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Biomedical subjects

H B Lampe

Publications and source records attributed to H B Lampe.

36 records · Page 2Linked to original sources
PubMed1992

Measurement of proliferative index in squamous cell carcinoma by flow cytometry.

Squamous cell carcinoma of the upper aerodigestive tract presents significant problems in determining appropriate treatment regimens. Staging aided by sophisticated investigations allows for planning of treatment, but there is a definite need for a specific and reproducible marker to quantify biological aggressiveness. For some classes of tumors the DNA ploidy of cells, as determined by flow cytometry, has shown good correlation to pathologic grading and prognosis. Using a mathematical model, it is possible to calculate the S-phase fraction, which is indicative of proliferative activity and may reflect tumor aggressiveness. However, this parameter is often difficult to determine reliably in squamous cell carcinoma. An optimal marker would be a measureable protein related to proliferation. An attempt was made to use flow cytometry to measure the nuclear enzyme topoisomerase II to assess proliferation in cultured cell lines. Although the antibody was specific to the extracted protein, constituents of the rabbit serum bound non-specifically throughout fixed cells. Further purification of this antibody preparation could realize its diagnostic potential. Antibody against proliferating cell nuclear antigen was more specific, resulting in good correlation flow cytometrically with the S-phase fraction of the cultured cell lines. The results obtained with these protein markers deems further investigation into their use as prognostic indicators. The protocol has been established to apply this technology to tumor samples and establish a meaningful parameter of biological behavior of tumors, upon which treatment regimens can be confidently based.

Antigens, Neoplasm↗
PubMed1992

The potential clinical impact of the fine needle aspiration/flow cytometric diagnosis of malignant lymphoma.

The objective of this study was to determine the potential application of fine needle aspiration (FNA) and flow cytometry (FCM) for the diagnosis of non-Hodgkin's lymphoma (NHL). At our institution, we have used FNA coupled with FCM to accurately diagnose both reactive lymphoid processes and most lymphomas in a prospective series of more than 90 patients. A retrospective review of 266 patients with NHL who were treated at the London (Ont.) Regional Cancer Centre over a five-year period was performed. Two-thirds presented with palpable lymphadenopathy which would have been amenable to FNA. Based upon the results of our prospective study, FNA/FCM could have provided an accurate diagnosis of malignancy for these patients. Furthermore, the subclassification of the lymphomas would have been accurate in 75% of cases. For 25% of patients, including those with T-cell lymphoma, accurate subclassification may have been problematic. Fifty of the 266 patients developed recurrences during the period of study. Ninety per cent of these were at sites amenable to FNA. Furthermore, the cytomorphology could have indicated whether transformation to a higher grade of lymphoma had occurred. Currently, FNA coupled with FCM is an under-utilized diagnostic technique which has great potential for the investigation of patients with both newly diagnosed and recurrent lymphoma.

Adolescent↗
PubMed1991

Advances in the use of fine-needle aspiration cytology in the diagnosis of palpable lesions of the head and neck.

Our experience in performing fine-needle aspiration for the investigation of palpable lesions of the head and neck region is reviewed. Three hundred cases were performed over a period of approximately two years. In most circumstances, a diagnosis could be rendered simply on the basis of routine cytomorphologic interpretation. In some situations, it was necessary to employ ancillary techniques such as immunoperoxidase staining, electron microscopy, and flow cytometry to confirm the morphologic diagnosis. Several cases illustrating the clinical utility of the technique are presented in detail. Fine-needle aspiration is a relatively atraumatic, well-tolerated procedure which can be readily performed in the usual outpatient setting. This technique is an excellent first-line method for investigating the nature of palpable lesions in the head and neck region.

Adult↗
PubMed1990

Radioprotective effect of free radical scavenging enzymes.

Ionizing radiation is an important treatment modality in the management of head and neck squamous cell carcinoma. The superoxide (O2-) and hydroxyl (OH.) radicals produced from oxygen and the radio-hydrolysis of water are responsible for most of the DNA and lipid membrane injury caused by radiotherapy. Superoxide dismutase (SOD) and catalase (CAT) are intracellular enzymes that scavenge the superoxide and hydroxyl radicals respectively. The effect of intravenous SOD and CAT on acute and delayed radiation injury was investigated in a rat model. Catalase was shown to reduce the severity of radiation-induced changes in both the vascular endothelium and squamous epithelium. SOD, alone or with CAT, showed no radioprotective effect. As intravenous catalase does not penetrate intracellularly it should have no effect on the tumoricidal effect of radiation. Further investigation of catalase as an agent to reduce the acute side-effects of radiotherapy is warranted.

Animals↗
PubMed1989

Parathyroid cysts.

Parathyroid cysts are relatively uncommon lesions. Approximately 200 cases have been reported. Despite their location in the region of the thyroid gland, they have not previously been discussed in the otolaryngologic literature. They arise from remnants of the pharyngeal pouch or as a result of cystic degeneration of a parathyroid adenoma. A case of a parathyroid cyst occurring in a 13-year-old female is presented. This is the youngest case ever reported. Fine needle aspiration of an anterior neck mass yielded clear fluid, a finding highly suggestive of a parathyroid cyst. Radioimmunoassay of the fluid demonstrated a high level of parathormone and low level of thyroglobulin concentration, thereby confirming the diagnosis. In this case, which was diagnosed by FNA, the need for a trial of thyroid hormone suppression or hemithyroidectomy was obviated.

