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Biomedical subjects

H Iro

Publications and source records attributed to H Iro.

At least 145 records · Page 8Linked to original sources
PubMed1991

Piezoelectric shock wave lithotripsy of salivary gland stones: an in vitro feasibility study.

The feasibility of fragmentation of salivary stones by a new extracorporeal piezoelectric lithotripter was investigated. A total of 40 salivary stones were submitted to piezoelectric shock wave treatment. The diameter, weight, and volume of all the stones were determined prior to shock wave administration. After shock wave administration the chemical composition of the stones was investigated by X-ray diffractometry. Fragmentation was achieved in 35 out of the 40 (87.5%) stones. Twenty-five of the 40 (62.5%) stones were disintegrated "therapeutically adequate" (residual fragments less than 1.5 mm). A statistically significant correlation was not observed between the number of discharges required for disintegration and the diameter, weight, volume, or the chemical composition of the stones.

Feasibility Studies↗
PubMed1991

[Simultaneous radiotherapy and chemotherapy with cisplatin and 5-fluorouracil in advanced head and neck tumors].

Between 1.1. 1987 and 31.12. 1988 47 patients with locally advanced head- and neck tumours (UICC-stage II: one patient, stage III: 16 patients, stage IV: 30 patients) were treated with simultaneous radio-chemotherapy. Localisations were hypopharynx (23 = 49%), oropharynx (16 = 34%) and other sites (8 = 17%). Radiation therapy consisted of 60 Gy (primary region, N+) or 50 Gy (N0) in daily fractions of 2 Gy each over six weeks. During week 1 and 5 of radiotherapy two courses of chemotherapy with 5-FU (600 mg/m2/day, i.v. continuous infusion for five days) and cis-platin (25 mg/m2/day i.v. bolus for five days) were administered. 43/47 patients (91%) responded to therapy. 34/47 (72%) patients achieved a complete remission, 9/47 (19%) a partial remission, and 4/47 (9%) no change. With a minimum follow-up of 26 months 17/47 patients (36%) are alive and NED, 4/47 (9%) are alive with tumour. 18 patients (38%) died of cancer, eight patients (17%) died of second tumours, intercurrent diseases and of unknown reasons. Actuarial four-year survival is 45% (stage III: 56%, stage IV: 42%), four-year NED survival is 35% (stage III: 68%, stage IV: 18%). There were no loco-regional recurrences after additional surgical treatment of the primary and the neck following complete remission. In contrast after RCT alone and complete remission local recurrences in 6/21 patients (29%) and regional recurrences in 5/24 patients (21%) occurred. We conclude that simultaneous RCT is a new very effective treatment modality of locally advanced head and neck tumours producing superior loco-regional control compared to conventional management.

Adult↗
PubMed1991

[Endoral sonography in comparison with transcutaneous sonography, computerized tomography and magnetic resonance tomography].

Endoral ultrasound was introduced for imaging of T1 and T2 tumors of the anterior third of the tongue and the floor of the mouth in 1988. Using this method, 100 patients with diseases of the oral cavity and the oropharynx were examined, and the findings were compared with those of transcutaneous ultrasound, CT and MRI. Endoral ultrasound provided valuable additional information in tumors of the tongue base and the middle and dorsal third of the tongue. Tumors of the tonsil were demonstrated very well. MRI proved to be superior for imaging of large lesions. CT was of less value in diagnostic imaging of the oral cavity and the oropharynx due to low soft tissue contrast.

Adult↗
PubMed1991

[Interstitial and percutaneous radiotherapy after limited surgery in carcinoma of the oral cavity].

