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E L Applebaum

Publications and source records attributed to E L Applebaum.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Epiglottitis in the adult. A proposition for a clinical classification and therapeutic strategy].

Because lack of criteria for staging and treatment of epiglottitis can lead to unnecessary morbidity and mortality, we have introduced a staging system for early classification and appropriate management of adult epiglottitis patients. We retrospectively staged 20 adults with epiglottitis to see in their final outcome would have been altered using our protocol. We found that staging and management according to our protocol were appropriate and possibly could have reduced mortality from 10% to nearly 0%.

Adult↗
PubMed1988

Intracranial and intratemporal meningiomas with primary otologic symptoms.

Intratemporal extensions of cerebellopontine angle (CPA) meningiomas are unusual and primary intratympanic meningiomas are extremely rare. The initial symptoms of both types are otologic. The presenting symptoms of even large meningiomas of the cerebellopontine angle can also be otologic. In this article we report the clinical features, diagnosis, and management of five CPA meningiomas, three combined intratemporal and CPA meningiomas, and one primary intratympanic meningioma.

Adolescent↗
PubMed1988

Cholesteatoma of the middle ear and mastoid. A comparison of CT scan and operative findings.

High-resolution CT scanning accurately depicts the status of the structures of the temporal bone, allowing delineation of pathology prior to surgical exploration of ears with cholesteatoma. It provides information concerning location and extent of disease as well as possible anatomic variations and complications that may be encountered. The main advantages of CT scanning over polytomography are superior soft-tissue contrast resolution and improved spatial detail at a reduced radiation dose for the patient.

Bone Diseases↗
PubMed1987

Primary culture of squamous head and neck cancer with and without 3T3 fibroblasts and effect of clinical tumor characteristics on growth in vitro.

Twenty-one tumors from patients with squamous cell carcinoma of the head and neck (SCC H/N) were cultured with and without 3T3 fibroblasts in order to determine whether, on the basis of improved tissue culture medium, 3T3 cells could be deleted without altering growth and cloning efficiency. Thirty-five additional primary SCC H/N specimens, cultured in the presence of 3T3 fibroblasts, were studied to assess the effect of tumor differentiation, site of primary tumor, and site of specimen procurement on growth. The authors conclude that 3T3 cells remain essential for optimal growth and cloning efficiency. Also, 3T3 cells improved the number of successful cultures by 33% to 100% depending on the plating density, and cloning efficiency was improved by 50% in the presence of 3T3 cells. Growth did not correlate with tumor differentiation or site of origin of the tumor specimen. Culture of specimens from the primary site resulted in growth significantly more frequently than culture of specimens obtained from metastatic neck nodes.

Carcinoma, Squamous Cell↗
PubMed1987

Histological and morphological observations of the paravestibular canaliculus.

The paravestibular canaliculus was studied by light microscopy in serial sections of the temporal bones from otosclerotic patients who underwent fenestration or stapes surgery. In all examined 23 specimens (13 cases), the endolymphatic duct and sac were observed to be normally developed with no pathological findings. The paravestibular canaliculus was found in 14 of the specimens (60.9%). Its course was traced from the proximal to the distal area in 12 specimens, and it appeared to merge into the distal portion of the endolymphatic sac in 7 of them. Twelve of the paravestibular canaliculi contained one vein, and 3 contained several veins. No artery was found. The paravestibular canaliculus was observed to originate from small vascular channels around the vestibule in the otic capsule, lateral to and near the internal aperture of the vestibular aqueduct.

Adult↗
PubMed1986

Porphyrin fluorescence and photosensitization in head and neck cancer.

Indistinct margin demarcation and autofluorescence are problems in fluorescence delineation of porphyrin-containing head and neck squamous cell cancer (HNSCC). We studied the time course and in vivo localization of porphyrin fluorescence in a squamous cell cancer hamster model and in human HNSCC. After intravenous injection, a gradient in fluorescence intensity developed rapidly until tumors fluoresced above a lower-intensity mucosal background. Hamster tumor and ulcerated HNSCC without porphyrin injection demonstrated autofluorescence grossly indistinguishable from fluorescence in porphyrin-injected tumors. However, fluorescence microscopy revealed autofluorescence to be a surface phenomenon and showed injected porphyrin localized in tumor stroma. We conclude that autofluorescence must be considered when interpreting porphyrin fluorescence. In addition, empirically designed photodynamic therapy can be effective in selected HNSCC. Data from animal experiments provide useful guidelines for the delivery of this therapy.

