Search PubMed⌕ Search

Biomedical subjects

J Y Ko

Publications and source records attributed to J Y Ko.

At least 55 records · Page 3Linked to original sources
PubMed1997

Salvage surgery for recurrent nasopharyngeal carcinoma.

OBJECTIVE: To assess the efficacy of salvage surgery for patients with recurrent nasopharyngeal carcinoma (NPC) at the primary site after radiotherapy. DESIGN: Retrospective analysis of 24 patients treated by transpalatal, transmaxillary, or transmandibular approach to resect the recurrent tumor, with maximum follow-up of 50 months. SETTING: Academic tertiary referral center. RESULTS: Radiotherapy before salvage surgery included 1 to 3 courses of radiation to the nasopharynx, with doses ranging from 60 to 190 Gy. Eighteen (75%) of the patients relapsed within 2 years, and 6 (25%) relapsed more than 6 years after the last irradiation. In 4 of 6 late-relapsing cases, the histopathological type changed to keratinizing squamous cell carcinoma, which is rare in cases of NPC in Taiwan. Fourteen patients (58%) survived for 8 to 50 months after surgery (median, 18 months). The surgical complications were tolerable. CONCLUSIONS: Salvage surgery is feasible in selected patients with recurrent disease at the primary site. Thus, we can offer alternative retreatment in addition to external irradiation for patients with recurrent NPC.

Carcinoma↗
PubMed1997

A 10-year longitudinal study of tubal function in patients with nasopharyngeal carcinoma after irradiation.

OBJECTIVE: To follow up the chronological change of tubal function in patients with nasopharyngeal carcinoma for 10 years after irradiation. DESIGN: Patients with nasopharyngeal carcinoma were subjected to eustachian tube function tests before irradiation and 6 months, 5 years, and 10 years after irradiation. SETTING: University hospital. PATIENTS: Ten patients (20 ears), 7 men and 3 women. RESULTS: Twelve (60%) of the ears had patulous tubes 10 years after irradiation, which might result from atrophy of peritubal tissues. The occurrence of a patulous tube was independent of the radiation dosage, but it was related to the interval since irradiation. CONCLUSIONS: Development of a patulous tube is associated with correction of organic obstruction of the eustachian tube. Resolution of the inflammatory reaction plays the most important role in recovery of function of the tube. Therefore, the prevalence of middle ear complications is low 10 years after irradiation.

Adult↗
PubMed1996

Radiation-induced malignant fibrous histiocytoma in patients with nasopharyngeal carcinoma.

OBJECTIVE: To evaluate the prevalence, 15-year cumulative incidence, time interval, and prognosis of radiation-induced malignant fibrous histiocytoma of the head and neck in long-term survivors of nasopharyngeal carcinoma. DESIGN: Cohort. SETTING: Tertiary care hospital. PATIENTS: Eight long-term survivors of nasopharyngeal carcinoma with malignant fibrous histiocytoma in the maxillary sinus or nasal cavity. MAIN OUTCOME MEASUREMENT: Survival of postirradiation malignant fibrous histiocytoma in patients with nasopharyngeal carcinoma. RESULTS: The prevalence of radiation-induced malignant fibrous histiocytoma in long-term survivors of nasopharyngeal carcinoma was 0.38%. The 15-year cumulative incidence was 2.2%. Most tumors occurred in the maxillary sinus and were characterized by spindle-shaped tumor cells with plump nuclei arranged in a whorl or storiform pattern in a fibrous stroma. The mean interval between malignant fibrous histiocytoma and nasopharyngeal carcinoma was 121 months. Local recurrence developed in all cases within 9 months after surgery. Six patients died of disease without distant metastasis within 30 months. Two patients were alive with disease for 20 and 32 months, respectively. CONCLUSIONS: Radiation-induced malignant fibrous histiocytoma in the head and neck region in long-term survivors of nasopharyngeal carcinoma is rare. It takes a long time to occur after irradiation and is locally invasive with poor prognosis.

Adolescent↗
PubMed1996

Surgical treatment of complex fracture of the proximal humerus.

