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Biomedical subjects

A Vermey

Publications and source records attributed to A Vermey.

At least 19 recordsLinked to original sources
PubMed1995

An important role for chromosome 17, band q25, in the histogenesis of alveolar soft part sarcoma.

A cytogenetic study of two cases of alveolar soft part sarcoma showed near-diploid karyotypes with multiple chromosomal rearrangements. An abnormality of the long arm of chromosome 17, involving band q25, is present in both cases and in 2 of 4 cases in the literature. This recurrent structural abnormality probably plays an important role in the histogenesis of this unusual neoplasm and therefore is important for further molecular investigation.

Adult↗
PubMed1995

Aggressive fibromatosis (non-familial desmoid tumour): therapeutic problems and the role of adjuvant radiotherapy.

Aggressive fibromatosis is a rare soft tissue tumour with a high tendency to local recurrence, even after apparently adequate resection. Wide local excision with a margin of at least 3 cm, depending on the anatomical location, should be performed to improve rates of recurrent disease. There is no consensus concerning the role of radiotherapy in the treatment of these lesions. The clinical findings of 39 cases diagnosed between 1972 and 1991 were reviewed retrospectively. Local control was effected in 19 of 32 patients treated with surgery alone after a median (range) follow-up of 72 (18-236) months. There were 40 cases of recurrent fibromatosis in 15 patients. Local control was obtained in 13 of 14 patients who received radiotherapy using a wide-field technique and doses of more than 50 Gy over a period of 5 weeks after marginal or incomplete resection of primary or recurrent lesions (P < 0.001). The results suggest that in a selected group of patients with aggressive fibromatosis radiotherapy may effectively achieve control of residual disease after surgery without marked disfigurement and loss of function.

Adult↗
PubMed1995

Total thyroidectomy in the treatment of thyroid carcinoma in childhood.

Between 1974 and 1993 ten girls and six boys aged 6-16 years underwent total thyroidectomy, with therapeutic selective neck dissection in six patients. All were treated after operation with radioactive iodine (131I) for ablation of thyroid tissue remnants. Papillary carcinoma occurred in ten patients, follicular carcinoma in two and medullary thyroid lesions in four. The patients were followed for a median of 11.5 (range 1-20) years with regular determinations of serum thyroglobulin levels and 131I whole-body scanning when indicated. Only one patient had a slight increase in thyroglobulin levels without evidence of disease on further screening. In children with medullary lesions the serum levels of basal and pentagastrin-stimulated calcitonin remained normal. Currently all patients are alive and without disease. Hypocalcaemia lasting for more than 1 year was observed in one patient. Recurrent nerves were not injured accidentally, but because of tumour invasion two of 32 recurrent nerves had to be sacrificed. This surgical approach is safe and well tolerated in children.

Adolescent↗
PubMed1995

Comparison of epithelial dysplasia--the 4NQO rat palate model and human oral mucosa.

Epithelial dysplasia in the rat palatal mucosa was induced by application three times a week of the carcinogen 4-nitroquinoline 1-oxide (4NQO). With the Epithelial Atypia Index (EAI), the successive stages of 4NQO-induced epithelial dysplasia were compared with specimens of human oral epithelial dysplasia. It appeared that there was a close similarity between the histologic features of 4NQO-induced dysplasia in the rat palatal mucosa and human oral epithelial dysplasia. Thus, the 4NQO rat palate model seems to be appropriate to study and assess new treatment modalities of premalignant epithelial lesions of the oral mucosa in man.

4-Nitroquinoline-1-oxide↗
PubMed1995

Hereditary medullary thyroid carcinoma.

