[Study of the cytogenotoxic effects induced by N-acylglutamic acid in mice].
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Animals↗
Biomedical subjects
Y H Hu
Publications and source records attributed to Y H Hu.
[Radiotherapy of extra-medullary plasma cell tumor--report of 13 patients].
13 patients with extra-medullary plasma cell tumor treated by radiotherapy in a Cancer Hospital from March 1958 to December 1983 are reported. The tumor occurred more frequently in the head and neck, particularly in the upper respiratory tract and oral cavity. Grossly, the majority of the tumor showed dark reddish polypoid masses with the surface bled easily. A misdiagnosis of polyp or hemangioma was usually made. The tumor is sensitive to radiotherapy. In the patients with recurrence or metastasis, retreatment is still effective, at least, palliative. The 5 year survival rate was 70%. A dose of 4,000-6,000 rad in 4-6 weeks is advised for the primary tumor.
Adolescent↗
Immediate reconstruction using visceral transfer after pharyngolaryngoesophagectomy for advanced hypopharyngeal cancer.
The management of 32 stage IV cases of cancer of the hypopharynx was reviewed retrospectively with a view of selecting a pertinent treatment modality to ensure low morbidity and high survival and evaluating the applicability of abdominal viscera as a reconstructive measure after total pharyngolaryngoesophagectomy. Three methods of visceral reconstruction have been used at this hospital, viz., reversed gastric tube, colon interposition, and stomach transposition. In our experience, the gastric pull-up is more reliable. The success rate of oral alimentation of 20 gastric pull-ups was 95% and the mortality rate was 5%. The overall 3-, 5-, and 10-year survival rate was 37.5% (12/32), 38% (8/21), and 30% (3/10), respectively. Preoperative irradiation gave a 3-year survival rate of 40% (8/20) for T4 N0-3 cases.
Adult↗
Value of computed tomography in staging the primary lesion (T-staging) of nasopharyngeal carcinoma (NPC): an analysis of 54 patients with special reference to the parapharyngeal space.
CT scans of the nasopharynx and the base of skull were performed in 54 patients with histologically proven NPC. The CT findings are compared to those obtained by routine clinical examination. In this series, involvement of the parapharyngeal spaces was found by CT scan in 61% (33/54) of patients, which is impossible to assess by clinical means. Intracranial invasion was demonstrated by CT scan with intravenous contrast enhancement in five patients. CT is more sensitive in showing the erosion of skull base than X ray film. CT scans demonstrated 17% (5/30) of bony invasion in X ray negative patients. Clinical examination showed one involved wall in nine patients; CT scan discovered involvement of two or more walls in five (55%) of these nine. Routine clinical examination discovered extra-nasopharyngeal extensions in 34 locations, whereas CT scans discovered 106, a ratio of 1:3.1. The common sites of extra-nasopharyngeal extension detected by CT scan are: parapharyngeal space, intracranial invasion, sphenoidal sinus, orbit, ethmoidal sinus, maxillary antrum, oropharynx and the nasal cavity. In T-staging of NPC, 55% (6/11) of clinical T2 lesions are up-staged by CT. Thirty-six percent (4/11) of clinical T3 lesions were also up-staged. However, 94% (17/18) of clinical T4 lesions remained unchanged. Only 6% (1/18) of clinical T4 lesions were down-staged.
Bone and Bones↗
Improved technique for the diagnosis of atypical nasopharyngeal cancer.
This article presents an improved technique for the diagnosis of atypical nasopharyngeal carcinoma tumor at deep sites beneath mucosa. It includes: 1. using spherical gauze to rub the nasopharyngeal cavity for exfoliative cytology; 2. using 1% H2O2 stain in the nasopharyngeal cavity to direct biopsy for suspected early carcinoma; 3. using multiple-hole needle puncture in the nasopharynx. These methods are simple, safe, quick, and have a high positive rate.
Biopsy↗
[Pathogenesis of pupillary upward shift after cataract extraction].
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Adult↗
Multiple-hole needle for puncture biopsy. An analysis of 420 cases.
A multiple-hole needle for biopsy was designed. Use of needle diagnoses were obtained for 420 cases. Some of these were not diagnosed previously with other biopsy methods. This report describes biopsy procedure with case presentation, showing the advantage of this technique. The overall rate of successful diagnosis by biopsy method is 90.2%, and the rate of success in the thoracic cavity is 81.6%. Only 3 pneumothoraxes developed in 125 cases of thorax puncture using the multiple-hole needle.