Sixteen patients aged 19 to 63 years (average, 52 years) were observed from 1.8 to 5.6 years (average, 3.8 years) after open reduction and internal fixation with or without external fixation of 3- and 4-part displaced fractures of the proximal humerus. There were 12, 3-part displaced greater tuberosity and surgical neck fractures with 6 concomitant dislocations. Four cases were 4-part fractures with 3 concomitant dislocations. Fixation was achieved with heavy sutures or wire that incorporated the rotator cuff tendon, tuberosities, and shaft combined with threaded pins or Hoffmann external fixation to enhanced stability for early rehabilitation. According to Neer's criteria, 14 (87%) of the 16 patients had satisfactory or excellent results. Two (13%) of the 16 had unsatisfactory results. The use of a technique of limited soft tissue dissection and internal fixation with or without external fixation achieved good fracture stability and a high percentage of satisfactory results. The limitations of the procedure include (1) patients who could not tolerate anesthesia, (2) complex displaced fractures in older patients with osteoporotic bone that cannot hold pins or external fixation, (3) older patients with 4-part fracture dislocations in which avascular necrosis of the humeral head occurs frequently and in which a subsequent endoprosthesis insertion is inappropriate if osteosynthesis fails, and (4) head splitting fractures. The described approach provides an alternative method for the treatment of complex displaced fractures of the proximal humerus.

Adult↗
PubMed1995

Otitis media with effusion in patients with nasopharyngeal carcinoma, postirradiation.

Eighteen patients with nasopharyngeal carcinoma were subjected to eustachian tube function testing before and 6 months and 5 years after irradiation at the university hospital to investigate the chronological changes of tubal function induced by irradiation and to study the development of otitis media with effusion after irradiation. Improvement of tubal function was found 5 years after irradiation in those ears without otitis media. However, in patients who had otitis media with effusion after irradiation, deterioration of tubal function was persistent, and inflammatory reaction was detected in the upper respiratory tract, including the maxillary sinus and nasopharynx. Thus, the development of otitis media with effusion after irradiation in patients with nasopharyngeal carcinoma is attributable to both tubal and inflammatory factors. Insertion of a ventilatory tube in ears can relieve tubal obstruction but can possibly aggravate the inflammatory process. Therefore, it is our opinion that myringotomy plus local treatment may be preferable to insertion of a ventilatory tube in patients with nasopharyngeal carcinoma who have otitis media with effusion.

Adult↗
PubMed1995

Soluble interleukin-2 receptor as a clinical parameter for nasopharyngeal carcinoma.

We evaluated whether the serum soluble interleukin-2 receptor (sIL-2R) may be a parameter to monitor the efficacy of treatment for nasopharyngeal carcinoma (NPC). There were 177 NPC patients and 24 healthy controls. The level of sIL-2R was measured with a sandwich ELISA kit. Higher levels of sIL-2R than for controls were found in NPC patients before treatment and in patients with distant metastasis (p < 0.001). There was, however, no difference in sIL-2R levels between controls and NPC patients after radiotherapy in relapse-free or in primary relapse. The sIL-2R levels in sequential testing revealed good correlation with clinical response. The sIL-2R levels were found to be elevated when distant metastasis was detected. Two patients had elevated sIL-2R level up to 5 months before clinical detection of metastasis. These results indicate that serial measurements of sIL-2R levels are worthwhile for NPC patients in their clinical course. The sIL-2R level proved to be an adjunct clinical parameter to monitor the efficacy of treatment of NPC.

Adult↗
PubMed1994

Epstein-Barr virus harboring in the parotid gland without tumor association.

The purpose of this study is to clarify the relationship between Epstein-Barr virus (EBV) and tumors of the major salivary gland. EBV DNA was detected by polymerase chain reaction (PCR) in parotid secretions in 56% of patients (n = 32) regardless of the presence of tumors in the parotid gland and in tumor tissues in 19% of surgical specimens (n = 21). By Southern blot-hybridization analysis, we found type A EBV in three patients and type B EBV in one patient. In situ hybridization for EBV genome was positive in surgical specimens of salivary glands in 33% of patients (n = 21). Our results suggest that this virus may not play a role in the pathogenesis of most tumors of the major salivary gland. However, two patients with lymphoepithelial carcinoma were found to have a close relationship to EBV as shown by high titers of antibodies in the sera against EBV related antigens by standard immunofluorescent technique and by the presence of many copies of EBV genome in tumor cells using in situ hybridization.

Adult↗
PubMed1993

Association between bleomycin genotoxicity and non-constitutional risk factors for head and neck cancer.