From 1.1. 1986 to 31.12. 1990 50 patients with epidermoid carcinoma of the floor of the mouth and the mobile tongue (stage T1 18, stage T2 20, stage T3 eight and stage T4 four patients) were treated by surgery, 192-iridium implantation using the plastic tube technique and percutaneous irradiation. Surgery was performed as enoral resection (35 patients) or en bloc tumour resection with part of the mandible and flap reconstruction (15 patients). Interstitial therapy was considered as a boost to primary tumour region, the dose given ranged between 16 and 33 Gy. 50 to 60 Gy were applied with external beam radiotherapy. Management of the neck consisted of elective or radical neck dissection followed by external beam radiotherapy (50 to 60 Gy). At 2/1991 median follow-up was 17 (three to 53) months. 35 patients are alive and tumour-free, one patient lives with tumour. 14 patients died, eight patients tumour-related, four patients of intercurrent disease and two patients because of a second primary. Primary local control was 18/18 patients for stage T1, 19/20 patients for stage T2, 7/8 patients T3, 3/4 patients for stage T4. Three patients suffered from nodal recurrences, four patients from distant metastases. Complication rate was acceptable. Soft tissue necrosis occurred in 4/18 patients (T1); 5/20 patients (T2); 3/8 patients (T3) and 1/4 patients (T4). Three patients developed osteoradionecrosis. Our results show that combined modality treatment for tumours of the oral cavity yields high local control with acceptable complication rate.

Adult↗
PubMed1990

[Extracorporeal shock-wave lithotripsy of a salivary stone].

Ultrasonography revealed a 12 mm concrement in the left parotid duct of a 67-year-old man with an acute exacerbation of a left-sided purulent parotitis. After the acute phase had subsided under antibiotic therapy it was not possible to remove the stone either by bougie or cutting into the duct close to the papilla. Piezoelectric shockwave lithotripsy with a total of 1000 shock-waves fragmented the stone, and sonography 48 hours and four weeks later demonstrated that the parotid gland was free of stone.

Aged↗
PubMed1990

[Tissue reactions with administration of piezoelectric shock waves in lithotripsy of salivary calculi].

Before clinical application of an extracorporeal piezoelectric lithotripter to treat sialolithiasis, tissue reaction during shockwave application was examined in vitro and in experiments with animals. Application of shockwaves to human tissue in vitro showed neither macroscopic nor microscopic effects. In animal experiments, the acute experiment (16 rabbits, Chinchilla-Bastard) revealed minor bleeding in the parenchyma of the parotid gland, while the chronic experiment (14 rabbits, Chinichilla-Bastard) revealed no morphologic tissue damage to the parotid region of the rabbit, as a result of piezoelectric shockwaves. However, when the eye was placed in the shockwave focal area and the shockwaves were transmitted via the fissura orbitalis to the endocranium, brain damage could be detected morphologically. In conclusion, the authors feel that the clinical application of extracorporeal piezoelectric fragmentation of salivary stones is justified, provided that a reliable positioning of the patient and exact sonographic location of the concrement are possible.

Animals↗
PubMed1990

[Phase II study with pirarubicin in pretreated progressive head-neck neoplasms].

Sixteen heavily pretreated patients (pts) (4 surgery + chemotherapie + radiotherapy; 4 chemotherapy + radiotherapy: 6 surgery + radiotherapy; 2 chemotherapy) and one previously untreated patient, who refused surgery and or radiotherapy, all with progressive disease, with advanced squamous cell carcinoma of the head and neck were included in a phase II study with pirarubicin 60 mg/m2 i.v. day 1 every 3-4 weeks (CT). All pts received at least one course of CT. 15 pts were evaluable for response, all 17 pts were evaluable for toxicity. Female (male ratio 1/16; mean age 56 (42-68) yrs, mean performance status 70% (50-70). Seventeen pts received a mean of 3 (1-8) courses, 2 pts had received only one course of CT. Response and toxicity were assessed according to WHO classification. Results after 1-8 courses of CT: 1 (7%) complete remission; 1 (7%) partial remission; 9 (60%) no change; 4 (26%) progressive disease. No toxicity of grade IV was observed. Mean duration of remission 16 weeks. Median survival time 7 (1-10) months. 9 pts died and 8 pts are alive; six of them had progressive disease.

