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Biomedical subjects

A Sudarsanam

Publications and source records attributed to A Sudarsanam.

10 recordsLinked to original sources

Randomized study of local control and survival following radical surgery or radiation therapy in oral and laryngeal carcinomas.

From 1971 to 1975, 100 patients with glottic, supraglottic, and oral cavity lesions were prospectively randomized between primary radiation treatment and primary surgery. Local control and survival were similar with either treatment for lesions of the oral cavity or supraglottic larynx. Comparison between radiation alone and surgery alone for T1 and T2 glottic laryngeal lesions showed local control rates of 76% and 100% (P=0.32); after secondary salvage attempts, local control rates were 82% and 100%, respectively (P= 0.52). Neither result approached statistical significance. Successful radiation for early glottic larynx lesions resulted in superior deglutition and equivalent voice function compared to successful primary treatment with conservation laryngectomy. For oral cavity lesions, swallowing was impaired in the same percentage of radiated and operated patients, but fewer primary radiation patients had articulation difficulties. Among the patients with supraglottic larynx lesions, aspiration was not a problem with either radiation or surgery, but successful radiation perhaps maintained a slightly better voice quality.

Carcinoma, Squamous Cell

Randomized study of control of the primary tumor and survival using preoperative radiation, radiation alone, or surgery alone in head and neck carcinomas.

Fifty-five selected patients with previously untreated squamous cell carcinoma of the head and neck regions were studied in a randomized, prospective manner. The three treatment categories were primary radiation (Gp R), primary surgery (Gp S), and preoperative radiation of 4000 rads in four weeks (Gp R/S). The local control rates for the 44 evaluable patients with a two-year minimum followup were 24%, 39%, and 43% respectively. Further treatment attempts in patients failing initial therapy yielded local control rates of 35%, 39%, and 43% for Gp R, Gp S, and Gp R/S, respectively. None of the local control rates nor the corresponding survival curves were significantly different at P less than 0.10. However, the group sizes were sufficiently small that true differences might not have been detected. Postoperative complications were higher in the primary radiation failures subsequently operated upon compared to the primary surgery group (P = 0.07).

Carcinoma, Squamous Cell

Haemolytic-uraemic syndrome complicating shigella dystentery in south Indian children.

Shigella dysentery caused 65% of all cases of acute renal failure (ARF) seen in children treated at the Christian Medical College Hospital, Vellore, during the 33 months ending September 1977. In the 40 children with ARF secondary to shigella dysentery, haematological findings suggested that they were suffering from the haemolytic-uraemic syndrome, and glomerular hypercellularity and fibrin deposition were present in all 12 patients whose renal histology could be studied. Peritoneal dialysis was the main element of treatment: 43% of children who underwent dialysis improved, compared with only 25% of those who did not undergo dialysis. The haemolytic-uraemic syndrome precipitated by bacillary dystentery is therefore the most important cause of ARF in children aged under 5 years in Tamil Nadu and the adjoining area of Andhra Pradesh.

Acute Kidney Injury

Anal carcinoma: basic concepts and management.

Surgery has been the mainstay in the management of anal carcinoma. However, anal carcinomas are reasonably sensitive to ionizing radiation. By appropriate combinations of external radiation beams and interstitial implantation techniques, curative therapy with preservation of anal continence can be rendered by radiation alone. Sufficient radiation dose to the draining lymph nodes, both intraabdominal and inguinal, along with intensified dose to the primary lesions, is required for high cure and low complication rates.

Anus Neoplasms

Adjuvant role of radiation in soft tissue sarcoma in adults.

Forty-seven patients with soft tissue sarcomas were analyzed retrospectively. Treatment was non-randomized between surgery alone, preoperative radiation of 5,000 rads/5 weeks, postoperative radiation of 6,000 rads/6 weeks following total gross tumor removal, and postoperative radiation (variable dosees) for residual gross or unresectable tumor. Preoperative radiation was not statistically better for local control or survival compared to postoperative radiation after local excision of gross tumor. Wide excision, higher postoperative radiation dosage, and/or enlarged radiation portals perhaps would improve results. Additional adjuvant therapies, such as chemotherapy or immunotherapy, needs to be investigated.

Adult

Radiation therapy for exophthalmos: report of seven cases.

Five of 7 cases of exophthalmos showed improvement within three months with 2,000 rads of 6 MeV radiation. A new technique of X-ray beam localization employing a direct measurement 12 mm posterior to the anterior extent of the cornea was used and found more accurate than using a fixed point (external canthus). All cases should be treated bilaterally. Retreatment after radiation failure is not recommended. There were no complications. Improvement is usually rapid as orbital irradiation, not including the pituitary, causes rapid destruction of the massive collection of lymphocytes and a reduction in the bulky mass and edema of the orbit.

Exophthalmos