Aged↗
PubMed1986

Nonsquamous tumors of the nose and paranasal sinuses.

Nonsquamous tumors of the nose and paranasal sinuses are an uncommon group of neoplasms. Information is only available from case reports and short series. Therefore, conclusions concerning natural history and response to therapy are uncertain for tumors in these sites. The need for complete and timely evaluation of new and changing clinical signs must be emphasized. For each tumor, maximal interaction among the clinician, radiologist, and pathologist is needed to reach the correct diagnosis and plan effective therapy. This interaction is especially important for the deceptively benign-appearing tumors listed in Table 2. These tumors behave biologically in an unpredictable fashion, and long-term follow-up is mandatory.

Adenocarcinoma↗
PubMed1986

Culture of squamous head and neck cancer on 3T3 fibroblasts following isokinetic velocity sedimentation.

Growth in culture of squamous head and neck cancer is hampered by microbial contamination, low plating efficiency, and cellular heterogeneity within tumors. Furthermore, clumps of cells must be removed if plating efficiency is to be accurately determined. Isokinetic velocity sedimentation was applied to 44 primary tumor specimens in an effort to minimize these problems. Seven fractions were evaluated for cell number, clump number, cell viability, clonogenic growth, plating efficiency, and microbial overgrowth. Unseparated specimens were simultaneously cultured. Microbial growth was significantly associated with the highest gradient fraction. Clumps were significantly associated with the lowest gradient fraction. Colony formation was significantly associated with middle gradient isokinetic velocity sedimentation, although seven specimens grew only when fractionated, suggesting the possibility of inhibitor cells within the tumor specimen.

Carcinoma, Squamous Cell↗
PubMed1985

A phase II study of Adriamycin in previously untreated squamous cell carcinoma of the head and neck.

Twenty patients with squamous cell carcinoma of the head and neck (SCC H/N) were treated with Adriamycin (doxorubicin) at a dosage of 60 mg/m2 at 3-week intervals. No patient had received surgery, radiation, or chemotherapy before treatment with Adriamycin. Responses were observed in 44% of 18 evaluable tumors. We conclude that Adriamycin is a highly active drug in SCC H/N when no prior treatment has been administered.

Carcinoma, Squamous Cell↗
PubMed1985

Effects of magnetic resonance imaging fields on stapedectomy prostheses.

Seven different types of widely used metallic stapedectomy prostheses were individually placed on a millimeter scale in a plastic Petri dish. The Petri dish was moved within the core and around the magnet of a 1.5-tesla magnetic resonance imaging unit (General Electric Sigma). No movement of any of the prostheses was seen. We conclude that there is no apparent danger of these prostheses becoming displaced in stapedectomy patients subjected to the electromagnetic fields of magnetic resonance imaging units.

Electromagnetic Fields↗
PubMed1985

Use of CT in the evaluation of cochlear otosclerosis.

Otosclerosis (otospongiosis) occurs when the hard endochondral bone of the otic capsule is replaced by spongy vascular foci of haversian bone. Using computed tomography (CT), we studied the ears of 32 selected patients with mixed or sensorineural hearing loss (one patient had normal hearing); 24 were suspected of having otosclerosis. CT proved valuable in detecting cochlear otosclerosis, foci of demineralization, and changes in bony texture and enables the easy recognition of subtle radiographic findings. Our paper also reports the CT findings of temporal bones in osteogenesis imperfecta and Paget disease.

Adolescent↗
PubMed1985

Fluorescein angiography of the tympanic membrane.