Adolescent↗
PubMed1989

External carotid-external carotid crossover anastomosis for reconstruction of common carotid resection.

A pilot project studying the feasibility of external carotid-external carotid cross-over anastomosis for reconstruction of common carotid artery resection is reported. Common carotid artery resection in the treatment of head and neck malignancy may be necessary when carcinoma involves the common carotid or when the common carotid artery ruptures. Ligation of the common carotid is associated with high mortality rates and high rates of neurologic complications. The vasculature to the internal carotid can be maintained by anastomosing both external carotid arteries across the midline. The diseased common carotid can then be ligated below the bifurcation. The crossover anastomosis was performed successfully in six cadaveric dissections with unilateral neck dissection and laryngectomy. Mobilizing the facial artery in conjunction with the external carotid artery provides added length. A large vessel anastomosis across the midline was performed in six sheep. Technical errors in two sheep resulted in obstruction. The remaining four anastomoses remained patent. The external carotid-external carotid crossover anastomosis may have application in the management of squamous cell carcinoma involving the common carotid or in the treatment of carotid artery blowout. Further study is warranted.

Anastomosis, Surgical↗
PubMed1989

Carcinoma of the tongue in young patients.

Carcinoma of the tongue is the second most common malignancy of the oral cavity, predominantly affecting males in the sixth and seventh decades of life. The risk factors for this disease (primarily tobacco and ethanol abuse) are well documented in the literature. The current five-year survival for a T1 lesion without nodal involvement is approximately 80%. Over the past 10 years a group of younger patients (less than 40 years) has been identified. Eleven of these patients presenting to the London Regional Cancer Centre since 1976 are reviewed with respect to stage at diagnosis, known risk factors, and the outcome of treatment. Comparison is then made with a similar group of older (over 40 years) patients. The previously identified risk factors, and the male/female ratio are quite different from the older patients. This younger group would appear to have a biologically more aggressive tumor than the stage (TNM) at presentation would suggest. They require more complex treatment, frequently requiring major resections plus radiotherapy for what appears to be early disease. The role for more aggressive initial therapy must be considered.

Adult↗
PubMed1989

Otitis media with effusion in the adult.

The etiologic factors associated with serous otitis media or otitis media with effusion (OME) are well described in children. Little has been published with regard to OME and its etiology in adults. Thirty-five adult patients who presented with OME in a referral-based otolaryngologic practice over a five-year period were studied by retrospective chart review with a follow-up telephone interview. OME in adults may be related to previous middle ear surgery in the contralateral ear, a history of middle ear disease in childhood, chronic nasal symptoms of obstruction and nasal fullness, cigarette smoking, and a family history of middle ear disease. The onset is often associated with upper respiratory tract infection. Nasopharyngeal carcinoma was uncommon.

Adult↗
PubMed1988

Use of the modified barium swallow in the rehabilitation of the swallowing mechanism.

Swallowing is a rapid, dynamic and complex process. Surgical treatment of head and neck malignancies produces significant alterations in the swallowing mechanism. The modified barium swallow allows assessment of these physiologic and anatomic derangements in the postoperative patient. Small amounts of liquid barium, barium paste and a cookie coated with barium are ingested by the patient and the swallowing mechanism is recorded by videofluoroscopy. Unlike the routine barium swallow in which only the esophageal stage of swallowing is studied, using the modified barium swallow all four stages of swallowing are studied with particular emphasis on the oral and pharyngeal stages. Our experience with the modified barium swallow has shown it to be a valuable adjunct in the rehabilitation of the post-surgical patient allowing the otolaryngologist and speech pathologist to identify and modify swallowing abnormalities. Presentation of specific swallowing mechanism deficits as demonstrated using the modified barium swallow will be shown and appropriate therapeutic interventions discussed.

Aged↗
PubMed1988

Evaluation of parotid lesions by magnetic resonance imaging.

The effectiveness of magnetic resonance (MR) imaging in the evaluation of parotid lesions was tested by scanning 21 patients with parotid masses. In 20 patients the lesion was visualized, and in 19 benign/malignant differentiation was accurately made, indicating sensitivity and specificity of .95. The deep extent of the lesions was readily assessed by MR but the facial nerve could not be identified.

Adenoma↗
PubMed1987

Flow cytometry: DNA analysis of squamous cell carcinoma of the upper aerodigestive tract.