Sensitivity of phytohaemagglutinin-stimulated lymphocytes to bleomycin clastogenicity is increased in patients with tumours in organs and tissues that are in direct contact with the external environment, such as the mucosa of the head and neck. Sensitivity to bleomycin may reflect a genetically determined hypersensitivity to certain genotoxicants and therefore may be important in the carcinogenic process. In this study the applicability of bleomycin genotoxicity was investigated in cultured lymphocytes of forty individuals without a tumour history. No correlations were observed with increasing age or the well-known head and neck cancer risk factors alcohol and tobacco consumption. Since inter-individual variation in sensitivity greatly exceeded intra-individual variation, our results suggest that an elevated bleomycin clastogenicity score may identify individuals who have a constitutional hypersensitivity towards certain genotoxicants and may show an increased cancer susceptibility.

Alcohol Drinking↗
PubMed1993

Multiple schwannomas of the foot: report of a case.

Schwannoma, a relatively common tumor of the nerve sheath, rarely involves the foot. A review of the literature disclosed that most reports of schwannoma of the foot were solitary tumors. There has been only one reported case of multiple schwannomas of the foot. We report a case of multiple schwannomas involving both the medial and lateral plantar nerves of the right foot. The patient had been treated for plantar fasciitis for the previous eight years. After excision of one tumor, magnetic resonance imaging (MRI) was used in the diagnosis, revealing four additional tumors. These tumors were also successfully excised and the patient's symptoms relieved. Patients with prolonged intractable pain and tenderness of the foot may require examination by MRI or sonography to search for deep tumors impinging upon the plantar nerves.

Foot Diseases↗
PubMed1991

Elevated levels of soluble interleukin 2 receptor and tumor necrosis factor in nasopharyngeal carcinoma.

Depressed cell-mediated immunity as a measure of the mitogenic response of mononuclear cells in patients with nasopharyngeal carcinoma is well documented, but the mechanism is still unclear. The enzyme-linked immunosorbent assay was used to measure soluble interleukin 2 receptor and tumor necrosis factor levels in 295 patients with nasopharyngeal carcinoma and 97 age-matched control subjects. Soluble interleukin 2 receptor levels in patients with nasopharyngeal carcinoma were elevated and correlated with clinical staging. Higher soluble interleukin 2 receptor levels were found in patients with bone metastasis but not in patients with intracranial involvement. The levels of tumor necrosis factor in nasopharyngeal carcinoma were higher than in control subjects but did not correlate with clinical staging. These data suggest that soluble interleukin 2 receptor levels might be more useful than soluble tumor necrosis factor levels that indicate tumor bulk. Soluble interleukin 2 receptor serves as a blocking factor that competes with interleukin 2 function, resulting in a decreased mitogenic response in patients with nasopharyngeal carcinoma. The usefulness of the levels of soluble interleukin 2 receptor to monitor the efficacy of treatment in patients with nasopharyngeal carcinoma with bone metastasis requires further study.

Adolescent↗
PubMed1989

[Serum B-protein in patients with nasopharyngeal carcinoma].

B-protein is an acidic glycoprotein that appears in the serum of cancer patients, although it is not produced by cancer cells. It is not a cell surface antigen but can serve as a biological marker for detecting malignancies and monitoring cancer therapy. From January to August 1987, serum samples were collected from 133 patients with nasopharyngeal carcinoma (NPC) and 19 patients without cancer as the control group. The positive rates of B-protein in NPC patients without distant metastasis (107) and with distant metastasis (26) were 78.5% and 84.6% respectively. The overall positive rate of B-protein in NPC patients was 79.7%, which did not correlate with tumor stage and sex. The positive rate of B-protein in the control group was 5.3%. The difference in positive rates between NPC and the control group was significant (p less than 0.001). The quantitative changes of B-protein did not correlate with the tumor burden of NPC patients. Therefore, B-protein assay is not recommended in monitoring the treatment of NPC.

Adolescent↗
PubMed1988

A cephalometric appraisal of edgewise Class II nonextraction treatment with extraoral force.

The purpose of this study was to determine the treatment effects of nonextraction edgewise therapy combined with cervical headgear on Class II, Division 1 malocclusions. Data from a sample of 43 treated patients with a mean age of 11 years 11 months and a mean treatment time of 2 years 8 months were recorded. A cephalometric appraisal was done and the initial and final measurements of points, lines, and angles based on accepted cephalometric analyses were compared. Student's t test for paired cases was used to evaluate the significance of all measurement changes. The significant findings were as follows: the inhibition of forward growth of the maxilla, downward tipping of the anterior part of the palate, reduction of flaring of the maxillary incisors, reduction of the facial convexity, and extrusion and mesial movement of maxillary and mandibular first molars. The overall results tend to indicate the efficacy of this treatment modality in the treatment of the Class II, Division 1 malocclusion.

