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Biomedical subjects

M Kind

Publications and source records attributed to M Kind.

At least 19 recordsLinked to original sources
PubMed1999

Obliteration of the frontal sinus--state of the art and reflections on new materials.

Despite increasing advances in endonasal frontal sinus surgery, obliteration of the frontal sinus is necessary in some cases for definitive clearing frontal sinus pathology. Reviewing the literature and considering pathophysiological aspects, successful obliteration of the frontal sinus depends on the complete removal of the mucosa and a sufficient closure of the nasofrontal duct, but not on the material used for obliteration, if special considerations are taken into account and foreign materials are avoided. Complete removal of the mucosa has to include removal of the inner bony cortex of the frontal bone. Occlusion of the nasofrontal duct is achieved with a sufficiently fixed fibrous layer.

Adipose Tissue↗
PubMed1998

Extranasopharyngeal angiofibroma in a 15-month-old child.

Angiofibromas are usually characterized by typical location with involvement of the posterior nasal cavity and nasopharynx. They are most commonly found in adolescent males. Despite these facts, a case of an angiofibroma presented in a 15-month-old boy at an atypical site anterior and medial to the lacrimal sac. The tumor was resected via an endonasal, micro-endoscopic approach avoiding an external incision.

Angiofibroma↗
PubMed1998

[Is chronic laryngitis associated with Helicobacter pylori? Results of a prospective study].

H. pylori is found in the stomach of patients with chronic gastritis. The infection is usually transmitted by the gastro-oral route and bacteria could be identified in saliva and dental plaque. An essential cause of chronic laryngitis is gastroesophageal reflux. The aim of the study was to evaluate if a H.pylori-associated chronic laryngitis exists. 38 patients with chronic laryngitis underwent gastroscopy. Biopsies were taken from the gastric antrum and body, lower, middle and upper esophagus. H. pylori was diagnosed by rapid urease test and histology. 14 of the patients (36.8%) were H.pylori-positive, but the bacteria could not be identified between stomach and larynx. 24 patients were H. pylori-negative. Seven patients (18.4%) suffered from esophagitis, six of these patients were H. pylori-negative. The H. pylori-infected patients received triple therapy for one week, in case of esophogitis Omeprazole 20 mg BID was prescribed. Six weeks later a follow-up endoscopy was performed. The eradication rate was 12/14 (85.7%), in all patients with reflux the esophagitis was cured. The laryngitis was clinically and endoscopically unchanged in ten of the twelve (83.3%) patients after successful treatment for H. pylori; in the remaining two patients as well as in the two H. pylori-positive patients the laryngitis was improved. In six out of the seven patients with esophagitis the laryngitis had healed completely and was improved in the remaining patient. It may be concluded that there is no evidence for the existence of H. pylori-associated laryngitis, suggesting that acid reflux is the underlying etiology.

Adult↗
PubMed1997

Extranasopharyngeal angiofibroma in a 15-month-old child.

Angiofibromas are usually characterized by typical location with involvement of the posterior nasal cavity and nasopharynx. They are most commonly found in adolescent males. Despite these facts, a case of an angiofibroma presented in a 15-month-old boy at an atypical site anterior and medial to the lacrimal sac. The tumor was resected via an endonasal, micro-endoscopic approach avoiding an external incision.

Angiofibroma↗
PubMed1997

Magnetic resonance imaging in the treatment planning of radiation therapy in carcinoma of the cervix treated with the four-field pelvic technique.

