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Biomedical subjects

M P Hier

Publications and source records attributed to M P Hier.

11 recordsLinked to original sources
PubMed2001

Skin metastases in squamous cell carcinoma of the head and neck.

UNLABELLED: Distant metastases in squamous cell carcinoma of the head and neck (SCCHN) are most often to the lung, liver, and bone. SCCHN rarely metastasizes to skin sites. OBJECTIVE: To ascertain the significance of skin metastases (SM) on the prognosis of patients with SCCHN. METHODS: A retrospective review of all patients between 1987 and 1999 with SCCHN was conducted. Patients in whom SM developed were identified. Data pertaining to demographics, primary tumor staging, SM development, and outcome were investigated. RESULTS: In 798 consecutive patients diagnosed with SCCHN between 1987 and 2000, 19 developed SM. The average time of onset of the SM was 17.65 months. The average survival time was 7.2 months after the development of SM. The overall survival time of patients who developed SM from the initial presentation of the primary tumor was 24.85 months. The 1-year survival rate from the time of development of SM was 0%. CONCLUSIONS: Metastasis to skin sites is an uncommon feature of SCCHN. SM may represent the first clinical evidence of impending loco-regional recurrence or distant metastasis. The development of SM is an ominous sign associated with an extremely poor prognosis, similar to the development of distant metastasis at more typical sites. Both the development of SM and survival of patients developing SM are independent of primary tumor stage. Current treatment options of SM are limited in their efficacy.

Carcinoma, Squamous Cell↗
PubMed2001

An aggressive approach to the surgical management of suspicious thyroid nodules.

Thyroid cancer accounted for about 2.5% of all new cancers among Canadian females in the year 2000. The surgical management of well-differentiated thyroid cancer remains controversial. We reviewed 100 consecutive cases of total thyroidectomy for thyroid masses suspicious for malignancy done between 1998 and 1999. When feasible, a capsular dissection was performed using only the bipolar cautery for hemostasis. The accuracy of preoperative diagnosis and complications of surgery are evaluated. We suggest that total thyroidectomy can be performed, without excessive morbidity. If performed for all suspicious thyroid nodules, it will eliminate the need for completion thyroidectomies and high ablative does of 131I.

Adenocarcinoma, Follicular↗
PubMed2000

Squamous cell carcinoma of the nasal vestibule.

Squamous cell carcinoma of the nasal vestibule is a rare disease. Most advocate radiotherapy as a primary treatment for early tumours, with surgery reserved for salvage. For advanced disease, combined therapy with surgery and postoperative radiotherapy is generally recommended. Fourteen patients with squamous cell carcinoma of the nasal vestibule were reviewed. A classification of early versus late lesions was used. We achieved a 78% local regional control rate (minimum follow-up 3 years) in patients with early disease, with either radiotherapy or surgery as a primary modality of treatment. All patients with late disease recurred, requiring further surgical and/or radiation treatment. Only 20% of these patients were disease free at 2 years. Recurrent disease in either group, whether local or regional, carried a grave prognosis, with a 25% disease-free survival at 3 years.

Adult↗
PubMed1999

Fibromatosis.

Fibromatosis represents a diverse group of fibroproliferative tumours. Their behaviour and pathological qualities are situated in an intermediate position between benign and malignant disease. The following represents the pathological and radiological presentation of a 29-year-old female with fibromatosis.

Adult↗
PubMed1998

Electroporation therapy of head and neck cancer.

The purpose of this paper is to introduce the concept of electroporation therapy and present our results from using this new technique combined with intralesional bleomycin in head and neck cancer patients. Electroporation therapy is a technique wherein high-voltage electric impulses delivered into a neoplasm transiently increase cell membrane permeability to large molecules, including cytotoxic agents. In this phase I/II study, extremely low-dose bleomycin sulfate was electroporated into head and neck malignant neoplasms in 10 patients. Tumor responses included 2 nonresponders, 3 partial responders, and 5 complete responders, with a mean follow-up of 40 weeks. We conclude that this technique offers promising possibilities in the local treatment of head and neck cancer.

Adult↗
PubMed1997

Generation of therapeutic T cells from draining lymph nodes in a murine model of head and neck squamous cell carcinoma.

OBJECTIVES: To study immunotherapy for advanced head and neck squamous cell carcinoma using AT-84, a spontaneously arising murine tumor. We examined the draining lymph nodes (DLNs) for generation of potential therapeutic lymphocytes in head and neck squamous cell carcinoma. DESIGN: Experimental randomized control trial. INTERVENTION: Therapeutic T cells from DLNs were generated by the sequential activation of the in vivo-primed DLN cells with 2C11, and anti-CD3 antibody, and interleukin-2 (IL-2). Immunotherapy of mice bearing lung metastases was carried out in various experiments with low-dose systemic IL-2 and activated DLN cells. Using a 4-hour radioactive chromium Cr 51 release assay, in vitro cytotoxicity of these cells also was examined. RESULTS: Mice immunized with this tumor failed to reject the growth of a subsequent challenge with the tumor. Immunotherapy with low-dose systemic IL-2 resulted in a mean reduction of 79% in the number of lung metastases. Adoptive immunotherapy with activated DLN cells was effective in all experiments, with a mean reduction of 59% in the number of metastases in immunodeficient mice. However, DLN cells were not directly cytotoxic to the tumor cells in in vitro assays, unlike control lymphokine-activated killer cells. CONCLUSIONS: AT-84 is a nonimmunogenic tumor similar to many human malignant neoplasms, making this a suitable model for immunotherapy. Low-dose systemic IL-2 was effective in reduction of established metastasis in this model. Activated DLN cells show reproducible in vivo therapeutic efficacy despite lack of in vitro cytotoxicity. Use of DLN cells as sources of therapeutic T cells in patients with head and neck squamous cell carcinoma deserves exploration because they are readily obtainable and because conventional treatment is of limited benefit.

Animals↗
PubMed1996

Collapsed nasal-valve widening by composite grafting to the nasal floor.

OBJECTIVE: The primary aim of this article is to provide surgeons with a "how to do it" approach to surgically increase the widest diameter of the nasal valve. METHOD: An approach utilizing a composite graft from the aural concha to the nasal floor is described, with a brief report of the postoperative results in 13 cases. RESULTS: An objective, measurable improvement in nasal-valve aperture was demonstrated in 77% of operated cases, with 77% of patients indicating a good to excellent rating in satisfaction with the procedure. CONCLUSION: With minimal scarring and no excisions of supporting structures involved, this method has proved to be effective in the repair of nasal-valve narrowing.

Adult↗
PubMed1995

A murine model for the immunotherapy of head and neck squamous cell carcinoma.

A murine model for the immunotherapy of head and neck cancer was established. The AT-84 tumor, a spontaneously arising oral squamous cell tumor of C3H mice, was evaluated for susceptibility to lymphokine-activated killer (LAK) cells. In vitro chromium-release assays demonstrated that AT-84 is sensitive to LAK-cell-mediated killing. Furthermore, in vivo experiments employing a lung metastasis model demonstrated a 50% reduction in the number of metastases in LAK-cell-treated mice as compared with untreated controls (P2 = .001). These experiments showed that AT-84 is an appropriate model for the immunotherapy of head and neck cancer. This model should be invaluable for further study of the mechanisms involved in immune-mediated therapy of head and neck cancer.

Animals↗