Biomedical subjects

C J Krause

Publications and source records attributed to C J Krause.

At least 37 records · Page 2Linked to original sources

PubMed1982

Treatment of the patient with extensive osteoradionecrosis of the mandible.

The management of osteoradionecrosis of the mandible remains controversial. Involvement of large areas of the mandible or the entire mandible with osteoradionecrosis may result in severe functional disability and cosmetic deformity. Pain, trismus, difficulty with speech and eating, and a malodorous wound are all problems that must be corrected. Local forms of therapy may be inadequate in the treatment of extensive osteoradionecrosis, and more aggressive surgical management is required. The extent of surgical intervention depends on the individual case. However, preservation of function and avoidance of disfigurement are important goals in the treatment plan. From both a functional and cosmetic standpoint, surgical management can be effective in achieving satisfactory rehabilitation goals.

Adult↗

PubMed1981

Human squamous cell carcinoma. Establishment and characterization of new permanent cell lines.

Squamous cell carcinoma is the most common of human cancers, and yet because it is poorly represented by cultured cell lines, little is known about the characteristic cell biology and the cell-surface antigenic phenotypes of such tumors. To develop a continuously available source of squamous cell carcinoma for repeated and reproducible serologic analysis and for better understanding of its biologic characteristics, tissue culture methods and nude mice were used to establish new cell lines of squamous carcinoma. Special media, serum supplements from several sources, and methods of handling fresh tissue specimens were all examined as a means of improving the survival of tumor cell lines. Several new cell lines were established. Features characteristic of a squamous cell origin, eg, microvilli, desmosomes, tonofilaments, and the squamous cell differentiation antigen (pemphigus antigen), were found. The clinical course of disease in individual donor patients has been examined.

Aged↗

PubMed1981

Cleft lip, cleft palate, and other fusion disorders.

The more common consequences of mesodermal migrational delay or failure in the fourth to seventh weeks of gestational life and of plate fusion failure in the seventh to twelfth weeks of gestational life are cleft lip and cleft palate, respectively. The team approach with a balanced emphasis allowing optimal development of deglutition, speech, hearing, facial growth, and dental development combined with acceptable esthetic results provides comprehensive treatment and an improved outlook for this long term problem.

Child, Preschool↗

PubMed1980

Immunologic diagnosis of Legionnaires' disease: cross-reactions with anaerobic and microaerophilic organisms and infections caused by them.

The hundred twenty-four isolates of anaerobic and microaerophilis organisms were examined with a polyvalent direct immunofluorescent antibody (DFA) reagent directed against Legionella pneumophila, serogroups (SG) I-IV. Three of 53 isolates of Bacteroides fragilis cross-reated with the SG I component of the reagent. Rabbit antisera to three SG I strains of L. pneumophila cross-reacted with these three B. fragilis isolates, and cross-reactivity was not due to preexisting rabbit antibodies; antisera to a fourth SG I strain did not cross-react with these isolates. Indirect fluorescent antibody (IFA) examinations of convalescent-phase sera from eight of 41 patients with B. fragilis group infections showed titers of greater than or equal to 1:128 or a fourfold or greater seroconversion against L. pneumophila, SG I. All eight patients had bacteremia due to B. fragilis, but five B. fragilis isolates available from these patients were DFA-negative. Thus, false-positive reactions may result from DFA as well as IFA examinations of sera from patients with B. fragilis infections.

Aerobiosis↗

PubMed1980

Carcinoma of the lip.

Carcinoma of the lip is a common variety of head and neck malignancy frequently seen in the elderly Caucasian male. Three hundred and fifty consecutive cases of invasive squamous cell carcinoma of the lip are anlayzed and the treatment methods and their results are presented. Surgical management is recommended for most patients because of the advantage of tumor margin assessment, avoidance of radiotherapy complications, and rapid rehabilitation.

Adult↗

PubMed1979

Acinic cell carcinoma: a clinicopathologic study of thirty-five cases.

A clinicopathologic study of 35 cases of acinic cell carcinomas is presented. Complete follow-up information was available on 31 patients (average period, 7-5 years). The malignant potential of these neoplasms is affirmed by observations that metastases (local and distant) occurred in nine patients and that eight patients died as a consequence of their carcinoma. Retrospective classification of the carcinomas into high and low grade lesions correlated well with ultimate biologic behavior but is unlikely to be successful in an intra-operative (frozen section) mode. This limitation is due to: (a) sampling limitations at the time of primary surgery and (b) the malignant behavior of the occasional low grade carcinoma. Histologic features characterizing high grade carcinomas are local aggressive infiltration and areas of the tumor that appear analogous to the embryonic and post-embryonic terminal tubules and intercalated ducts. The best opportunity for cure of these neoplasms lies in their complete surgical removal at the time of initial treatment. For this, a total parotidectomy is the procedure of choice. Enucleation and local excision is to be condemned.

