6c 65 72 2c 20 4f 73 | 62 6f 75 72 6e 65 2c 20 |ller, Os|bourne, |
|00005320| 61 6e 64 20 54 68 6f 6d | 70 73 6f 6e 7d 0d 0a 24 |and Thom|pson}..$|
|00005330| 54 61 62 6c 65 7b 54 61 | 62 6c 65 20 4f 6d 69 74 |Table{Ta|ble Omit|
|00005340| 74 65 64 7d 0d 0a 24 43 | 6f 6d 6d 65 6e 74 61 74 |ted}..$C|ommentat|
|00005350| 6f 72 7b 7d 0d 0a 0d 0a | 43 6f 70 79 72 69 67 68 |or{}....|Copyrigh|
|00005360| 74 20 28 63 29 20 59 65 | 61 72 20 42 6f 6f 6b 20 |t (c) Ye|ar Book |
|00005370| 4d 65 64 69 63 61 6c 20 | 50 75 62 6c 69 73 68 65 |Medical |Publishe|
|00005380| 72 73 2c 20 49 6e 63 2e | 2c 20 31 39 38 39 0d 0a |rs, Inc.|, 1989..|
|00005390| 0d 0a 31 39 38 39 20 59 | 65 61 72 20 42 6f 6f 6b |..1989 Y|ear Book|
|000053a0| 20 6f 66 20 44 69 61 67 | 6e 6f 73 74 69 63 20 52 | of Diag|nostic R|
|000053b0| 61 64 69 6f 6c 6f 67 79 | 20 28 52 29 0d 0a 0d 0a |adiology| (R)....|
|000053c0| 43 68 61 70 74 65 72 20 | 36 2d 2d 50 65 64 69 61 |Chapter |6--Pedia|
|000053d0| 74 72 69 63 20 52 61 64 | 69 6f 6c 6f 67 79 0d 0a |tric Rad|iology..|
|000053e0| 0d 0a 49 6d 61 67 69 6e | 67 20 61 6e 64 20 49 6e |..Imagin|g and In|
|000053f0| 74 65 72 76 65 6e 74 69 | 6f 6e 61 6c 20 54 65 63 |terventi|onal Tec|
|00005400| 68 6e 69 71 75 65 73 0d | 0a 0d 0a 2d 2d 2d 2d 2d |hniques.|...-----|
|00005410| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005420| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005430| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005440| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005450| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 54 68 65 |--------|---..The|
|00005460| 20 54 72 65 61 74 6d 65 | 6e 74 20 6f 66 20 50 6f | Treatme|nt of Po|
|00005470| 73 74 2d 4f 70 65 72 61 | 74 69 76 65 20 61 6e 64 |st-Opera|tive and|
|00005480| 20 50 65 70 74 69 63 20 | 45 73 6f 70 68 61 67 65 | Peptic |Esophage|
|00005490| 61 6c 20 53 74 72 69 63 | 74 75 72 65 73 20 41 66 |al Stric|tures Af|
|000054a0| 74 65 72 0d 0a 45 73 6f | 70 68 61 67 65 61 6c 20 |ter..Eso|phageal |
|000054b0| 41 74 72 65 73 69 61 20 | 52 65 70 61 69 72 3a 20 |Atresia |Repair: |
|000054c0| 20 41 20 50 72 6f 67 72 | 61 6d 20 49 6e 63 6c 75 | A Progr|am Inclu|
|000054d0| 64 69 6e 67 20 44 69 6c | 61 74 61 74 69 6f 6e 20 |ding Dil|atation |
|000054e0| 57 69 74 68 20 42 61 6c | 6c 6f 6f 6e 0d 0a 43 61 |With Bal|loon..Ca|
|000054f0| 74 68 65 74 65 72 73 0d | 0a 0d 0a 48 6f 66 66 65 |theters.|...Hoffe|
|00005500| 72 20 46 41 2c 20 57 69 | 6e 74 65 72 20 48 53 2c |r FA, Wi|nter HS,|
|00005510| 20 46 65 6c 6c 6f 77 73 | 20 4b 45 2c 20 46 6f 6c | Fellows| KE, Fol|
|00005520| 6b 6d 61 6e 20 4a 0d 0a | 28 54 68 65 20 43 68 69 |kman J..|(The Chi|
|00005530| 6c 64 72 65 6e 27 73 20 | 48 6f 73 70 2c 20 42 6f |ldren's |Hosp, Bo|