Cephalometry↗
PubMed1988

[Detection of serum gamma interferon in nasopharyngeal carcinoma patients using reversed passive hemagglutination method].

In order to detect the difference in serum gamma-interferon levels between patients with nasopharyngeal carcinoma (NPC) and normal controls, the reversed passive hemagglutination (RPHA) method was used. Serum gamma-interferon level was determined in 93 patients with NPC, of these, 47 were newly diagnosed, untreated patients. Of the treated patients, 15 had received radiotherapy but were proved later to have distant metastasis. Thirty-one patients had received radiotherapy and survived over 5 years without local recurrence or distant metastasis. Another 47 healthy subjects, age and sex matched with fresh NPC cases, were used as control group. The results revealed that the concentration of gamma-interferon in the serum of neither males nor females showed significant difference (p greater than 0.1). Among the NPC fresh cases, the concentration of gamma-interferon also showed no significant difference in patient serum in either early stages (stages I and II) or later stages (stages III-V) (p greater than 0.1). The serum gamma-interferon level was significantly increased in fresh NPC patients compared with normal controls (p less than 0.05). Concerning the irradiated patients, serum gamma-interferon level was not increased in patients who survived over five years, without relapse, compared with normal controls (p greater than 0.1). However, the serum gamma-interferon level in patients with distant metastasis was higher than in normal controls (p less than 0.05). Also, the serum gamma-interferon level was significantly increased in distant metastatic patients compared with patients without relapse (p less than 0.05).

Female↗
PubMedDate not supplied

Congenital dislocation of the knee.

Between February 1988 and June 1995, 24 congenital dislocations of the knee joints (17 patients) were reduced with closed methods including immediate reduction, serial casting, or traction in patients from 10 min to 26 days old. At an average follow-up of 4 years and 10 months, an excellent or good result was achieved if there were no associated anomalies. Fair or poor results were the result of delayed treatment or associated musculoskeletal anomalies including arthrogryposis multiplex congenita or Larsen's syndrome. Routine check of the hip dislocation is suggested. Diagnosis with manual testing was difficult, and other methods such as radiography or sonography were suggested in combination to detect hip dysplasia. The dislocated knee should be reduced before treating the hip dislocation. Concomitant treatment of the congenital dislocation of the knee and the hip with Pavlik harness provided satisfactory results. When late, progressive, genu valgus deformity occurred because of global instability of the knee and asymmetric physeal growth, reconstruction of the medial structures of the knee and prolonged bracing provided good results.

Casts, Surgical↗
PubMedDate not supplied

"Trapdoor" procedure for osteonecrosis with segmental collapse of the femoral head in teenagers.

Osteonecrosis of the femoral head in adolescents often leads to serious destructive changes in the hip with resulting significant disability. Between March 1981 and June 1990 we treated 13 teenagers (14 hips) using the "trapdoor" bone grafting procedure for severe femoral head osteonecrosis with articular surface collapse. Nine cases (10 hips) had the trapdoor procedure combined with containment osteotomy of the femur and acetabulum. Thirteen of the 14 hips had adequate follow-up to be included in this report. The main focus of this report is the 10 hips treated with a trapdoor bone grafting plus containment procedure (femoral osteotomy, acetabular osteotomy, or both). At an average follow-up of 4 years 5 months, clinically seven cases (eight hips) had a good result and two had a fair result. Radiographic evaluation showed six hips with a good result, three hips with a fair result, and one with a poor result. None of these 10 hips has yet required hip fusion or replacement arthroplasty, suggesting that trapdoor bone grafting plus containment can serve as a procedure to delay the need for hip fusion in femoral head avascular necrosis in teenagers.

Adolescent↗
PubMedDate not supplied

Pyogenic granuloma--an uncommon complication of nasal packing.

Nasal packing is a very common procedure in the otolaryngologic service for nasal bleeding and postoperative hemostasis. However, a pyogenic granuloma complicated from nasal packing has not been reported in the literature. A 50-year-old man underwent nasal packing by use of vaseline gauze due to nasal bleeding. Two weeks later, a dark brown nasal tumor was found in his nasal cavity. He underwent partial turbinectomy for removal of the tumor. The pathology demonstrated a pyogenic granuloma. It is the first case of a confirmed pyogenic granuloma complicated from nasal packing in the literature. To prevent complications and decrease the discomfort, we strongly recommend the use of inflatable balloons or nontraumatic materials for nasal packing.

Epistaxis↗