Adult↗
PubMed1990

[Imaging of parotid gland diseases with high resolution magnetic resonance tomography].

Twenty-one patients with tumors or chronic inflammation of the parotid gland were examined both by MRI and ultrasound. The findings of MRI were compared with sonography and with the findings of other imaging methods. In most cases MRI provided valuable additional information about the structure of the gland and the extent of a tumor. Sonography provided a correct estimation of the tumor extent in 11 of 15 patients with tumours, but MRI did so in all cases. In 5 out of 6 patients with stones or chronic inflammation, sonography provided the correct diagnosis; resolution of the gland structure was superior by MRI.

Diagnosis, Differential↗
PubMed1990

[Extracorporeal piezoelectric lithotripsy of salivary calculi. Initial clinical experiences].

Piezoelectric lithotripsy was performed in 14 patients with salivary stones. None of the patients required anaesthesia, analgesics or sedatives. All of the salivary stones could be fragmented totally during the first lithotripsy procedure. Three months after treatment with extracorporeal shock waves all the patients were free of symptoms and in 7 out of 14 patients no concrement could be found by sonography. The piezoelectric lithotripsy of salivary stones had caused no serious side effects as proved by clinical, biochemical, sonographic and magnetic resonance imaging examinations. Extracorporeal piezoelectric lithotripsy is a new and promising non-surgical therapy for selected cases of sialolithiasis of the large salivary glands of the neck.

Adult↗
PubMed1989

Foix-Chavany-Marie-syndrome--neurological, neuropsychological, CT, MRI, and SPECT findings in a case progressive for more than 10 years.

In a 66-year-old woman signs and symptoms of bilateral opercular syndrome (Foix-Chavany-Marie-syndrome) developed progressively over a period of more than 10 years. Facio-linguo-velopharyngeo-masticatory diplegia with automatic-voluntary dissociation was accompanied by motor aphasia and oral apraxia leading to a state of almost complete anarthria. Although it initially resembled the anterior biopercular syndrome there are also features indicating involvement of the posterior opercula. Although the aetiology remains obscure without pathological data, a bilateral focal brain atrophy is assumed. This is probably the first case documented by MRI and SPECT.

Aged↗
PubMed1989

[Nutrition of ENT tumor patients treated with radiotherapy. Comparison of oral and enteral nutrition using percutaneous gastrostomy].

The nutritional state of 99 patients with head and neck malignancies was assessed before, during and up to 18 weeks after radiotherapy (DXRT) using anthropometry, immunology and blood chemistry. 73 patients were fed orally during therapy, first with a normal diet and later, when the side effects of DXRT worsened, with a supplemental liquid formula diet. During the first two weeks 26 patients were treated with a PEG (percutaneous endoscopically controlled gastrostomy) and were fed mainly enterally with formula diets. The parameters of those patients fed orally during DXRT worsened rapidly and only recovered slowly and incompletely. On the contrary, in spite of their poor initial condition, the patients with PEG improved their state of nutrition, even during DXRT. Both the objective parameters of nutrition and the subjective condition of the patients were measured with the help of the "quality of life index". During DXRT the quality of life of both groups deteriorated equally. The objective parameters of nutrition showed that the patient's strength and the capacity for work remained constant. Unexpectedly, after DXRT only the orally fed patients were found to have an improved subjective condition, probably because the PEG patients were reminded of their disease by the tube, in spite of successful completion of tumor therapy. This undoubtedly impedes the return to normal family and working life. Early and consistent enteral diet with PEG helps to stabilize the state of nutrition of patients with head and neck cancer, and is recommended, especially for patients already suffering from malnutrition before starting an aggressive multimodal tumor therapy.

Body Mass Index↗
PubMed1989

[Comparison between oral nutrition and enteral nutrition using a percutaneous endoscopically guided gastrostomy (PEG) in patients undergoing radiotherapy for head and neck tumors].

