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Biomedical subjects

E Serrano

Publications and source records attributed to E Serrano.

At least 91 records · Page 5Linked to original sources
PubMed1995

[Facial motor lesion after surgery of the parotid gland].

The authors report a retrospective study of 351 parotidectomies observed during a 28 years period. The average follow-up is 28 months. Preoperative and post-operative facial nerve function, type of parotidectomy, surgical management of facial nerve and histologic diagnosis according to the revised WHO classification (1990) are presented. Type of parotidectomy and degree of tumor malignancy are statistically analyzed. It seems that occurrence of post-operative facial nerve dysfunction depends on radical parotidectomy, whereas long term dysfunction is determined by tumor malignancy. Malignant epithelial tumors of the major salivary glands proved to be radiosensitive. Apart from preoperative dysfunction, clinical involvement and impossible facial nerve dissection, the authors insist upon sparing the facial nerve, event in the case of microscopic residual tumors, and prefer postoperative radiotherapy.

Adenoma↗
PubMed1994

Radiotherapy of stage I and II carcinomas of the mobile tongue and/or floor of the mouth.

From 1977 to 1990, 94 evaluable patients were treated with iridium-192 implantation in the Centre Claudius Regaud for a Stage I (52 patients) or a Stage II (42 patients) squamous cell carcinoma of the mobile tongue and/or the floor of the mouth. Interstitial brachytherapy was associated with external irradiation in 68 patients (group 1; mean dose, 48 Gy for external irradiation, 26 Gy for brachytherapy) or was exclusive in 26 patients (group 2; mean dose, 66 Gy). The mean follow-up was 44 months. Eleven acute complications were noted during or immediately after the implant (1 lethal myocardial infarction, 6 hematomas of the tongue which spontaneously resolved, 3 local sepsis). The mean duration of the mucositis was 9 weeks (from 4 to 20 weeks). Ten patients (17%) experienced a late complication (8 in group 1, 2 in group 2): 3 bone necroses requiring hemimandibulectomy (1 post-operative death), 1 tongue necrosis treated by a transoral mucosal excision, 6 bone expositions which recovered after medical treatment. Local control rates for T1 and T2 tumors were 75% (39/52) and 51% (21/41), respectively. Sixteen patients (17%) presented a nodal relapse which was associated in 6 cases with a concomitant local relapse. The local control rate of T1 tumors was 64% (23/36) in group 1 versus 100% (16/16) in group 2 (p < 0.01). For T2 tumors, these figures were 45% (14/31) and 70% (7/10), respectively (p > 0.3). The influence of 13 parameters on the local control was studied in analysis. In the one model analysis, a cox regression tumor size was significantly predictive of actuarial local recurrence (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Radiologic study of the mechanism of deglutition].

The radiological study of the mechanism has helped to define the physiology of the oral and pharyngeal phase of deglutition. Being a dynamic examination, it is part of the work-up in swallowing disorders, such as cervical dysphagia and inhalation episodes. Among the various techniques available, videofluoroscopy remains the examination of choice.

Deglutition↗
PubMed1994

[Facial nerve involvement after surgery of the parotid gland].

The authors report a retrospective study of 351 parotidectomies observed during a 28 years period. The average follow-up is 28 months. Preoperative and postoperative facial nerve function, type of parotidectomy, surgical management of facial nerve, and histologic diagnosis according to the revised WHO classification (1990) are presented. Type of parotidectomy and degree of tumor malignancy are statistically analyzed. It seems that occurrence of post-operative facial nerve dysfunction depends on radical parotidectomy, whereas long term dysfunction is determined by tumor malignancy. Malignant epithelial tumors of the major salivary glands proved to be radiosensitive. Apart from preoperative dysfunction, clinical involvement and impossible facial nerve dissection, the authors insist upon sparing the facial nerve, even in the case of microscopic residual tumors, and prefer postoperative radiotherapy.

Adolescent↗
PubMed1994

[Concomitant association of radiotherapy and chemotherapy (CDDP 4-6 mg/m2/daily in continuous i.v. administration) in locally advanced ORL tumors].

In order to enhance radiation effects in the treatment of unresectable Head and Neck squamous cell carcinoma, we initiated a phase I-II study in February 1991 with concomitant radiation and cisplatin in the treatment of resectable Head and Neck squamous cell carcinoma. The first patient was treated in a palliative intend for a cervical recurrence (cutaneous metastatic lymphangitis) of laryngeal cancer. The seven other patients had a Stage IV M0, previously untreated, oropharyngeal carcinoma. Standard external radiation was carried out up to a total dose of 60 Gy/6 weeks (7 MeV electron beam) for the 1st patient and 72 Gy/8 weeks (Co60 beam) for the 7 other patients. Cisplatin was given during the entire radiation treatment, by continuous infusion, 5 days a week, at doses of 4 mg/m2/d for the 1st patient, 5 mg/m2/d for the two following patients and 6 mg/m2/d for the last five patients. One patient with a poor initial performance status (three in the WHO scale) stopped his treatment on the 6th week due to a grade 3 mucositis with deglutition pneumonia. He died 2 months later with progressive carcinoma. For one other patient, treatment was discontinued for 1 week after 48 Gy, due to a grade 3 mucositis. The other patients completed the planned protocol without any interruption. Mucositis (grade 3 in two cases, grade 2 in four cases), dermitis (grade 3 in two cases, grade 2 in four cases) and neutropenia (grade 2 in two cases) were the most frequent acute toxicity. Of the seven patients treated with a curative intend, six are free of disease at 6 to 28 months after completion of treatment. A pharmacokinetic study showed a total platinum accumulation. The mean value at the end of treatment reached 1157 ng/ml. Only one patient experienced an accumulation of the ultrafilterable platinum (137 ng/ml at the end of treatment).