|00005540| 73 74 6f 6e 3b 20 48 61 | 72 76 61 72 64 20 4d 65 |ston; Ha|rvard Me|
|00005550| 64 20 53 63 68 6f 6f 6c | 29 0d 0a 50 65 64 69 61 |d School|)..Pedia|
|00005560| 74 72 20 52 61 64 69 6f | 6c 20 31 37 3a 34 35 34 |tr Radio|l 17:454|
|00005570| 2d 34 35 38 2c 20 31 39 | 38 37 0d 0a 2d 2d 2d 2d |-458, 19|87..----|
|00005580| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005590| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000055a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000055b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000055c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 0d 0a |--------|----....|
|000055d0| 41 62 73 74 72 61 63 74 | 0d 0a 0d 0a 20 20 20 20 |Abstract|....    |
|000055e0| 20 42 61 6c 6c 6f 6f 6e | 20 63 61 74 68 65 74 65 | Balloon| cathete|
|000055f0| 72 20 64 69 6c 61 74 61 | 74 69 6f 6e 20 6f 66 20 |r dilata|tion of |
|00005600| 65 73 6f 70 68 61 67 65 | 61 6c 20 73 74 72 69 63 |esophage|al stric|
|00005610| 74 75 72 65 73 20 68 61 | 73 20 61 64 76 61 6e 74 |tures ha|s advant|
|00005620| 61 67 65 73 20 6f 76 65 | 72 0d 0a 62 6f 75 67 69 |ages ove|r..bougi|
|00005630| 65 6e 61 67 65 2e 20 20 | 41 20 6d 65 74 68 6f 64 |enage.  |A method|
|00005640| 20 6f 66 20 64 69 6c 61 | 74 61 74 69 6f 6e 20 69 | of dila|tation i|
|00005650| 6e 20 63 68 69 6c 64 72 | 65 6e 20 61 66 74 65 72 |n childr|en after|
|00005660| 20 72 65 70 61 69 72 20 | 6f 66 20 65 73 6f 70 68 | repair |of esoph|
|00005670| 61 67 65 61 6c 0d 0a 61 | 74 72 65 73 69 61 20 69 |ageal..a|tresia i|
|00005680| 73 20 64 65 73 63 72 69 | 62 65 64 2c 20 61 6e 64 |s descri|bed, and|
|00005690| 20 74 68 65 20 72 65 73 | 75 6c 74 73 20 69 6e 20 | the res|ults in |
|000056a0| 39 20 70 61 74 69 65 6e | 74 73 2c 20 61 67 65 64 |9 patien|ts, aged|
|000056b0| 20 36 20 77 65 65 6b 73 | 20 74 6f 20 31 37 20 79 | 6 weeks| to 17 y|
|000056c0| 65 61 72 73 2c 0d 0a 61 | 72 65 20 72 65 76 69 65 |ears,..a|re revie|
|000056d0| 77 65 64 2e 0d 0a 0d 0a | 20 20 20 20 20 54 65 63 |wed.....|     Tec|
|000056e0| 68 6e 69 71 75 65 2e 2d | 2d 42 61 6c 6c 6f 6f 6e |hnique.-|-Balloon|
|000056f0| 20 63 61 74 68 65 74 65 | 72 20 64 69 6c 61 74 61 | cathete|r dilata|
|00005700| 74 69 6f 6e 20 77 61 73 | 20 70 65 72 66 6f 72 6d |tion was| perform|
|00005710| 65 64 20 77 69 74 68 20 | 67 65 6e 65 72 61 6c 0d |ed with |general.|
|00005720| 0a 61 6e 65 73 74 68 65 | 73 69 61 2e 20 20 44 69 |.anesthe|sia.  Di|
|00005730| 6c 61 74 69 6e 67 20 63 | 61 74 68 65 74 65 72 73 |lating c|atheters|
|00005740| 20 77 69 74 68 20 32 20 | 62 61 6c 6c 6f 6f 6e 73 | with 2 |balloons|
|00005750| 20 34 2d 34 30 20 6d 6d | 20 69 6e 20 64 69 61 6d | 4-40 mm| in diam|
|00005760| 65 74 65 72 20 77 65 72 | 65 20 75 73 65 64 2e 0d |eter wer|e used..|
|00005770| 0a 54 68 65 20 62 61 6c | 6c 6f 6f 6e 20 77 61 73 |.The bal|loon was|