Little is known about the dynamic vasculature of the tympanic membrane, despite the fact that it is within easy view of the otolaryngologist. An understanding of its blood supply dynamics may lead to a better understanding of the tympanic membrane's physiological properties and response to surgery. Also, certain patterns of blood flow may correlate with disease entities and be of diagnostic value. Currently, we have done 30 fluorescein angiograms of the tympanic membrane. The fluorescein angiograms from a normal ear and from ears with several types of ear pathology are described.

Ear Neoplasms↗
PubMed1985

Internal auditory canal vascular loops: audiometric and vestibular system findings.

Prominent loops of the anterior inferior cerebellar artery in the cerebellopontine angle are found frequently during anatomic studies of this region. These vascular loops are suspected of causing hearing loss, tinnitus, and vertigo, and surgery has been advocated to separate the vascular loop from the eighth cranial nerve. Previous reports have described pathologic anatomy, surgical approaches, and results of treatment. In this study, we report the results of a uniform battery of audiometric and vestibular system test results administered to fifteen patients with prominent vascular loops in the internal auditory canal diagnosed by pneumo-CT. All patients were tumor suspects before CT because of unilateral (or asymmetric) tinnitus or hearing loss. Hearing losses ranged from mild to profound, and most were of a cochlear type with excellent speech discrimination. Only one-third of the patients had abnormal caloric tests, but spontaneous nystagmus was detected in all but one of the patients by photoelectric nystagmography. The wide range of audiometric and vestibular system test results probably reflects the complex interaction between the vascular loop and eighth cranial nerve, in which the loop exerts pressure on the nerve, and the nerve compromises inner ear circulation. Eighth nerve tumors and vascular loops produce similar symptoms, but a cochlear type of hearing loss with good speech discrimination and normal caloric testing should raise suspicion of a vascular loop. Pneumo-CT is an effective means of diagnosing vascular loops and differentiating them from other lesions of the cerebellopontine angle.

Adult↗
PubMed1984

Preirradiation chemotherapy for advanced head and neck carcinomas.

Twenty-six patients with locally advanced squamous cell carcinoma of the head and neck region were treated with combination chemotherapy (cisplatin, bleomycin sulfate, and vincristine sulfate) prior to radiotherapy (RT). The chemotherapy produced a 65% major response rate, all partial responses. Significant hematologic toxic effects occurred in only two patients and severe renal toxic effects were not seen. Concurrently, 20 additional patients with locally advanced cancers were treated with high-dose RT along. Weight loss at the completion of RT and normal tissue reactions were similar in both groups. Complete tumor resolution occurred in 45% of RT-alone patients and 42% of patients completing combined-modality therapy. No difference in recurrence-free survival was seen. Despite minimal additional morbidity and a high response rate, this preirradiation chemotherapy regimen demonstrated no major impact on complete response rate or on long-term recurrence-free survival.

Bleomycin↗
PubMed1984

Advanced supraglottic carcinoma: a comparative study of sequential treatment policies.

Data from 131 consecutive patients with operable stage III or IV (American Joint Committee) supraglottic carcinoma were analyzed. Based on existing treatment policies at the time of presentation, patients received either preoperative radiation therapy (RT) (48 patients), surgery alone (42 patients), or postoperative RT (41 patients). Preoperative RT dose levels were either 2,000 rad in five fractions (33 patients) or 5,000 rad in 25 fractions (15 patients). Postoperative RT dosages were 5,000 to 6,000 rad in 6 to 6 1/2 weeks. Surgical procedures included either subtotal or total laryngectomy and radical neck dissection. Tumor control was achieved in 21 of 42 patients (50%) treated with surgery alone, 23 of 48 patients (48%) treated with preoperative RT, and 29 of 41 patients (71%) treated with postoperative RT (P = 0.005). The actuarial, recurrence-free survival at 5 years was 36% and 35%, respectively, in the surgery alone or preoperative RT groups as compared to 55% in postoperatively irradiated patients. The authors conclude that advanced but resectable supraglottic carcinomas may be best treated with surgery followed by RT, rather than with surgery alone or with combined preoperative RT and surgery.

Carcinoma, Squamous Cell↗