Antineoplastic Agents↗
PubMed1993

Predictive factors of a complete response to and adverse effects of a CDDP-5FU combination as primary therapy for head and neck squamous carcinomas.

Retrospective analysis of detailed patient and tumour factors associated with a complete response to combination inductive chemotherapy with CDDP-5FU (96 or 120 hour continuous infusion) was performed using data from 147 patients with a previously untreated squamous cell carcinoma of the oral cavity, oropharynx or pharyngo-larynx following completion of two (29 patients) or three (118 patients) cycles. Adverse reactions to chemotherapy were documented for all 164 patients included in the study. Eight drug-related deaths occurred due to: acute myocardial infarction (five patients), peptic ulcer disease (two patients) and severe neutropenia with sepsis (one patient). Severe non-lethal complications included marrow depletion (14 patients), peptic ulcer (two patients), thrombophlebitis (seven patients), angina pectoris (two patients), stroke (one patient), pulmonary oedema (one patient) and convulsions (one patient). Six patients refused further treatment because of untoward side effects and tumoral progression was observed in three cases. Separate response rates for the primary site and nodes were determined and analysis of respective predictive factors of response was performed. Complete response was obtained in 31 per cent at the primary site versus 18 per cent for the nodes (p < 0.05). The combined (primary site + nodes) overall complete response rate was 22 per cent. Among 11 factors studied (age, sex, performance status, primary site, tumour differentiation, initial resectability, 5FU dosage per cycle, number of cycles, T, N and TN stages), only performance status, N stage, resectability and number of cycles were associated with a combined complete response. Multivariate analysis showed performance status, N stage, TN stage and resectability to be significant predictive factors of a combined complete response.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Use of an enzyme-linked immunosorbent assay for serodiagnosis of clinical paratuberculosis in goats. Study by western blotting of false-positive reactions.

An enzyme-linked immunosorbent assay (ELISA) was performed for diagnosis of paratuberculosis in goats, using as antigen a protoplasmic extract (PPA-3). The test was developed on the basis of the results obtained with two serum reference pools, positive and negative respectively. To avoid day-to-day variations, dilutions of the positive serum pool were included in each plate to obtain an arbitrary system, transforming absorbance into immunoglobulin (Ig) G anti-Mycobacterium paratuberculosis units. The ELISA was used on sera of two reference groups of animals. One group consisted of 35 goats suspected of being infected with paratuberculosis, which was confirmed by histological findings and isolation of M. paratuberculosis. The negative group consisted of 61 healthy goats from a farm free of paratuberculosis. The test showed a sensitivity of 100% and a specificity of 91.8%. Absorption of sera with a Mycobacterium phlei suspension did not modify either the sensitivity or the specificity of the test. Sera from the negative group were analysed by Western blotting, and four of them recognized two fractions with a molecular weight of 17.3 and 28.1 kDa.

Absorption↗
PubMed1993

Deglutition after supra-glottic laryngectomy.

This study of swallowing after a horizontal supra-glottic laryngectomy proposes to analyze the frequency of long-term post-operative complications, their mechanisms of onset, as well as their compensatory mechanisms. It rests on the study of three groups of patients: a retrospective series of 74 charts, a group of 14 patients studied at a distance from the intervention, and a group of 15 patients who have been entered in a prospective study concerning the post-operative care of partial laryngectomies. For these two groups, the swallowing work-up consisted of, besides a clinical evaluation, a video-laryngoscopy and a video-radioscopy. Knowledge of the compensatory possibilities as a function of the specifics of the surgical technique, and their evaluation for each patient with video-radioscopy allows for an adapted care protocol.

Deglutition↗
PubMed1993

[Diagnostic perspectives in rhinology].

The physical evaluation of the nasal cavity and paranasal sinuses has been improved by recent advances in diagnostic endoscopic systems and computerized tomography. Today, nasal endoscopy is considered to be the only comprehensive diagnostic rhinoscopic examination and computerized tomography has replaced the standard plain film roentgenograms in the initial evaluation of the paranasal sinuses. Advances have also been made in the evaluation of nasal functions, particularly in the assessment of obstruction. Rhinomanometry is the only method of objective assessment of the patency of the nasal cavities and makes it possible to perform nasal provocation tests. Today, this method of exploration should not be overlooked. Secretory function may be assessed by various methods: nasal cytology, quantification of inflammatory mediators in nasal cavity washing, and biochemical analysis of nasal secretions (albumin/protein ratio). Mucociliary function can be evaluated by measuring the nasal mucociliary clearance, by determining the frequency of cilia strokes (after brushing of the nasal mucosa and microscopic examination under stroboscopic light) and by election microscopic ultra-structure studies. Other methods of exploration which do not yet have a practical application are currently being investigated: rheologic studies of the mucus, immunologic evaluation of nasal secretions and acoustic rhinometry.