Adult↗
High dose rate radiosensitization: a clinical pilot study of 27 cancer patients.
In laboratory experiments, it was reported by some authors that radiation response increases with the dose rate, although other workers have reported that this relationship does not exist. Up to the present, this problem has remained controversial. The present clinical pilot study was designed with the aim of comparing the effect of high and low dose rates. The study was carried out on 27 patients who suffered from various types of malignancy. Twelve patients with advanced but relatively comparable bilateral metastases in the neck region, and 15 patients with multiple pulmonary metastatic foci were studied. Radiation was given at a high dose rate (1112 rad/min) when irradiating one side of the neck or one of the metastatic lesions in the lung, while radiation was given at a low dose rate (400 rad/min) on the opposite side of the neck or a separate lesion in the lung. All other aspects of radiation, however, were identical for all lesions. The total dose varied from 4000-7000 rad/4-7 wk. Five fractions per week and a daily dose of 200-300 rad was given. It was observed that the high dose rate gave rise to a higher radiosensitivity than the low dose rate. Tumor regression rates were calculated by measuring the dimensions of the lesions. The tumor regression rate in the high dose rate group was universally higher than that in the low dose rate group. The radiation response in the high dose rate group was about 5.2-37.6%, averaging 18%, higher than that in the low dose rate group. In conclusion, a high dose rate of radiation elicits a higher radiosensitivity, and hence, a possible higher cancericidal effect.
Adolescent↗
Pregnancy and nasopharyngeal carcinoma: a prognostic evaluation of 27 patients.
In order to study the influence of pregnancy on the prognosis of nasopharyngeal carcinoma (NPC), we have retrospectively studied 27 patients who either were discovered to be pregnant during radiotherapy (9 patients, herein abbreviated as concurrent group) or became pregnant after treatment (18 patients, herein abbreviated as subsequent group). This material was collected from the 811 NPC patients treated in our hospital from March 1958 to 1972. The results obtained are presented as follows: Concurrent pregnancy had a disastrous effect on the prognosis of NPC patients giving a five year survival of only 11% (1/9). Of the eight patients who died, six did so within one year of the treatment, five of whom died of distant metastases. This fatal outcome was not altered by any measure we instituted. This adverse influence was not observed in the subsequent group, yet the time of gestation seemed to be relevant to the prognosis. Two of the three patients who became pregnant within one year of the treatment died of disease, those who became pregnant beyond the second year after irradiation had the best prognosis. All seven patients who became pregnant after the second year of treatment survived. The frequency of pregnancy did not influence the prognosis of patients if the conception occurred beyond the second year in the subsequent group. All the five patients who gave birth to two, three or even four children survived for more than five years without any evidence of tumor. A total of 21 children were born to the patients of these two groups. They have been followed regularly for 10 to 20 years. No deformity, or retardation in growth or mentality was discovered, nor was there any evidence of radiation tumor or leukemia observed.
Carcinoma↗
Influence of biopsy on the prognosis of nasopharyngeal carcinoma--a critical study of biopsy from the nasopharynx and cervical lymph node of 649 patients.
Most of the nasopharyngeal carcinomas (NPC) are histopathologically either poorly differentiated or undifferentiated. After radiotherapy, hematogenous spread is the chief cause of failure for these patients. Biopsies taken from the nasopharynx or the enlarged neck nodes should be performed to establish diagnosis before radiotherapy. The present study was done to ascertain whether the biopsy procedure would affect the final outcome of this malignancy, and to establish certain criteria for clinicians as they endeavor to correctly diagnose and prepare the patients for treatment. Six hundred and forty-nine of 702 NPC patients treated in our hospital from March 1958 through 1972 were analyzed for this purpose and the results are as follows: For patients with fixed and partially fixed neck nodes, the interval between the first biopsy and radiotherapy, the number of times or frequency of biopsy either taken from the nasopharynx or the lymph node and the type of biopsy done on the lymph node did not influence the prognosis. For patients with or without only movable neck nodes, the interval between the first biopsy from the nasopharynx and radiotherapy influenced the final outcome. Patients who received radiotherapy within 14 days after biopsy had a five year survival of 61% (42/69), which is better than that of the patients who started their treatment beyond the 15th day (47.5%-58/122). This is statistically significant (p less than 0.05). The number of times or frequency of biopsy taken from the nasopharynx before radiotherapy did not influence the result of treatment. The interval, therefore, and not the frequency, is important in the biopsy from the nasopharynx. For patients with movable lymph nodes, partial excision of the node gave a poorer five year survival (22%-2/9) than that of patients on whom complete excision was done (50%-9/18). Therefore, complete excision of the node is advised for patients with movable neck node metastasis.
