Biomedical subjects
A Alfonso
Publications and source records attributed to A Alfonso.
Intraoral papillary squamous cell tumor of the soft palate with features of sialadenoma papilliferum-? malignant sialadenoma papilliferum.
An unusual, recurring, squamous papillary tumor involving and possibly arising from minor salivary gland excretory ducts in the palate is presented. Similarity to sialadenoma papilliferum and upper respiratory tract papillomatosis is noted. A paraglandular cystic mass with some resemblance to the palatal lesion, and a solitary lymph node with papillary squamous epithelial deposits was found in a radical neck dissection. We suggest that the lymph node lesion represents a metastasis which may have arisen from the palatal lesion, and therefore propose the concept of a possible malignant analogue of sialadenoma papilliferum.
Primary carcinoma of the duodenum producing a malignant duodenocolic fistula.
A unique case of primary duodenal carcinoma with a malignant duodenocolic fistula is reported. En-bloc resection of the lesion with pancreatico-duodenectomy and right hemicolectomy resulted in a 15-month disease-free interval.
Treatment of hepatic metastases with a combination of hepatic artery infusion chemotherapy and external radiotherapy.
Systemic chemotherapy has given good results when compared with that of patients who received no chemotherapy. When resection was performed, the results are slightly better. The group of patients who underwent combined therapy, using infusion chemotherapy, radiation and systemic chemotherapy, had the best results. It appears that infusion chemotherapy and radiotherapy can improve the palliation available for patients with metastases in the liver from carcinoma of the colon and rectum and warrants further investigation.
Adenocarcinoma of the proximal third of the stomach. Pitfalls in surgical management.
Adenocarcinoma of the proximal third of the stomach is a florid tumor with a high propensity for esophageal extension limphagitic invasion, and hepatic dissemination. Treatment results in 117 consecutive cases indicate that cure rates may be improved by a closer attention to the esophageal margin of resection.
The value of laparoscopy in general surgery.
Fifty-six general surgical patients were evaluated by laparoscopy, primarily for diagnostic problems, ascites or liver assessment for potential metastatic disease. There was minimal morbidity and no mortality from the procedure. Overall laparoscopic accuracy was 87%. In properly selected cases, laparoscopy can often resolve a diagnostic problem, determine the extent of disease and permit initiation of appropriate therapy.
Repair of large chest wall defects using pedicle flaps.
Three cases of chest wall resection illustrate the use of three different full thickness pedicle flaps which can be used to cover almost any area of the anterior chest wall. The medially based acromiothoracic flap was swung inferiorly to cover a lateral defect. Laterally based abdominal wall and axillary flaps were used to cover more medial defects. In case III bilateral axillary flaps were necessary to cover a huge central defect after resection of the anterior sternum and anterior cartilages of seven ribs for a sebaceous carcinoma.
Analysis of patient disability after curative resection for colonic and rectal cancer.
Ninety-seven patients undergoing curative resection for colonic or rectal cancer were investigated to determine the degree of early disability, that is, disability one to four years postoperatively. Seventy per cent of the patients were disability free postoperatively and fully employable, and among those who died of the disease, 73 per cent had no disability three months prior to death. The results indicate that waiting five years to determine cure in this disease wastes many man-years of fruitful employability.
Major surgery in Jehovah's witnesses.
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Effect of end-to-side and side-to-side portacaval shunt on liver function.
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Outcome differences in younger and older patients with laryngeal cancer: a retrospective case-control study.
PURPOSE: Younger or older age has a significant impact on the outcome of patients with head and neck cancer. However, the data regarding outcomes based on age are conflicting. The aim of this article is to determine the impact of age on the outcome of laryngeal cancer. MATERIALS AND METHODS: A retrospective study was performed including all patients with squamous cell carcinoma of the larynx for over a 9-year period. The patients were divided into 3 groups based on age. The younger age group included patients 40 years of age and younger, the older group included patients over 80 years of age, and the remaining patients served as the control group. Descriptive statistics were used to summarize study data. Nonparametric quantitative and qualitative analyses were performed using the Mann-Whitney U test and Fisher's exact test, respectively. Survival analysis was performed using the generalized Wilcoxon test. The Cox proportional hazards model was used for multivariate analysis. RESULTS: Of the 209 patients with laryngeal carcinoma presenting to our institution over a 9-year period, 20 (10%) were < or =40 years and 15 (7%) were > or =80 years of age. No differences in TNM stage at presentation, treatment, or treatment-associated complications were observed based on age. However, younger patients were less likely to report tobacco (50%; P < .001) or alcohol (57%; P = .03) use and more likely to have human immunodeficiency virus infection (50%; P< .001). Older patients showed a trend toward having a worse baseline medical status. Recurrence was significantly more common in older patients (P = .02) and cause-specific survival significantly poorer for both younger and older patients (P = .002). CONCLUSIONS: The presentation and outcome of laryngeal cancer is influenced by the age at presentation. The differences may be related exact reason for the observed survival differences needs to be determined.