Endoscopy↗
PubMed1992

[Inverted papilloma of the nose and paranasal sinuses. Apropos of 10 cases].

Authors report a retrospective study of 10 new cases of inverted papilloma of the nose and paranasal sinuses, observed during a 26 years period, with a 6.1 years average follow up. This group is marked by 2 cases of directly carcinomatous association, 4 cases of recurrence and 2 cases of later malignant transformation. The responsibility of different types of human papillomavirus in the origin of this tumor and its malignant transformation is suspected. Preoperative evaluation is based on clinical examination, CT scan and endoscopic method while diagnosis and prognosis depend on histopathologic finding of the whole tumor. The aim of surgical treatment is the most complete removal of the tumor with as limited after effects as possible. Lateral rhinotomy is the most favoured surgical approach versus mid facial degloving and intranasal endoscopy. No surgical patient, no removal tumor, inadequate limits, malignant papilloma and early recurrence are indications for external radiotherapy.

Adult↗
PubMed1992

[Vertigo and diving].

The appearance of a vertigo during scuba-diving result from different pathophysiological mechanism at which oppose specific therapeutic. Whether it's during barotrauma or decompression accident, the vestibular reach can cause drowning. It is possible to make the difference between barotrauma and decompression accident, with the good study of the scuba-diving and the time when the vertigo has came. So, the therapeutic will use recompression in a multiplace hyperbaric chamber or only hyperbaric oxygen.

Acoustic Impedance Tests↗
PubMed1992

[Spontaneous hematoma of the thyroid gland: apropos of 2 cases].

Authors report two cases of spontaneous hematoma of the thyroid gland. Emergency surgery was performed on note of them. After reminding the role of different investigations, they discuss the interest of computed tomography to exclude extracranial carotid artery aneurysm. They explain a therapeutic approach according to the repercussions of hematoma: a compressive syndrome requires a difficult emergency surgery.

Aged↗
PubMed1992

[Comparative contribution of endoscopy, x-ray computed tomography and MRI in the preoperative evaluation of cancers of the endolarynx: apropos of 18 surgically-treated patients].

The authors carried out a prospective and comparative study of 18 patients with endolaryngeal carcinoma, with preoperative imaging of the extent of the disease by computed tomography (CT) and magnetic resonance imaging (MRI). The correlations between CT, MRI, endoscopy and postoperative histology are reported. It appears to the authors that the contribution of imaging is evident and that at present the reliability of CT is comparable to that of MRI, taking account of the current technical problems of MRI.

Adult↗
PubMed1992

[Olfactory esthesioneuroma. Apropos of 12 cases].

The authors report a 12-case series of olfactory esthesioneuromas, in which they review the main characteristics of this rare tumor. The olfactory esthesioneuroma diagnosis should be evoked for all nasal tumors, especially for tumors originating in a high position. This diagnosis is confirmed by the difficult pathological examination, which currently benefits widely from immunohistochimy. Prognosis is poor and surgery is the main treatment, associated with varying degrees of radiotherapy. As far as chemotherapy is concerned, its role must be clarified.

Adult↗
PubMed1992

[ENT and neurosurgical team approach to malignant ethnoido-frontal tumors].

The authors describe a surgical technique of total ethmoidectomy by mixed frontal and paralateronasal duct for excision of the ethmoidal bloc tumors. This technique requires a surgical team aware of neurosurgical and ORL problems. The authors report their experience on a series of six patients, surgically managed from 1983 to 1990.

Adolescent↗
PubMed1991

Experimental study of the effect of 6-methyl-prednisolone on ingestion-microbicidal function activity in dog neutrophils.

The effect of increasing doses of 6-methyl-prednisolone on the ingestion-microbicidal function activity of dog neutrophils was studied. Histochemical and spectrophotometrical NAT reduction techniques, together with a direct overall method using C. albicans as a test micro-organism were carried out. Samples were analysed 2 and 48 h after inoculation of different doses. The histochemical NAT technique was not very precise, but quantification of responses using the spectrophotometric method revealed that at 48 h.p.i. neutrophil reducing activity declines continuously. At 2 h.p.i. in the first few days of the experiment (i.e. at lower doses), NAT reduction increased, but subsequently fell back to O.D. levels below those recorded at 48 h.p.i. Ingestion and destruction of C. albicans followed the same pattern as that recorded for NAT activity. Simple and differential leukocyte counts performed in all samples revealed leukocytosis (with neutrophilia and lymphopaenia) at 2 h.p.i. This returned to normal levels in the intervals between inoculations.

Animals↗