PURPOSE: To evaluate magnetic resonance imaging (MRI) in the planning of radiation therapy for patients with carcinoma of the cervix treated with a four-field technique. METHODS AND MATERIALS: Between May 1994 and February 1995, 18 patients with carcinoma of the cervix were entered in the study (1 T1 N-; 2 T2a N-; 1 T2b NO; 10 T2b N-; 2 T2b N+; 2 T3b N+). Node status was assessed by a laparoscopic pelvic lymphadenectomy. During the first step, all the patients were simulated with an isocentric four-field pelvic technique. In one group (11 patients) simulation was done based on clinical examination, computed tomography (CT), and standard guidelines. In the second group (seven patients) simulation was based on clinical examination, CT, and with the help of diagnostic MRI, which was available at that time. During the second step, MRI in treatment position with skin markings of the isocenter of the radiation fields was then performed in every patient. During the third step, in each patient, the simulated radiation fields were correlated with the MRI defined target volume by superimposing them on midsagittal and midcoronal MR images. The adequacy of the margins was arbitrarly defined as 1 cm around the MRI defined target volume (tumor of the cervix and its extension, and uterus). RESULTS: In the first group (11 patients), MRI in treatment position led to a change in 7 patients: six inadequate margins in the lateral fields and one in the anterior and lateral field. In almost all the cases, the adjustments were of an increase of 10 mm, equally matched between the anterior and posterior borders of the lateral fields. In the second group (seven patients), MRI in treatment position has led to a change in lateral fields in five patients. The mean adjustment was 10 mm: four increases (two anterior border, one posterior border, one anterior and posterior border), and one decrease of the posterior border. In the two groups, modifications of the anterior border of the lateral fields have allowed adequate margins around the uterine fundus and modifications of the posterior border have allowed adequate coverage of the cervical tumor. CONCLUSION: When treating carcinoma of the cervix with a four-field radiation technique, standard portals do not exist. The design of lateral fields has to be based on individual morbid anatomy, which is given accurately by diagnostic MRI. Magnetic resonance imaging in treatment position assesses the design of simulated lateral fields.

Adenocarcinoma↗
PubMed1997

[Early childhood angiofibroma in an unusual site].

Angiofibromas are usually characterized by their occurrences in adolescent males with a typical localization and involvement of the posterior nasal cavity and nasopharynx. Even the suspicion of an extranasopharyngeal angiofibroma or an angiofibroma in young children must be viewed in general with skepticism, although reports of angiofibromas with atypical localizations and manifestations in young children have appeared in the literature. Three cases of this fibro-vascular neoplasm with manifestations in the first decade of life and atypical localizations are presented: (1) an angiofibroma medial to the left lacrimal sac in a 15-month old boy, (2) a right paranasal localization in a 9-year-old boy and (3) an angiofibroma limited to the right sphenoid sinus in a 6-year old boy. In all three cases the neoplasm was resected via an endonasal, micro-endoscopic approach that avoided an external incision. According to the literature and based on our own experiences with typical histological findings in all three cases, the clinician has to be aware that the rare angiofibroma can occur in preadolescent children with atypical localizations. The endonasal surgical approach is without any doubt the least traumatic one and in selected cases allows resection of a circumscribed tumor considering functional and aesthetic aspects.

Angiofibroma↗
PubMed1996

[Locally developed sarcoma of the thoracic wall].

Important advances have been obtained in the care of soft tissue sarcoma in adults, mainly in the field of locoregional treatment. Surgery or combination of surgery and radiotherapy allow adequate tumor control with preservation of function for the majority of patients. However, the management of locally advanced primaries remains problematic. Moreover, although patients survival mainly depends on the metastatic risk of the disease, controversies remain in definition of pronostic factors as well as in the evaluation of the role of chemotherapy in curative therapeutical strategies. The case reported here allows a discussion of the different modalities of treatment for adults with soft tissue sarcomas and stresses the necessity of a multimodal approach in these patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

A phase I trial of repeated tumour-infiltrating lymphocyte (TIL) infusion in metastatic melanoma.