The most well-known form of familial thyroid cancer is hereditary medullary thyroid carcinoma (MTC). This neoplasm is often associated with pheochromocytoma and hyperparathyroidism, a combination known as the multiple endocrine neoplasia syndrome type 2A (MEN 2A). The rare association of MTC and pheochromocytoma with multiple mucosal neuromas is called multiple endocrine neoplasia syndrome type 2B (MEN 2B). Of those who present with clinical signs and symptoms, almost half die of the disease and others may suffer significant morbidity. By contrast, early diagnosis by screening of family members allows for treatment with thyroidectomy and/or adrenalectomy, which are often curative. Measurement of serum calcitonin before and after stimulation with pentagastrin and/or calcium is mandatory for the diagnosis of MTC. Testing of first-degree relatives of patients with MTC should be started by the age of 3 to 5 years. In families with the MEN 2B syndrome, screening should be started during the first year after birth and include a search for the characteristic phenotype. The mapping of the MEN 2A gene to the centromeric region of chromosome 10 has provided an alternative approach to the diagnosis of MEN 2A gene carriers. Genetic screening using linked markers can now be done with an accuracy of 95% in informative families. Surgery is the treatment of choice for cases of MEN 2, but the extent of surgical resection of the involved endocrine organs is still a subject of debate.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Detection of lymph node metastases of squamous-cell cancer of the head and neck with FDG-PET and MRI.

UNLABELLED: The uptake of 2-deoxy-2-[18F]fluoro-D-glucose (FDG) in neck lymph nodes of twelve patients with a squamous-cell carcinoma of the oral cavity was studied with PET in order to detect and locate lymphogenic metastases. METHODS: The results of FDG-PET imaging were compared with clinical, MRI and histopathologic findings. Standardized uptake values (SUV) were also calculated. RESULTS: A sensitivity of 91% and a specificity of 88% were calculated for FDG-PET. In contrast, a sensitivity of 36% and a specificity of 94% were calculated for MRI. Calculated SUVs for reactive lymph nodes, metastatic lymph nodes and the primary tumor were undifferentiated. CONCLUSION: Using FDG-PET, lymph node metastases of squamous-cell carcinomas of the oral cavity can be visualized with a high sensitivity and specificity. FDG-PET can be an improvement in the evaluation of the neck.

Aged↗
PubMed1992

Protocol for the prevention and treatment of oral sequelae resulting from head and neck radiation therapy.

In addition to the desired antitumor effects, head and neck radiation therapy induces damage in normal tissues that may result in oral sequelae such as mucositis, hyposalivation, radiation caries, taste loss, trismus, soft-tissue necrosis, and osteoradionecrosis. These sequelae may be dose-limiting and have a tremendous effect on the patient's quality of life. Current policies to prevent these sequelae primarily are based on clinical experience and show great diversity. A protocol for the prevention and treatment of oral sequelae resulting from head and neck radiation therapy, based on fundamental research and data derived from the literature, is presented. The protocol is particularly applicable in centers with a dental team. This team should be involved at the time of initial diagnosis so that a successful preventive regimen is an integral part of the overall cancer treatment regimen.

Clinical Protocols↗
PubMed1992

A survey of prevention and treatment regimens for oral sequelae resulting from head and neck radiotherapy used in Dutch radiotherapy institutes.

Radiation treatment plays an important role in the management of head and neck cancer. Unfortunately several radiation-induced side effects may occur including mucositis, hyposalivation, radiation caries, trismus and osteoradionecrosis. It is generally accepted that most side effects can be prevented or reduced in severity. The purpose of this investigation was to make a survey of the prevention and treatment regimens for oral sequelae resulting from head and neck radiotherapy applied in all radiotherapy institutes in the Netherlands, and to evaluate the differences in these regimens. In all Dutch centers (n = 20) in which irradiation of head and neck cancer patients is performed, members of the staff responsible for prevention and treatment of oral side effects were interviewed. Questions referred to composition of the dental team, screening and care pre-irradiation, care during irradiation, and care post-irradiation. There appeared to be a great diversity in the preventive approach of the head and neck cancer patient in Dutch radiotherapy institutes. The most comprehensive counseling was performed by those centers in which a dental team was active, particularly when an oral hygienist was a member of such a team. The diversity is among others based on lack of well-defined guidelines in many centers, the spread of a relatively small patient group over a rather large number of centers, absence of a dental team in some centers, absence of an oral hygienist in some dental teams, and the observation that a rather large number of patients were not referred, or not timely referred to the dental team. There seems to be a need for the development of a general protocol for the prevention of oral complications applicable in all centers.

