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Biomedical subjects

L Naval Gias

Publications and source records attributed to L Naval Gias.

11 recordsLinked to original sources

Tumor DNA content as a prognostic indicator in squamous cell carcinoma of the oral cavity and tongue base.

BACKGROUND: Nuclear deoxyribonucleic acid (DNA) content is a prognostic factor in several tumors, and decisions regarding treatment have been made using this parameter. Nevertheless, there is no agreement in head and neck cancer. The purpose of the present study was to ascertain whether tumor DNA content correlated with prognosis in cases of primary squamous cell carcinoma (SCC) of the oral cavity and tongue base. METHODS: A retrospective study of formalin-fixed, paraffin-embedded tissue from patients with histologically confirmed SCC of the oral cavity and tongue base was performed using flow cytometry. Tumor DNA content was studied in 109 sets of specimens from previously untreated patients. All of them underwent surgical resection at the University "Hospital de La Princesa" between 1982 and 1992. Clinical parameters (age, sex, site of primary tumor, clinical stage, adjuvant therapy received, and disease-free and overall survival) and histologic parameters (histopathologic stage, tumor differentiation, type of inflammatory infiltration, presence of perineural invasion) were recorded in all cases. An exhaustive statistical analysis was applied. RESULTS: Only the histograms of 93 patients were adequate for consideration. In flow cytometric analysis, DNA aneuploidy was observed in 51 tumors (55%). The proportion of aneuploid tumors was significantly higher in advanced-stage carcinomas (p < .05), tumors with perineural invasion (p < .05) and in men (p < .05). In the 24 patients with lymph node metastasis, the incidence of aneuploidy was 82% (19 of 24) (p < .05). The rate of metastasis and aneuploidy increased as the degree of differentiation decreased (p < .05 for both). Patients with aneuploid carcinomas in both early and advanced stages had shorter relapse-free and overall survival periods than did the patients with diploid tumors (p < .001 for both). A Cox regression analysis demonstrated that ploidy was the single most important prognostic factor in determining relapse and death (p < .001 for both). CONCLUSIONS: The results indicate that tumor DNA analysis by flow cytometry appears to be useful as a supplement to clinical and histologic evaluation in predicting the tendency of SCC of the oral cavity and tongue base to metastasize to regional lymph nodes and to predict the outcome of the disease.

Adult↗

Primary mandibular reconstruction with bridging plates.

25 cases in which the mandible was resected and reconstructed using a reconstruction plate (AO titanium reconstruction system and Leibinger titanium reconstruction system) are presented. 16 patients suffered from oral carcinoma, 7 presented with odontogenic tumours and 2 had chronic osteomyelitis of the mandible. The mean age was 54.2 years, the male to female ratio was 2.6:1. 3 patients had a reconstruction plate for mandibular resection without continuity defect (marginal resection), in all the other patients the reconstruction plate bridged a mandibular resection with a continuity defect: 13 were located in the body, body-angle or ascending ramus with preservation of the mandibular condyle; 4 hemimandibulectomies with disarticulation of the TMJ; and 5 involved the anterior arch, crossing the midline. 12 patients received radiotherapy (3 pre-operatively). Only 3 patients with significant local side effects needed the treatment to be stopped for a period of time. There was no perioperative mortality. Only one plate was removed. Although minor complications were noted in 11 patients, the general improvement in the functional and cosmetic balance of the patients when compared with patients in whom no plate was used, justifies the use of this reconstruction system, in our opinion.

Adolescent↗

[Intravascular endothelial papillary hyperplasia in the masseter muscle].

Intravascular Papillary Endothelial Hyperplasia (IVPEH) is a benign process, even uncommon. It was first described by Masson in 1923 under the name "Hemangioendotheliom vegetant intravascular". We present a case of IVPEH located in the masseter muscle. The treatment for this lesion was surgical excision. The histological examination is very important in order to separate this lesion from angiosarcoma.

Adult↗

[Cephalometric study of the cranial base in 133 cases of Down's syndrome].

Previous studies in patients with Down's syndrome have revealed signs of major anomalies of base of skull. A cephalometric radiography study was conducted to determine extent of these anomalies by quantitative methods. Skull morphology and structure were investigated in two groups of patients with Down's syndrome in whom cytogenetic analysis had demonstrated the presence of an extra chromosome in group G. The first group included 100 patients of both sexes aged between 9 and 30 years, the second group consisted of 33 patients aged 5 to 19 years. A matched control group was also studied. Cephalometric analysis (Björk, Delaire) showed shortening of anterior segment of base of skull in patients with Down's syndrome, as well as an increase in angle of base of skull when compared with controls, the differences being statistically significant.

Adolescent↗

[Dens invaginatus].

Dens invaginatus is an abnormal enamel growth first described by Salter in 1855. It has an incidence between 0.4 - 10%, and the tooth most frequently affected is the lateral upper incisor. Its etiology is not explained. There are many asymtomatic cases and others with symptoms derived from periapical lesions. Treatment must be as conservative as possible. A bibliographic review has been made and we demonstrate a radiologic sequence of the many cases observed in our Service in the last two years.

Dens in Dente↗