Understanding the skeletal effects of resistance exercise involves delineating the spatially heterogeneous response of bone to load distributions from different muscle contractions. Bone mineral density (BMD) analyses may obscure these patterns by averaging data from tissues with variable mechano-response. To assess the proximal femoral response to resistance exercise, we acquired pre- and post-training quantitative computed tomography (QCT) images in 22 subjects (25-55 years, 9 males, 13 females) performing two resistance exercises for 16 weeks. One group (N=7) performed 4 sets each of squats and deadlifts, a second group (N=8) performed 4 sets each of standing hip abductions and adductions and a third (COMBO) performed two sets each of squat/deadlift and abduction/adduction exercise. Subjects exercised three times weekly, and the load was adjusted each session to maximum effort. We used voxel-based morphometry (VBM) to visualize BMD distributions. Hip strength computations used finite element modeling (FEM) with stance and fall loading conditions. Cortical and trabecular BMD, and cortical tissue volume employed QCT analysis. For muscle size and density, we analyzed the cross-sectional area (CSA) and mean Hounsfield Unit (HU) in the hip extensor, flexor, abductor and adductor muscle groups. While SQDL increased vertebral BMD, femoral neck cortical BMD and volume, and stance hip strength, ABADD increased trochanteric cortical volume. The COMBO group showed no changes in any parameter. VBM showed different effects of ABADD and SQDL exercise, with the former causing focal changes of trochanteric cortical bone, and the latter showing diffuse changes in the femoral neck and head. ABADD exercise increased adductor CSA and HU, while SQDL exercise increased the hip extensor CSA and HU. In conclusion, we observed different proximal femoral bone and muscle tissue responses to SQDL and ABADD exercise. This study supports VBM and vQCT to quantify the spatially heterogeneous effects of types of muscle contractions on bone.

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The authors have investigated digital subtraction angiography (DSA) for the differential diagnosis of breast lesions detected initially by mammography. Eighteen patients scheduled for biopsy first underwent digital subtraction angiography of the breast (DSAB). Criteria for malignancy included the presence of abnormal vessels and a "blush" in the area of the lesion. A total of 17 lesions are currently available for histopathologic correlation. Although this is a small series, the initial results of DSAB suggest its potential utility for differentiating between benign and malignant lesions.

Restrospective analysis was done of 304 patients who underwent colostomy closure at Henry Ford Hospital between 1967 and 1977. A mortality of less than 0.3 per cent and a morbidity rate of 14 per cent, with an average hospital stay of 15 days, is hereby reported. Wound infection was the most common complication with an incidence of 9.5 per cent. Late complications during the study period were less than 3 per cent. In our experience, if and intraperitoneal closure technique with resectiona and anastomosis is used, colostomy closure can be a safe procedure with minimal mortality and morbidity. We believe colostomy closure should be considered as nothing less than a major colonic resection.

Radiation therapy, often used to treat gynecologic and urologic pelvic malignancies, has varying, adverse effects on the bowel. Radiation enteritis may occur from one month to 20 years after irradiation, and disabling symptoms may require surgery in 10 to 20 per cent of patients. From our experience with 20 patients who required surgery for radiation enteritis and who were followed for up to 20 years, we were able to identify three clinical groups. Patients in the first group need only medical treatment for their symptoms, and observation, whereas patients in the second group may present with acute, debilitating, life-threatening symptoms that may require emergency surgery. Patients in the third group have a long-standing history of intermittent bowel obstruction and/or enteric fistulas that are best treated with adequate nutritional support followed by timely surgical intervention.