Dental Caries↗
PubMed1992

Peripheral ameloblastoma. A case report and review of the literature.

Peripheral ameloblastoma is a benign odontogenic tumor with the same histological characteristics as the centrally located ameloblastoma, but appearing in the gingiva and mucosa of the tooth-bearing area of the jaws. A review is presented of 53 cases: 45 being reported as peripheral ameloblastoma and 8 as basal cell carcinoma of the gingiva, including the case presented. Based on the review it is recommended to treat this lesion by local excision including a small margin of healthy tissue. Local recurrence is unlikely, unless incomplete removal is performed.

Adult↗
PubMed1992

Malignant parotid tumors: clinical use of MR imaging and histologic correlation.

Magnetic resonance (MR) imaging was performed in 116 patients in whom a parotid mass lesion was clinically suspected. Eighty-six patients had benign disease. The 30 patients in whom a malignant tumor was found were further evaluated. To determine which features are characteristic of malignant parotid tumors, spin-echo T1- and T2-weighted images of malignant lesions in the parotid gland were compared with those of benign disease. In our series, tumor margins, homogeneity, or signal intensity were not discriminative factors to correctly predict benign or malignant disease. Infiltration into deep structures (eg, the parapharyngeal space, muscles, and bone) was observed only in malignant tumors. Infiltration into subcutaneous fat was noticed in malignant as well as in inflammatory disease. No statistically significant correlation was found between tumor grade and MR imaging features in malignant disease. MR imaging is useful in delineating malignant tumors but is unreliable in correctly predicting the histologic nature of a mass lesion in the parotid gland.

Adult↗
PubMed1991

Effect of selective elimination of the oral flora on mucositis in irradiated head and neck cancer patients.

Recently it has been reported that chlorhexidine 0.1% rinsing was not successful in eradication of gram-negative bacilli in patients who have head and neck cancer. These bacilli could play a role in irradiation mucositis. This study reports the effect of lozenges containing 2 mg polymyxin E, 1.8 mg tobramycin, and 10 mg amphotericin B qid on the oropharyngeal flora in 15 irradiated head and neck cancer patients. The results were compared with those of a previous study in two groups of 15 patients comparing chlorhexidine rinsing with placebo. In all patients using lozenges, eradication of gram-negative bacilli and yeasts was achieved within 3 weeks. A significant increase of enterococci was found. Mucositis was significantly reduced compared with the previous two groups. All patients showed erythema only, whereas 80% of both the placebo and chlorhexidine rinsing patients suffered from severe mucositis, with signs of pseudomembranes developing from the third week of conventional irradiation protocol. The effect of selective elimination of gram-negative bacilli from the oropharynx and the prevention of severe mucositis may be explained by the eradication of these bacteria and/or neutralization of salivary endotoxin, released by gram-negative bacilli, mediating the inflammatory processes.

Adolescent↗
PubMed1991

Evaluation of results of temporal bone resection.

The results of 16 cases of temporal bone resection were evaluated. The resections, 12 of which were total and 4 partial, had mostly been performed for squamous cell carcinoma invading the temporal bone. Five patients in whom the intervention was considered radical and not followed by irradiation, were alive and well 9 years or more later. The significance of postoperative radiotherapy was demonstrated in 3 patients who were alive and in good health 9 years or more later, although histological examination of resection margins showed residual tumour. Eight patients died 10 months to 5 1/3 years after operation, 6 of whom from recurrence, one from radiation necrosis of the temporal lobe of the brain, and one from cerebrovascular occlusion. Histologically, squamous cell carcinoma was found significantly more among the patients who died from recurrence than among those still living.