The flow cytometer is capable of analyzing a large number of cells or cell nuclei. The flow cytometer has been used to analyze the DNA content of tumor cells from squamous cell carcinomas of the upper aerodigestive tract using a modification of the Vindelov staining procedure. The main difficulty in analyzing solid tumors using flow cytometry technology is the disaggregation of the cells and the quantification of the diploid point (2N point). A set of internal standards was developed for establishing the 2N point, as well as a technique for disaggregation, which is described. A histogram characteristic of a more aggressive squamous cell carcinoma which tends to recur more quickly and more frequently than the other squamous cell carcinoma histogram types was identified. The flow cytometer proved to be a practical method of analysis allowing for quantitative measurement of DNA content from a large number of cells originating from a squamous cell carcinoma. The trend between recurrence and histogram type will require further study.

Animals↗
PubMed1987

The radial forearm flap in head and neck reconstruction.

The radial forearm flap has proven to be a very reliable and versatile technique for reconstructing head and neck defects. It is of particular value where segmental defects in the mandible and intraoral mucosa exist, and in reconstructing defects within radiated tissue. The skin of the flap drapes well over the radial bone to allow denture fitting. The radial bone provides an adequate bony strut to allow essentially normal mandibular function. In a previously radiated bed, the flap (from a non-irradiated area) has the virtue of being highly vascular, thus benefiting wound healing. The lack of bulk in the flap prevents separation at the site of inset as wound healing occurs. It is a one-stage reconstruction, and since the donor site is on the upper extremity, early patient mobilization is possible. The donor defect is cosmetically acceptable, and since it lies against the body in the position of rest, it is not frequently exposed. The osseous portion of the flap in a postmenopausal woman should be approached with caution and patients should be warned of the risk of radius fracture. This flap is capable of providing tissue for reconstruction of the head and neck and should be considered for closure of all major defects, particularly those with bone defects or in defects created postirradiation.

Adult↗
PubMed1986

Head and neck cancer in the elderly.

The elderly patient is making up an increasing percentage of our total population and the incidence of head and neck cancer in this group is high. A review of 758 cases seen at the London Regional Cancer Clinic is presented showing the prevalence of the disease in the elderly population and the unique distribution at certain sites of head and neck cancer as they occur. The survival of the elderly patient was found to be similar to that of the younger patient. The special considerations for management of these patients is examined under the following headings: anesthesia risks; reconstruction and wound healing; chemotherapy; and radiotherapy. With improvement in all four areas, outcome for the elderly patient with head and neck malignancy should improve.

Adult↗
PubMed1986

Erosive parapharyngeal space teratoma.

An erosive teratoma of the parapharyngeal space is described. Our patient at three months of age presented with an eight-week history of torticollis. Diagnosis was strongly suggested by CT scan which clearly demonstrated bony, fluid and intermediate densities suggestive of a teratoma. The tumor had eroded the petrous bone with inferior extension to the level of the hyoid cartilage. An angiogram revealed compromise of the internal carotid artery at the skull base. Surgical resection at five months removed the tumor from the right parapharyngeal space and included a portion of the petrous bone involving the contents of the middle ear and extending to the base of skull. All vital structures including the facial nerve, carotid artery and vagus nerve preserved. An intraoperative CSF leak was controlled with a muscle plug. To our knowledge, such an extensive teratoma eroding the petrous bone and base of skull, presenting as a neck mass, is the first reported case in the literature. The value of a CT scan as an aid in diagnosis of this tumor is stressed.

Head and Neck Neoplasms↗
PubMed1985

Conservation laryngeal surgery. A critical analysis.

Three hundred forty-two cases of laryngeal cancer were treated at the University of Michigan, Ann Arbor. One hundred ten supraglottic cancers and 150 glottic cancers were studied in depth. Conservation surgery was performed on 63 patients. Determinate two-year disease-free survival for glottic cancer was 90% in those irradiated primarily, 83% for those treated with vertical hemilaryngectomy, and 58% in the group that had total laryngectomy. Supraglottic cancers had a determinate survival rate at two years of 62% for those irradiated primarily, 80% for those treated with a supraglottic laryngectomy, and 62% when total laryngectomy was required. The cost of preserving the respiratory and sphincteric functions of the larynx in some cases amounted to the morbidity associated with a protracted hospital stay, altered deglutition, instances of a weak but functional voice, and the possibility of a permanent tracheostomy. Despite high recurrence rates of 30% to 40%, the overall determinate survival with salvage was an acceptable 80% for the conservation surgery group.

Adult↗
PubMedDate not supplied

Carcinoma of the ethmoid sinus.

Cancer of the ethmoid sinus is a rare tumor in the head and neck, accounting for less than 1 per cent of all such malignancies. This paper examines squamous cell carcinoma arising in the ethmoid sinus, the most common form of ethmoidal malignancy in a series reviewed at the University of Michigan. Sixteen cases diagnosed between 1964 and 1974 (inclusive) were included in this study. Peak incidence of the disease occurred in the seventh decade of life. All patients had a minimum follow-up of at least five years. The patients had relatively common nasal complaints that unfortunately represented an unusual and frequently fatal disease. The symptoms of ethmoid sinus cancer are reviewed, and the many modalities of treatment that can be used are discussed. The problems of staging ethmoid sinus cancer are elucidated, and difficulties with the suggested classification systems are discussed. Ultimately, only 29 per cent of the patients survived five years.

Adolescent↗