Adolescent↗

PubMed1979

Increased survival with surgery alone vs. combined therapy.

Recent investigations have questioned the efficacy of a combined therapy regimen with irradiation. The purpose of this study was to compare the survivals with surgery alone versus combined therapy (pre-op irradiation) and to analyze any apparent differences to identify the source(s) of failure. Two and five-year determinate survivals for this group identify the source(s) of failure. Two and five-year determinate survivals for this group were found to be significantly better for surgery alone. There is no instance where combination therapy is found to be statistically superior. An analysis of treatment failures showed that distant metastases occurred at a greater rate in the combined therapy patients than they did with those treated by surgery alone. The advisability of combined therapy using preoperative irradiation with its increased cost and morbidity to the patient is questioned if it does not improve survival over surgery used as a single modality.

Female↗

PubMed1979

Characteristics of tumor associated antigens in squamous cell carcinoma.

For centuries physicians have been intrigued by the variable biologic behavior of cancer in humans. In recent years, attention has focused upon the host immune response as an indicator of patient prognosis and for potential use in tumor detection. In this study, tumor associated antigens were extracted from fresh squamous cell carcinoma and their biologic properties were characterized. Using the Leukocyte Migration Inhibition (LMI) assay, considerable sharing of antigenic determinates was noted among the 12 carcinomas and 18 patients studied, though none cross-reacted with each of the others which were studied. Immune assays using pooled tumor extracts successfully differentiated between tumor patients and control subjects, though further development will be necessary before small aggregates of tumor may be consistently detected.

Adult↗

PubMed1978

Radiation effects on microvascular anastomosis.

Three groups of rats were studied. Group 1 rats received 6,000 R of irradiation, group 2 rats received 4,000 R, and group 3 rats acted as a control. Four weeks following irradiation, the femoral artery of each rat was cut and reapproximated using microvascular surgical techniques. Four weeks after surgery, the same femoral artery was evaluated for patency. There was no notable effect of irradiation on the patency of subsequently performed anastomosis of these small (1 mm in diameter) muscular arteries. Radiation effects were obvious on histological examination, but the anatomical and physiological alterations apparently were not severe enough to cause early thrombosis after microsurgical manipulation of these vessels.

Animals↗

PubMed1978

Cervicofacial actinomycosis. Rapid diagnosis by thin-needle aspiration.

Thin-needle aspiration cytology is a well-known minimally invasive technique that is used in the diagnosis of neoplastic disease. The same biopsy technique provides a means for immediate identification of actinomycosis. Aspiration specimens may be used for morphologic studies, as well as for microbiologic isolation. The diagnostic histologic feature of sulfur granules remains intact with this cytologic aspiration technique. This technique is a safe, simple, and rapid means of diagnosing actinomycosis and appears to have value in the diagnosis of other infectious diseases as well.

Actinomycosis, Cervicofacial↗

PubMed1978

Spinal accessory lymph nodes: a prospective study of metastatic involvement.

The traditional radical neck dissection involves excision of the spinal accessory nerve en bloc with the soft tissue of the posterior triangle in an effort ot remove completely all node-bearing tissue. The resultant decrease in range of motion of the involved extremity and subsequent pain have prompted some surgeons to seek alternatives. The purpose of this study is to review prospectively radical neck specimens with the specific intent of evaluating the frequency of metastatic involvement of the spinal accessory lymph nodes with head and neck malignancies. Fifty neck specimens were studied and the frequency of cancerous involvement of the spinal accessory nodes was not found to be significantly different from nodal involvement of the entire neck specimen. The location of accessory nerve involvement was predominantly in the proximal portion which is not within the posterior triangle. The results are further evaluated with the subsequent conclusion that preservation of the spinal accessory nerve cannot be justified on the basis of infrequent involvement with metastatic lymph nodes.

Accessory Nerve↗

PubMed1978

Cephalometric findings in two cases with unrepaired bilateral cleft lip and palate.

Two cases with unoperated bilateral cleft lip and palate were examined clinically and cephalometrically and compared to matched normals. The findings indicate a severe premaxillary skeletal protrusion which results in a maxillary-mandibular discrepancy. The maxillary incisor inclination was acceptable, while the mandibular incisors were relatively more lingually inclined in the cleft group. Surgical management of one case necessitated premaxillary resection.