Biopsy, Needle↗
Lymph node metastases in the neck from an unknown primary. Report on 113 patients.
A series of 113 patients with cervical lymph node metastases from an unknown primary tumour is reported. The 5-year survival was 5 per cent after chemotherapy and 37 per cent after irradiation. The factors relevant to the prognosis after irradiation were the location of the mass and the total dose given. The prognosis was better if the mass was located in the neck than in the supraclavicular fossa. It is recommended that most patients with metastases in the upper or middle part of the neck from an unknown primary be radically irradiated with extended fields including nasopharynx, oropharynx, hypopharynx, and the opposite upper part of the neck in addition to the side with metastases. The tumour dose should preferably be higher than 50 Gy. With this policy it was possible to obtain a 5-year survival in about 50 per cent in a series of Chinese patients, which is quite comparable with the result of surgery. In the series reported, the primary lesions were detected during follow-up in only 6 per cent of the cases.
Adolescent↗
Radiation therapy of recurrent nasopharyngeal carcinoma. Report on 219 patients.
Recurrent nasopharyngeal carcinoma (NPC), if left untreated, has a 5-year survival of less than one per cent. In contrast, the overall 5-year survival in a treated series of patients was 18 per cent. Excluding those with distant metastases at the beginning of the retreatment, the 5-year survival was 23 per cent. If the recurrence was limited to the neck, a 5-year survival of 34 per cent was obtained and if it was confined to the nasopharynx the 5-year survival was 25 per cent. High doses (about 60 Gy), using multiple narrow beams, carefully directed, were required. For recurrences in the neck, lymph node dissection supplemented by a lower radiation dose should be considered. Surgery was sometimes the only possible method for cure, when recurrence occurred in the neck nodes. Recurrences in the neck, especially when repeatedly appearing, most often were combined with a local recurrence in the nasopharynx.
Humans↗
Radiation treatment of carcinoma of the oropharynx. Report on 201 patients.
The prognosis for 201 patients with carcinoma of the oropharynx, treated mainly by irradiation, was analyzed. The crude 5, 10, 15 and 20 year survival rates were 50.3 per cent, 36 per cent, 26 per cent, and 17 per cent respectively, and the corresponding cure rates 44, 35, 26 and 17 per cent respectively. Patients under 50 years of age had a better 5 year survival than those over 60 years. The poorly differentiated and the anaplastic carcinomas had a better prognosis than the well differentiated lesions. Early stages had a much better prognosis than advanced lesions. Split course and continuous course irradiation gave similar results. The optimum dose range was 60 to 70 Gy. Early disappearance of the primary tumor during radiation therapy was prognostically favourable.
Adolescent↗
Serologic diagnosis of nasopharyngeal carcinoma. A double-blind study of four EB virus antibodies with evaluation by sequential discrimination.
It is generally known that a close relationship exists between Epstein-Barr Virus (EBV) and nasopharyngeal carcinoma (NPC). Recently, patients with early lesions of NPC have been detected in the general population by use of serologic mass survey. Using the double-blind method, we have studied the diagnostic value of the four EBV antibody titers, VCA-IgA, VCA-IgG, EA-IgA and EA-IgG, in four groups of subjects, each consisting of 50 persons: patients with nasopharyngeal carcinoma (NPC group), patients with cancers other than NPC in the head and neck regions (HNC group), patients with cancers outside of head and neck regions (OC group) and normal individuals (NS group). The results of these four antibodies were evaluated both singularly and together by multivariate sequential discrimination. Taking 1:10 as the criterion of being positive, in the NPC group, the positive rate of VCA-IgA is 88%, the VCA-IgG rate is 100%, the EA-IgA rate is 48% and the EA-IgG rate is 74%. In the non-NPC group, the positive rates of VCA-IgA are as high as 86%-92%, but those of the other antibodies are as low as 0-42%. The positive rates and the geometric mean titers of these four antibodies were all elevated as compared with those in the three non-NPC groups. These differences are statistically significant. VCA-IgG is unimportant in the diagnosis of NPC because of its low specificity. By treating the antibody titers of VCA-IgA, VCA-IgG, EA-IgA and EA-IgG with sequential discrimination, the correlation rate between the serology and pathology of NPC is 88% and the false positive rate is 7.3%.