Adult↗
PubMed1991

Carbon dioxide laser surgery of oral leukoplakia.

Oral leukoplakia is a precancerous lesion of the oral mucosa. The risk of malignant transformation depends on the clinical and histologic classification and the location of the lesion. For a nonhomogeneous leukoplakia, this risk is 23.4% to 38.0%. In the presence of epithelial dysplasia, the possibility of malignant transformation is 36.3% to 43.0%. Leukoplakia is limited to the epithelium, so a selective removal of this part of the mucosa seems to be the best preventive treatment. Carbon dioxide laser surgery accomplishes a superficial removal by evaporation. A total of 70 patients with 103 oral leukoplakias were treated with carbon dioxide laser evaporation. This resulted in an excellent wound healing with virtually no scarring. The patients were followed up during a period of up to 12 years (mean 5.3 years), showing a cure rate of 90%.

Adult↗
PubMed1990

Chlorhexidine inactivation by saliva.

Chlorhexidine mouth rinsing is commonly used for oral flora reduction. Indigenous microorganisms (viridans streptococci) are significantly suppressed, while "hospital-acquired" gram-negative bacilli are not affected in vivo. To explain the discrepancies between good in vitro and poor in vivo activity of chlorhexidine, minimum bactericidal concentration values for 120 isolates were studied by means of a standard dilution method in fresh whole saliva, broth, and glucose 5%. Both saliva and broth significantly reduced the bactericidal activity of chlorhexidine against all microorganisms tested as compared to glucose 5% (p less than 0.01). Minimum bactericidal concentrations for indigenous flora were significantly lower than the values obtained for the "hospital-acquired" microorganisms (p less than 0.05). These observations of chlorhexidine inactivation by saliva may explain why chlorhexidine mouth rinsing is of limited value in decontaminating the oral cavity.

Analysis of Variance↗
PubMed1990

Successful surgical treatment of parathyroid carcinoma in two haemodialysis patients.

Parathyroid carcinoma is rare, occurring in less than 2-3% of the patients with clinical features of primary hyperparathyroidism. In haemodialysis patients parathyroid carcinoma has only once been described, although secondary hyperparathyroidism in these patients is common. We discuss two female haemodialysis patients with parathyroid carcinoma. Both were treated surgically: in one patient only local excision of the malignancy was performed; the other patient underwent a modified neck dissection on the side of the tumour as well. Physical, biochemical and radiological evaluation for 4-7 years after operation gave no evidence of recurrence of the malignancy.

Adenoma↗
PubMed1990

Mucositis prevention by selective elimination of oral flora in irradiated head and neck cancer patients.

Mucositis induced by irradiation is the reactive inflammatory-like process of the oropharyngeal mucous membranes following irradiation. Bacteria colonizing the oral tissues are thought to contribute to this inflammatory process. The eradication of Gram-negative bacilli (selective elimination of oral flora) in fifteen comparably irradiated head and neck cancer patients was found to be associated with a significant reduction in mucositis compared with two groups of 15 patients receiving either placebo or chlorhexidine rinsing. Criteria used were the extent of local mucositis signs (mucositis score), as well as generalized side-effects such as the need of nasogastric tube feedings following severe feeding problems. Mucositis signs were confined to erythema only in all selectively decontaminated patients. No pseudomembranes were observed and artificial feeding was completely prevented. These promising results need further confirmation in larger (multicenter) studies.

Adult↗
PubMed1990

[Prevention of oral mucositis in head and neck irradiation].

Head-neck irradiation is associated with oral complications. During the irradiation period patients are most burdened by mucositis. Changes of the oral flora with colonisation with the more pathogenic aerobic Gram-negative bacilli seems crucial in the development and severity of mucositis. Prevention of mucositis is reported to be successful during selective oral flora elimination.

Gram-Negative Bacteria↗