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Biomedical subjects

H B Neel

Publications and source records attributed to H B Neel.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Lymphoproliferative disorders of the head and neck.

Lymphoproliferative disorders are the frequent cause of indeterminate processes in the head and neck region for which otolaryngologists are often consulted by colleagues seeking a diagnosis. Because a wide spectrum of diseases may be represented, tissue diagnosis is often required. Recent advances in tissue immunotyping and DNA probes permit more precise identification and classification of these disorders. Lymphoproliferative disorders may be subdivided into five categories: Hodgkin's disease, non-Hodgkin's lymphoma, histiocytosis X, benign reactive lymphoproliferative disorders, and plasma cell neoplasms. Representative cases are presented, along with a brief discussion of each category.

Adult↗
PubMedDate not supplied

Transbronchoscopic cryosurgery of respiratory structures: experimental and clinical studies.

Although resection is the only treatment proven effective for localized malignant tumors in the tracheobronchial tree, alternative methods for cure or control of unresectable or recurrent tumor should be explored. In 24 dogs, cryonecrosis of sizable portions of carina, main stem bronchi, first division bronchi, and lung parenchyma was well tolerated, and the necrosis was localized, reproducible, and followed by prompt healing of frozen tissue. The gross architecture of the bronchi was not permanently altered, and no strictures formed. Six patients with endobronchial tumors were treated transbronchoscopically with cryosurgery. All patients tolerated the procedures well, and there were no complications. Palliation was achieved in five of the six patients.

Aged↗
PubMedDate not supplied

Sputum cytologic diagnosis of upper respiratory tract cancer.

Sputum cytologic testing has been applied in the screening of high-risk individuals for presymptomatic lung cancer. This same screening procedure sometimes identifies patients with upper respiratory tract cancers and thereby may permit earlier treatment. Patients enrolled in the Mayo Lung Project undergo sputum cytologic and chest roentgenographic screening at four-month intervals and are compared with matched controls who are not intensively screened. Experience to date indicates an incidence rate of approximately 1 per 1,000 per year of cancer in the upper respiratory and alimentary passages among males more than 45 years old who are heavy cigarette smokers. This compares with a rate of approximately 4 per 1,000 per year of lung cancer. Recognition of early cancer of the upper respiratory tract is an additional benefit of screening for lung cancer. Since cigarette smoking represents an etiologic agent common to both upper and lower respiratory tract cancers, tumors should be searched for in both sites in this high-risk population.

Aged↗
PubMedDate not supplied

Sputum cytologic diagnosis of upper respiratory tract cancer. Second report.

Screening for cancer is a popular issue for debate because few, if any, evaluations of the screening process have been conducted on a long-term prospective basis with use of concomitant, unscreened controls. We have found that screening of high-risk persons for presymptomatic lung cancer will identify patients with cancer in the upper and lower respiratory passages. Randomly selected patients enrolled in the Mayo Lung Project have undergone sputum cytologic and chest roentgenographic screening at four-month intervals and were compared with randomly selected matched control subjects who were not intensively screened. The search for upper airway tumors in the head and neck region was instigated by abnormal findings on sputum cytology in 12 screened patients. In the same period, 12 other screened patients with abnormal results of sputum cytology were found to have roentgenographically "occult" lung cancer. This finding emphasized the importance of the otorhinolaryngologic examination in screening programs for airway cancer. It is also important to emphasize that sputum-negative patients may have obvious, symptomatic tumors of the upper aerodigestive tract that can be easily diagnosed by those who are skilled in examining this area. Contrary to our expectation, there is no definitive evidence that screening has reduced mortality from either upper or lower airway cancer.

Aged↗
PubMedDate not supplied

Bronchoscopic cryotherapy.

Bronchoscopic cryotherapy of localized endobronchial tumors can be applied in selected patients who are not candidate for other traditional therapy. Twenty-eight patients were treated on 60 occasions with a closed liquid nitrogen system and a long insulated probe that was specifically designed to be used through an open ventilating bronchoscope. The conditions of 15 patients (54%) was improved, as judged by local tumor control, decreased bleeding, or improved airway patency. Fatal complications that could be ascribed to cryotherapy occurred in 2 of the 60 treatments (3%). Two patients have experienced complete control of squamous cell cancers four years and five years nine months after cryotherapy.

Aged↗
PubMedDate not supplied

Laryngeal sarcoidosis: report of 13 patients.

Of 220 patients with sarcoidosis of the head and neck region, representing 9% of 2,319 patients with sarcoidosis seen at the Mayo Clinic from 1950 through 1981, we identified 12 who had laryngeal sarcoidosis. Edematous, pale, diffuse enlargement of the supraglottic structures was the most common laryngeal manifestation. The diagnosis is made by a group of clinical, radiologic, and laboratory findings, confirmed by the finding of noncaseating granuloma on biopsy. Sarcoidosis is a disease with frequent remissions and exacerbations and generally burns itself out; glucocorticoids may be indicated in particularly severe disease. When laryngeal sarcoidosis is suspected, the laryngologist should collaborate with other clinicians in a thorough evaluation of the patient.

Adolescent↗
PubMedDate not supplied

Wegener's granulomatosis of the subglottis and the upper portion of the trachea.

A relatively little-known complication of Wegener's granulomatosis is involvement of the subglottis and upper part of the trachea, which is illustrated in this report on 17 patients. Each of the patients had biopsy-proved Wegener's granulomatosis of the nose and paranasal sinuses. Some had concomitant involvement of the eye, kidney, lung and skin. Nine of the 17 patients required tracheotomy; 5 still require a tracheotomy tube, and 4 have had decannulation (1 had successful reconstructive surgery of the trachea). Medical treatment consisted of cyclophosphamide, with or without corticosteroids. All 17 are currently alive, the average follow-up having been 81 months. The otolaryngologist plays a key role in the detection and management of patients with Wegener's granulomatosis, particularly when the onset is a sudden progressive upper tracheal obstruction with airway symptoms that may overshadow the sometimes more subtle nasal manifestations.

Adolescent↗