The nutritional state of 99 patients with tumors in the head and neck area was determined prior to, during and after radiotherapy by anthropometric, laboratory-chemical and immunological parameters. In 73 orally nourished patients, the nutritional parameters deteriorated very quickly during radiotherapy and recovered slowly and incompletely after radiotherapy. In 26 patients treated prospectively by percutaneous endoscopically guided gastrostomy (PEG), however, an improved nutritional state was achieved already during the irradiation in spite of a less favorable starting point. The subjective feeling of patients was questioned by means of the "quality of life" index according to Padilla et al. (1983). The preliminary results show an identical deterioration of the subjective feeling in both groups, but - as opposed to the other patients - force and working capacity did not decrease during radiotherapy in the enterally nourished patients. This corresponds to the objective nutritional parameters. However, an improvement of the subjective feeling after the end of radiotherapy was observed only in the orally nourished patients. Possible reasons are discussed. We have the opinion that an early and constant enteral nutrition by PEG can stabilize the nutritional state of patients with tumors in the head and neck area. Therefore we recommend to establish a prophylactic, pretherapeutic PEG if an aggressive multimodal therapy is planned, especially in case of apparent primary malnutrition.

Body Mass Index↗
PubMed1989

[Intra-oral sonography in neoplasms of the mouth and base of the tongue].

Sonography has proved superior to CT and MRI for imaging T1 or T2 carcinomas of the oral cavity and base of the tongue. However, in examining the anterior half of the tongue and the floor of the mouth problems arise due to absorption of sound by the mandible and air inclusion. Ultrasound examination can be performed end-orally by means of a miniaturised transducer. End-oral sonography produces images of the anterior parts of the tongue and the floor of the mouth without artefacts. This method is superior to conventional transcutaneous sonography for this region.

Humans↗
PubMed1989

[Extracorporeal piezoelectric lithotripsy of salivary calculi. In vitro studies].

The feasibility of fragmentation of salivary stones by a new extracorporeal piezoelectric lithotripter was investigated. A total of 40 salivary stones were submitted to piezoelectric shockwave treatment. Prior to shockwave application the diameter, weight and volume of all the stones were determined. After shockwave application the chemical composition of the stones was investigated by X-ray diffractometry. Fragmentation was achieved in 35 of 40 (87.5%) stones. Of these 40 stones, 25 (62.5%) were disintegrated adequately (residual fragments less than 1.5 mm). No statistically significant correlation was observed between the number of discharges required for disintegration and the diameter, weight, volume or the chemical composition of the stones.

Humans↗
PubMed1989

[DNA impulse cytophotometry measurements in head and neck tumors. Initial results of a correlation with clinical stage, therapeutic response and pattern of recurrence].

The DNA index and proliferation rate (percentage of S-phase cells) of 52 head and neck tumours were analysed by flow cytometry. Thirty-one (60%) of these tumours were aneuploid, 21 (40%) diploid. The distribution of aneuploid tumours was nearly equal in all T-stages. In contrast, the number of aneuploid tumours increased with higher N-stages. Locoregional recurrences developed more often (69%) in aneuploid tumours than in diploid tumours (54%). Furthermore, recurrence presented earlier (median 5 months) than in the latter (median 11 months). Regional recurrences were mainly observed in aneuploid tumours, local recurrences in diploid tumours.

DNA, Neoplasm↗
PubMed1989

[Functional results following surgical management of isolated orbital floor fractures (blow-out fractures)].

Sixty five orbital floor fractures of varying degrees of severity were assessed retrospectively. The operative treatment was performed via the transorbital approach within 14 days of the trauma. Pre-operatively 26 patients had sensory disorders of the infraorbital nerve. Six months later the nerve had recovered fully or partially. Preoperatively 49 patients (74%) were found to have double vision. Six months after the operation 44 patients (90%) were either much better or the double vision could no longer be detected. Only 5 cases showed no improvement. In view of the poor results of non-operative therapy of orbital floor fractures, we recommend early operative treatment for blow out fractures.

Biological Dressings↗