Adolescent↗
Comparison of pre- and postoperative radiation in the combined treatment of carcinoma of maxillary sinus.
A series of 50 patients with cancer of the maxillary sinus treated by either preoperative or postoperative radiation from February, 1958 to June, 1974 is presented. In the postoperative group the patients were either free from recurrence, of if there was recurrence, the tumor was less than 0.5 cm in diameter. In the preoperative group, 23 of 36 patients survived for more than five years (64%). In the postoperative group, 4 of 14 patients survived for more than five years (26%). There is an obvious superiority in the preoperative radiation group. The surgical complication rate in the preoperative group was 29% as compared to 14% in the postoperative group. Although the incidence of complications in the preoperative group is higher, we believe it is worth attempting in clinical practice because of the more favourable survival rates.
Adult↗
[Lymphadenectomy as a definitive management of the residual lesion in the neck after radiotherapy for nasopharyngeal cancer -an analysis of 48 cases (author's transl)].
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Humans↗
Many ways to health: a study of 2,000 rural and urban Taiwan families.
Over two years the authors led a massive, government-supported survey of 2,000 Taiwanese families, half urban and half rural, to determine what actions the family would take when faced with disease or health problems. The major alternatives of folk healing, Chinese traditional medicine, and Western-oriented approaches were found to be frequently combined, and often supplemented by self diagnosis and self-medication. Thirty Chinese students entered the 2,000 families' homes for lengthy interviews covering a wide range of socio-demographic variables as well as medical behaviors. Cooperation of informants was outstanding, and the plentiful data from this large sample should provide ample ground for future studies and interpretations. The statistics substantially documented some findings suggested by earlier researchers: (a) that 90% of Taiwanese families combine a variety of approaches in warding off and treating illnesses (1); (b) that there is somewhat higher reliance on purely Western methods among young urban nuclear families, and among mainland-born Christians, than in the rural areas (2); and (c) that Taiwanese families avoid bringing mental health problems to medical or psychiatric health facilities (3). The statistics bear out some fairly predictable conclusions, such as: (a) Western medical methods are known and used more widely in the city than in the country (cf. "a" below); (b) there is more ignorance of facilities and medicines of all kinds in the country than in Taipei; and (c) traditional Chinese medicine is somewhat more used in the country than in Taipei. In addition, some fairly startling new developments are worth noting, including that (a) there is less rural/urban difference than expected--97-99% use some Western methods at some times; (b) while almost no one relies solely on folk healing, more city-dwellers use it (as well as massage and acupuncture) than do rural folk; and (c) urban families often go to private doctors, ignorant of their local public health stations.
Adult↗
Value of postoperative radiotherapy for thyroid cancer.
A series of 405 patients with thyroid cancer treated by surgery with or without postoperative radiotherapy from February 1958 through 1979 is reported. The immediate evaluation of the operation was that it was either incomplete or complete. Incomplete surgery implied that there was (1) possible residual tumor in the operative field, the result of difficult dissection of the tumor off the neighboring organs or tissues, as assessed by the surgeon; (2) multiple (more than five) lymph nodes involved; (3) positive border of the removed lesions; or (4) microscopic evidence of tumor in the operative field. Complete surgery implied through extirpation of cancer grossly and microscopically. In 297 patients who had complete surgery, 238 patients treated by surgery alone had a 5-year survival rate of 92% (218/238), while 59 patients who received postoperative radiotherapy had a 5-year survival rate of 78% (46/59). The optimum dose of postoperative radiotherapy was 50-70 Gy in 5 to 8 weeks, with the spinal dose kept under 40 Gy. Our experience shows that postoperative radiotherapy did not improve the survival of patients who had had complete surgery. Yet, in 108 patients who had incomplete surgery, surgery alone yielded a 5-year survival rate of 33% (19/57), while surgery plus radiotherapy yielded a 5-year survival of 71% (36/51). Our observation shows a remarkable benefit with postoperative radiotherapy in patients who have had incomplete surgery (P less than 0.05). According to pathologic criteria, postoperative radiotherapy was more effective in well-differentiated cancers than in poorly differentiated ones. It was equally effective in untreated as well as recurrent lesions. The prognosis for younger patients was better, but the sex of the patients did not affect prognosis.
Adolescent↗