Adolescent↗

PubMed1977

Irradiated homologous costal cartilate for facial contour restoration.

This study represents a retrospective evaluation of 145 implants of irradiated homologous costal cartilage used over a three-year period for facial contour restoration in a variety of anatomic sites. In this series, the immediate complication rate was 5.5%, the late complication rate was 2.1% and the partial resorption rate was 1.4%. The infection rate for the implants inserted intraorally onto the face of the maxilla did not have a statistically significant difference from the infection rate for the entire series, thus demonstrating that this implant is not easily infected. These results establish irradiated homologous costal cartilage as a valid implant material.

Adolescent↗

PubMed1977

The importance of tumor attachment to the carotid artery.

The records of 508 patients who had undergone radical neck dissection were reviewed. Twenty-eight of these patients (5.5%) were found to have tumor attached to the carotide arterial system. Twenty-four patients (86%) died with tumor, the mean survival time being 16.9 months. Local recurrence of tumor in the neck occurred in 46% of the patients and distant metastases in 67%. Eighteen percent of those who developed local recurrence did so in the absence of distant metastases and might have benefited from a more aggressive approach toward the tumor.

Adult↗

PubMed1977

Reconstruction of intraoral defects with the free groin flap.

A free flap has been defined as an island flap that has been completely detached from the body and transferred to a distant recipient site, where microvascular anastomoses are done to reestablish its essential intravascular circulation. The groin flap, based on its superficial circumflex iliac artery and venae comitantes, was utilized as a free flap to close large intraoral defects in six patients following ablative cancer operations. All patients received preoperative or postoperative irradiation therapy. Four of the six free groin flap operations were clinically successful. One flap became necrotic unexpectedly after 3 1/2 weeks. Infection played a major part in necrosis of the other flap. The use of the free flap in oral cavity reconstruction offers certain advantages over regional vascular flaps but definite limitations exist.

Adult↗

PubMed1977

DiGeorge syndrome associated with multiple squamous cell carcinomas.

Experimental evidence and clinical experiences have have shown that immune mechanisms and cancer are closely related. A case of a 42-year-old man with DiGeorge syndrome is presented as an interesting example of an impaired immune mechanism and is described in association with multiple squamous cell carcinomas of the upper respiratory system. The congenital absence of the thymus gland in DiGeorge syndrome results in an absence of a cell-mediated immune response. There are plasma cells and germinal centers in lymph nodes, but lymphocytes in the paracortical areas are sparse. Patients wiith DiGeorge syndrome have no delayed hypersensitivity, cannot be actively sensitized with dinitrochlorobenzene, reject allografts poorly, and have no lymphocytic response to phytohemagglutinin antigens.

Adult↗

PubMed1977

Carcinoma of the pyriform sinus a comparison of treatment modalities.

One hundred four patients with epidermoid carcinoma of the pyriform fossa were reviewed retrospectively. Survival, local recurrence and metastatic rates were all compiled for the purpose of comparing the efficacy of combined therapy with radiation therapy and surgery alone in treating such lesions. Combined therapy consisted of 4500 rad Cobalt60 therapy at 200 rad per day preoperatively. All lesions were staged according to AJC classification. There was a similar stage distribution of patients in each therapeutic category. Three-year determinate survival rates were as follows: radiation therapy --10%, surgery--56%, and combined therapy--40%. Evaluation of the local recurrence rate revealed it to be: radiation therapy--19/33 (58%), surgery--1/19 (5%), and combined therapy--9/32 (28%). We interpret this data to suggest that preoperative irradiation impaired the determination of adequate resection margins, despite the use of frozen sections from those margins at the time of surgery. The incidence of late contralateral palpable nodes was greatest in the surgery group--5/19 (26%), compared with radiation therapy--0/33, and combined therapy--1/32 (3%). This supports other studies which indicate that radiation therapy is very effective in controlling subclinical nodal metastases.

Carcinoma, Squamous Cell↗

PubMed1977

Microsurgical techniques in free flap reconstruction.

Free flap reconstruction is discussed with emphasis on microsurgical technique utilized in union of blood vessels 1 mm in external diameter. Proper microsurgical instrumentation, magnification and small vessel suture technique are all of importance in achieving a successful microvascular anastomosis. Technical maneuvers employed in identifying and avoiding small vessel thrombosis are presented. Surgical techniques, as presented here, have allowed us to successfully use free flaps to reconstruct large oral cavity defects following ablative cancer operations.

Blood Coagulation↗