|00005780| 20 70 6f 73 69 74 69 6f | 6e 65 64 20 77 69 74 68 | positio|ned with|
|00005790| 20 74 68 65 20 73 74 72 | 69 63 74 75 72 65 20 61 | the str|icture a|
|000057a0| 74 20 69 74 73 20 63 65 | 6e 74 65 72 20 61 6e 64 |t its ce|nter and|
|000057b0| 20 77 61 73 20 69 6e 66 | 6c 61 74 65 64 0d 0a 77 | was inf|lated..w|
|000057c0| 69 74 68 20 64 69 6c 75 | 74 65 20 63 6f 6e 74 72 |ith dilu|te contr|
|000057d0| 61 73 74 20 6d 61 74 65 | 72 69 61 6c 20 75 6e 64 |ast mate|rial und|
|000057e0| 65 72 20 66 6c 75 6f 72 | 6f 73 63 6f 70 69 63 20 |er fluor|oscopic |
|000057f0| 76 69 73 75 61 6c 69 7a | 61 74 69 6f 6e 2e 20 20 |visualiz|ation.  |
|00005800| 49 6e 66 6c 61 74 69 6f | 6e 20 77 61 73 0d 0a 64 |Inflatio|n was..d|
|00005810| 6f 6e 65 20 74 77 69 63 | 65 20 66 6f 72 20 33 20 |one twic|e for 3 |
|00005820| 6d 69 6e 75 74 65 73 2e | 20 20 42 61 72 69 75 6d |minutes.|  Barium|
|00005830| 20 77 61 73 20 69 6e 6a | 65 63 74 65 64 20 74 6f | was inj|ected to|
|00005840| 20 63 68 65 63 6b 20 66 | 6f 72 20 74 65 61 72 73 | check f|or tears|
|00005850| 2e 0d 0a 0d 0a 20 20 20 | 20 20 4f 66 20 74 68 65 |.....   |  Of the|
|00005860| 20 39 20 70 61 74 69 65 | 6e 74 73 2c 20 36 20 62 | 9 patie|nts, 6 b|
|00005870| 65 63 61 6d 65 20 61 73 | 79 6d 70 74 6f 6d 61 74 |ecame as|ymptomat|
|00005880| 69 63 2e 20 20 49 74 20 | 77 61 73 20 73 75 73 70 |ic.  It |was susp|
|00005890| 65 63 74 65 64 20 74 68 | 61 74 20 35 20 6f 66 20 |ected th|at 5 of |
|000058a0| 74 68 65 20 39 0d 0a 68 | 61 64 20 72 65 66 6c 75 |the 9..h|ad reflu|
|000058b0| 78 20 65 73 6f 70 68 61 | 67 69 74 69 73 2c 20 77 |x esopha|gitis, w|
|000058c0| 68 69 63 68 20 77 61 73 | 20 63 6f 6e 66 69 72 6d |hich was| confirm|
|000058d0| 65 64 20 69 6e 20 33 20 | 70 61 74 69 65 6e 74 73 |ed in 3 |patients|
|000058e0| 20 62 79 20 62 69 6f 70 | 73 79 20 61 6e 64 20 77 | by biop|sy and w|
|000058f0| 61 73 0d 0a 74 72 65 61 | 74 65 64 20 6d 65 64 69 |as..trea|ted medi|
|00005900| 63 61 6c 6c 79 20 62 65 | 66 6f 72 65 20 64 69 6c |cally be|fore dil|
|00005910| 61 74 61 74 69 6f 6e 2e | 20 20 53 65 76 65 6e 20 |atation.|  Seven |
|00005920| 70 61 74 69 65 6e 74 73 | 20 68 61 64 20 70 72 69 |patients| had pri|
|00005930| 6d 61 72 79 20 61 6e 61 | 73 74 6f 6d 6f 73 69 73 |mary ana|stomosis|
|00005940| 2c 20 31 0d 0a 68 61 64 | 20 61 20 67 61 73 74 72 |, 1..had| a gastr|
|00005950| 69 63 20 74 75 62 65 2c | 20 61 6e 64 20 31 20 68 |ic tube,| and 1 h|
|00005960| 61 64 20 61 20 63 6f 6c | 6f 6e 69 63 20 69 6e 74 |ad a col|onic int|
|00005970| 65 72 70 6f 73 69 74 69 | 6f 6e 2e 20 20 54 68 65 |erpositi|on.  The|
|00005980| 20 33 20 70 61 74 69 65 | 6e 74 73 20 77 68 6f 0d | 3 patie|nts who.|
|00005990| 0a 63 6f 6e 74 69 6e 75 | 65 64 20 74 6f 20 68 61 |.continu|ed to ha|
