[Our experience apropos of conventional ventilation in ORL surgery with CO2 laser].
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Biomedical subjects
Publications and source records attributed to A Ladgham.
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Secondary tumours after radio and/or chemotherapy are mainly of hematopoietic (acute non lymphoblastic leukemia, non-Hodgkin lymphoma) or soft tissue lineage previously described most frequently after breast cancer and Hodgkin disease treatment with radio and/or chemotherapy. We report two cases of classical osteosarcoma's observed 9 and 3 years after treatment for UCNT with combined radiotherapy and alkylant-based adjuvant chemotherapy in one case and exclusive loco-regional irradiation in the second case.
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A large body of evidence has suggested that the Epstein-Barr virus (EBV) is strongly associated with undifferentiated nasopharyngeal carcinoma. Immunologically, this neoplasia is characterized by the absence of anti-EBV circulating cytotoxic T lymphocytes (CTL), despite a high number of peripheral activated CD8+ cells, as previously determined in our laboratory. In order to determine whether the absence of anti-EBV CTL is related to a reduced number of circulating anti-EBV effector cells, we attempted to expand these hypothetical specific T cells by induction of proliferation with recombinant interleukin-2 (rIL-2), in the, absence of any stimulator cells. Optimal conditions for stimulation of peripheral blood lymphocytes (PBL) of nasopharyngeal patients were obtained with 100 U/ml rIL-2 during 10 days of culture. PBL treated with rIL-2 induced a selective expansion of CD8+ cells and generated a potent cytotoxicity towards autologous or HLA-compatible lymphoblastoid cell lines, used as target cells in a chromium-release thest. However, this cytolysis was non-MHC-restricted, since, the monoclonal antibodies anti-(HLA class I) and anti-(HLA class II) were inefficient in inhibiting this cytotoxicity. Interestingly, purified CD8+ cells acquired the capacity for non-MHC-restricted cytolysis.
The authors report 3 cases of skull base chordomas. In 2 cases, skull radiographies and computed tomography found lytic lesions of sphenoid and clivus, with calcifications into the tumors. In the third case, radiological findings suggest a naso pharynx tumor.
We present a comparative analysis of cell-mediated immunity between circulating lymphocytes and tumor-infiltrating lymphocytes (TIL) from patients with nasopharyngeal carcinoma (NPC). Phenotypic analysis using a panel of monoclonal antibodies (MAbs) to define lymphocytic subsets has revealed a selective homing of phenotypically lytic cells such as CD8- and CD16-positive cells, but a low percentage of macrophages when compared to PBL of NPC patients. Also, PBL and TIL contain an equivalent percentage of activated T-lymphocytes expressing HLA-DR molecules and IL-2 receptors. Functionally, TIL exhibit an abolished NK-cell activity and concomitant decrease of proliferative response to phytohemagglutinin (PHA) and concanavalin A (ConA) stimulation when compared with PBL.
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The authors report about a retrospective study on 52 cases of malignant tumors of the maxillary sinus gathered from January 1, 1977 to December 31, 1985 in the Department of Cervicofacial and ENT Carcinological Surgery of the Salah Azaïz Institut in Tunis. Epidermoid carcinomas dominate, but the histological types encountered are quite various; the tumors are very advanced on the first consultation in most cases. Computed tomography was a great help to assess extension prior to treatment and during follow-up. The evolution involved frequent recurrence and a great number of deaths during the first year.
The authors report the case of two patients presenting with increased bone density and lytic lesions of the skull due to tertiary syphilis. A malignant tumor has late developed on these lesions. Only one patient was imaged with CT Scan which was very useful to determine the tumoral extension.
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Thirty-two cases of paraneoplastic syndrome associated with nasopharyngeal carcinoma are reported. The prevalence of the syndrome in young subjects was striking: 29 of the patients were under 25 years of age. Seventeen presented with hypertrophic osteoarthropathy, 13 with clubbing of the fingers, 1 with dermatomyositis and 1 with myelemia due to excessive production of bone marrow cells. Twenty-eight patients had metastases which involved the lung in 24. These pulmonary metastases are held responsible for the osteoarticular paraneoplastic syndrome, but in our 4 patients without metastases the syndrome was probably caused by the primary tumour itself.
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A prospective study was done to test the efficacy of 5-fluorouracil (topical and systemic) in multiple and unresectable histologically proven facial squamous cell carcinomas (SCC) secondary to XP. Twelve patients (7M/5F, mean age 19.8 years) with multiple facial SCC were treated between 1994 and 1997. 5-FU was used as a twice-a-day local application in the documented areas, by continuous infusion associated with cisplatin (2 patients) and short infusion combined with folic acid (3 patients). Evaluation was done by clinical examination every two months for topical therapy and after every cycle for systemic treatment. Median treatment duration was 12 months (2 to 36 months). Treatment was well tolerated excluding episodes of pruritus in the treated areas. We observed mainly superficial tumour regression followed by dryness and crusting. In 5 cases, we performed biopsies after treatment showing in one case an extensive fibrosis with absence of tumour. However in the remaining 4 cases, despite a superficial reduction of tumour and a reconstitution of the epidermis, viable and unmodified squamous cell carcinoma remained in the deeper dermis. In the 5 patients treated by systemic 5-FU, we observed 1 complete response and 3 partial responses. Despite a dissociation between a good cosmetic result and a relatively superficial effect, topical 5-FU represents a useful therapeutic option in multiple unresectable facial SCC in patients with XP. Systemic chemotherapy is recommended in the event of more extended or profound lesions.
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