Biomedical subjects
Publications and source records attributed to P Dor.
The authors are describing a case of clear cell renal epithelioma metastasizing in the thyroid gland; the clinical course and the histological appearance were consistent with a primary carcinoma of the thyroid gland of the undifferentiated large cell type.
Needle biopsy is preferable to open biopsy for several reasons; no tumor spread, no inconvenient scars hampering future surgical intervention, no delay between diagnostic procedure and definitive therapy as well as its simplicity. A conclusive histological diagnosis of malignancy is only made in 70 to 80% of the cases by this technic. In the other cases however, the macroscopic and microscopic aspect usually very strongly suggests the nature of the disease. When a definite diagnosis of malignancy cannot be made this way an open biopsy is mandatory and to be performed under general anesthesia by a surgeon who is able to proceed immediately with the appropriate surgical therapy as soon as a peroperatory positive histological diagnosis is obtained. The classical therapy consists of a unilateral or bilateral radical neck dissection with or without resection of the primary tumor. The postoperative follow-up is usually simple. The incidence of postoperative complications is higher when the cervical region has been irradiated with a dose equal or higher to 5,500 tumor rads or when the larynx, pharynx and/or buccal cavity have been entered.
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One hundred and twenty-six patients underwent a mandibular resection (segmental or marginal) as a part in the treatment of a malignant lesion. The surgical morbidity is increased by the preoperative high-dose irradiation. Complications such as osteitis and/or fracture of the mandible were noted in 31 cases (a total of 80) who underwent a preoperative external irradiation with a tumor-dose of 5,500 rads or higher, whereas only in 8 cases (a total of 46) without such preoperative radiotherapy. Prophylactic antibiotics, the use of flaps to replace the buccal mucosa without any suture-tension, replacement of the mandible by a low profile stainless steel prosthesis are advocated to reduce these postoperative complications.
A survey of 27 604 sujets aged mostly between 17 and 19 revealed that 33.5% of them had a regular nasal obstruction and that 13.6% repeated sneezing fits. Prevalence of nasal manifestations related to an allergy to graminaceae pollen was estimated at 5%. Besides there was a close relationship between the chronic nasal symptomatology and the smoking habits of the subjects concerned.
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