|000059a0| 76 65 20 73 79 6d 70 74 | 6f 6d 73 20 69 6e 63 6c |ve sympt|oms incl|
|000059b0| 75 64 65 64 20 61 6e 20 | 69 6e 66 61 6e 74 20 64 |uded an |infant d|
|000059c0| 69 6c 61 74 65 64 20 63 | 6f 6e 73 65 72 76 61 74 |ilated c|onservat|
|000059d0| 69 76 65 6c 79 3b 20 61 | 20 70 61 74 69 65 6e 74 |ively; a| patient|
|000059e0| 0d 0a 77 69 74 68 20 72 | 65 63 75 72 72 65 6e 74 |..with r|ecurrent|
|000059f0| 20 73 74 72 69 63 74 75 | 72 65 20 61 66 74 65 72 | strictu|re after|
|00005a00| 20 73 74 6f 70 70 69 6e | 67 20 6d 65 64 69 63 61 | stoppin|g medica|
|00005a10| 6c 20 74 68 65 72 61 70 | 79 3b 20 61 6e 64 20 61 |l therap|y; and a|
|00005a20| 6e 20 69 6e 66 61 6e 74 | 20 77 69 74 68 0d 0a 70 |n infant| with..p|
|00005a30| 65 72 73 69 73 74 65 6e | 74 20 61 6e 61 73 74 6f |ersisten|t anasto|
|00005a40| 6d 6f 74 69 63 20 73 74 | 72 69 63 74 75 72 65 2c |motic st|ricture,|
|00005a50| 20 73 75 73 70 65 63 74 | 65 64 20 62 75 74 20 75 | suspect|ed but u|
|00005a60| 6e 74 72 65 61 74 65 64 | 20 72 65 66 6c 75 78 20 |ntreated| reflux |
|00005a70| 65 73 6f 70 68 61 67 69 | 74 69 73 2c 0d 0a 61 6e |esophagi|tis,..an|
|00005a80| 64 20 61 20 74 65 61 72 | 20 64 75 72 69 6e 67 20 |d a tear| during |
|00005a90| 62 61 6c 6c 6f 6f 6e 20 | 64 69 6c 61 74 61 74 69 |balloon |dilatati|
|00005aa0| 6f 6e 20 28 46 69 67 20 | 36 2d 33 29 2e 0d 0a 20 |on (Fig |6-3)... |
|00005ab0| 20 20 20 20 42 61 6c 6c | 6f 6f 6e 20 63 61 74 68 |    Ball|oon cath|
|00005ac0| 65 74 65 72 20 65 73 6f | 70 68 61 67 65 61 6c 20 |eter eso|phageal |
|00005ad0| 64 69 6c 61 74 61 74 69 | 6f 6e 20 69 73 20 73 61 |dilatati|on is sa|
|00005ae0| 66 65 20 61 6e 64 20 65 | 66 66 65 63 74 69 76 65 |fe and e|ffective|
|00005af0| 20 69 6e 20 74 68 65 0d | 0a 74 72 65 61 74 6d 65 | in the.|.treatme|
|00005b00| 6e 74 20 6f 66 20 63 68 | 69 6c 64 72 65 6e 20 77 |nt of ch|ildren w|
|00005b10| 69 74 68 20 65 73 6f 70 | 68 61 67 65 61 6c 20 73 |ith esop|hageal s|
|00005b20| 74 72 69 63 74 75 72 65 | 73 20 77 68 65 6e 20 72 |tricture|s when r|
|00005b30| 65 66 6c 75 78 20 65 73 | 6f 70 68 61 67 69 74 69 |eflux es|ophagiti|
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|00005b60| 0d 0a 0d 0a 50 6f 73 74 | 2d 43 6f 6d 6d 65 6e 74 |....Post|-Comment|
|00005b70| 0d 0a 0d 0a 20 20 20 20 | 20 50 61 74 69 65 6e 74 |....    | Patient|
|00005b80| 73 20 77 68 6f 20 68 61 | 76 65 20 68 61 64 20 73 |s who ha|ve had s|
|00005b90| 75 63 63 65 73 73 66 75 | 6c 20 74 72 65 61 74 6d |uccessfu|l treatm|
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|00005bc0| 72 65 71 75 65 6e 74 6c | 79 20 70 6c 61 67 75 65 |requentl|y plague|
|00005bd0| 64 20 62 79 20 67 61 73 | 74 72 6f 65 73 6f 70 68 |d by gas|troesoph|
|00005be0| 61 67 65 61 6c 20 72 65 | 66 6c 75 78 2c 20 73 74 |ageal re|flux, st|