The aim of the protocol was to evaluate the side-effects induced by repeated tumour-infiltrating lymphocyte (TIL) infusions in patients with metastatic melanoma (MM). Patients were to receive four TIL infusions at given intervals: every 3 weeks (two patients), every 2 weeks (3 patients) and weekly (4 patients). All patients were evaluated and received a total of 34 TIL infusions. The total number of TILs administered varied from 0.65 to 2.34 x 10(11) cells. TIL phenotypes were predominantly CD8+ (two patients), CD4+ (4 patients), CD4+ then CD8+ (two patients) or CD56+ (two patient). Autocytotoxicity was only observed for one culture. Six patients presented at least one WHO grade 3 side-effect: hypotension (5 patients), dyspnoea (two patients), fever (one patient), fatigue (one patient), chills (two patients), diarrhoea (one patient), agitation (one patient), locoregional pain (two patients). Hypotension was constantly seen in patients who were given TILs every week. Two cases of minor pericarditis were recorded. No objective response to treatment was observed; 1 stable disease occurred in one patient and progression in eight. However, five patients presented a partial response on a tumour site for 1-4 months. Three patients presented signs of inflammation or softening at one tumour site. Plasma tumour necrosis factor alpha (TNF-alpha) levels were increased 1.2- to 22-fold after TIL infusion. TILs could be produced in sufficient quantity to perform this study, so repetitive infusions of TIL became possible on a weekly basis. However, no objective response was observed even when TIL infusions were performed weekly. An increase in circulating TNF-alpha was noted after TIL infusion.

Adolescent↗
PubMed1995

[Synovial cell sarcomas of the head- and neck area].

The synovial cell sarcoma is a malignant soft tissue tumour which mostly occurs associated with or in a large joint. To date, the histogenetic origin has been discussed controversially and there is still no agreement as to whether it arises from normal synovium of joints, tendon sheaths or bursae, specialised forms of mesenchymal tissue (arthrogenous mesenchyma) or ordinary connective tissue. The tumour rarely occurs in the head and neck region. Only about 76 cases world-wide have been described up to now. We report on a case of a 30-year old man with a synovial cell sarcoma of the temporomandibular joint and a case of a 70-year old man with a synovial cell sarcoma of the hypopharynx. In the first case, although all possible therapeutical efforts were made (radical operation, radiotherapy, chemotherapy), recurrence of the tumour occurred locally, as well as metastases in the lungs and bones. The patient died three and a half years after the initial diagnosis of the tumour. The second patient suffered multiple metastases in the lungs and bones one year after operation followed by chemotherapy. To the present time there is no general agreement on how to treat synovial cell sarcomas, but without doubt first of all radical surgical excision must be performed if possible. Additional radiation and/or multidrug chemotherapy may be useful in special cases. In our opinion every case of synovial cell sarcoma should be published because it is of importance to get to know new aspects and therapeutical possibilities of this rare disease.

Adult↗
PubMed1992

[Breast microcalcifications].

Microcalcifications of the breast are better recognized as the quality of mammographs is improving. The clinical examination and complementary modalities are often essential to evaluate their significance and point out to an indication for surgery. However, especially when the microcalcifications are detected during a systematic examination, a strict analysis of mammographs is essential. The number of useless punctures must be reduced, as their psychological impact and socioeconomic weight are already demonstrated. Although there is no consensus, most recent publications contain ideas converging on the selection of the indications for a histological control on the basis of an accurate semiological study.

Breast Diseases↗
PubMed1992

[Extramammary carcinoid tumor metastatic to the breast. Apropos of a case].

We report the case of a 42-year-woman treated for an appendicular carcinoid tumor with bilateral ovary metastases and mesenteric node involvement. After a systematic mammography, an infraclinical lesion of the breast was detected. Mammographic and echographic images revealed nodular mass with possibly malignant features. Fine-needle aspiration biopsy indicated malignancy. The definitive diagnosis of breast metastasis of a carcinoid tumor was made by biopsy. This case is related to 14 previously published cases. The authors emphasize the importance of making a precise histological diagnosis to avoid overtreatment of a metastatic lesion.

Adult↗