|00005bf0| 72 69 63 74 75 72 65 73 | 2c 20 61 6e 64 20 73 65 |rictures|, and se|
|00005c00| 71 75 65 6c 61 65 0d 0a | 73 65 63 6f 6e 64 61 72 |quelae..|secondar|
|00005c10| 79 20 74 6f 20 74 68 65 | 20 61 62 73 65 6e 63 65 |y to the| absence|
|00005c20| 20 6f 66 20 6e 6f 72 6d | 61 6c 20 6d 6f 74 6f 72 | of norm|al motor|
|00005c30| 20 61 63 74 69 76 69 74 | 79 20 69 6e 20 74 68 65 | activit|y in the|
|00005c40| 20 65 73 6f 70 68 61 67 | 75 73 2e 20 20 49 74 20 | esophag|us.  It |
|00005c50| 69 73 0d 0a 69 6e 74 65 | 72 65 73 74 69 6e 67 20 |is..inte|resting |
|00005c60| 74 6f 20 6e 6f 74 65 20 | 74 68 61 74 2c 20 65 78 |to note |that, ex|
|00005c70| 70 65 72 69 6d 65 6e 74 | 61 6c 6c 79 2c 20 6d 75 |periment|ally, mu|
|00005c80| 63 6f 73 61 20 64 61 6d | 61 67 65 64 20 62 79 20 |cosa dam|aged by |
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|00005ca0| 69 73 0d 0a 63 6f 75 6c | 64 20 62 65 20 70 72 65 |is..coul|d be pre|
|00005cb0| 64 69 73 70 6f 73 65 64 | 20 74 6f 20 65 73 6f 70 |disposed| to esop|
|00005cc0| 68 61 67 65 61 6c 20 72 | 75 70 74 75 72 65 20 64 |hageal r|upture d|
|00005cd0| 75 72 69 6e 67 20 64 69 | 6c 61 74 69 6e 67 20 70 |uring di|lating p|
|00005ce0| 72 6f 63 65 64 75 72 65 | 73 3a 20 20 74 68 75 73 |rocedure|s:  thus|
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|00005d40| 62 6c 65 2e 0d 0a 20 20 | 20 20 20 52 65 6c 61 74 |ble...  |   Relat|
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|00005d80| 6c 6f 77 69 6e 67 3a 20 | 20 44 69 6e 61 72 69 20 |lowing: | Dinari |
|00005d90| 65 74 20 61 6c 3a 0d 0a | 43 72 69 63 6f 70 68 61 |et al:..|Cricopha|
|00005da0| 72 79 6e 67 65 61 6c 20 | 64 79 73 66 75 6e 63 74 |ryngeal |dysfunct|
|00005db0| 69 6f 6e 20 69 6e 20 63 | 68 69 6c 64 68 6f 6f 64 |ion in c|hildhood|
|00005dc0| 3b 20 54 72 65 61 74 6d | 65 6e 74 20 62 79 20 64 |; Treatm|ent by d|
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|00005de0| 65 64 69 61 74 72 0d 0a | 47 61 74 72 6f 65 6e 74 |ediatr..|Gatroent|
|00005df0| 65 72 6f 6c 20 4e 75 74 | 72 20 36 3a 32 31 32 2d |erol Nut|r 6:212-|
|00005e00| 32 31 36 2c 20 31 39 38 | 37 3b 20 53 61 74 6f 20 |216, 198|7; Sato |
|00005e10| 65 74 20 61 6c 3a 20 20 | 42 61 6c 6c 6f 6f 6e 20 |et al:  |Balloon |
|00005e20| 64 69 6c 61 74 61 74 69 | 6f 6e 20 6f 66 20 65 73 |dilatati|on of es|
|00005e30| 6f 70 68 61 67 65 61 6c | 0d 0a 73 74 65 6e 6f 73 |ophageal|..stenos|
|00005e40| 69 73 20 69 6e 20 63 68 | 69 6c 64 72 65 6e 2e 20 |is in ch|ildren. |
|00005e50| 20 41 4a 52 20 31 35 30 | 3a 36 33 39 2d 36 34 32 | AJR 150|:639-642|
|00005e60| 2c 20 31 39 38 38 3b 20 | 61 6e 64 20 48 65 79 6d |, 1988; |and Heym|
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+--------+-------------------------+-------------------------+--------+--------+