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At least 379 records · Page 21Linked to original sources
PubMed2004

13-cis retinoic acid in head and neck cancer chemoprevention: results of a randomized trial from the Italian Head and Neck Chemoprevention Study Group.

Patients with squamous cell carcinoma of the head and neck (HNSCC) after being treated radically remain at high risk for both recurrent and second primary tumours. 13-cis retinoic acid (13-cRA) was demonstrated to reverse pre-malignant lesions of the oral cavity and to reduce the incidence of second primary tumours in patients treated radically for HNSCC. Synergism between retinoids and interferon in tumoural cell lines have been demonstrated. Based on these data, the Italian Head and Neck Chemoprevention Study Group started a randomized chemoprevention study in patients radically treated for stage III and IV HNSCC. From February 1992 to January 1996, 267 patients were randomized: 126 were allocated to the control group, 126 were randomized to receive 13-cRA at a dose of 0.5 mg/kg per day per os and 15 patients have been assigned to the group of 13-cRA plus interferon alpha2a (IFN-alpha2a) at a dose of 3,000,000 UI 3 times a week (randomization in this arm interrupted due to administrative financial problems). The mean follow-up was 39 months. The 5-year actuarial survival was 58.9% for patients of the 13-cRA group and 57.2% for those of the control group (P=0.94). Among evaluable patients, disease progression was observed in 45 of 123 patients (36.6%) of the 13-cRA group and in 42 of 124 (33.9%) of the control group. The 5-year actuarial relapse-free survival was 48.9% for the 13-cRA group and 55.6% for the control group (P=0.62). Adverse effects, mostly of grade I were reported in 69.4% of treated patients (haematologic disorders, mucositis, conjunctivitis, cutaneous toxicity, hypertriglyceridemia and hypercholesterolemia). Only 5 patients (4.1%) reported grade III-IV toxicity. Low-dose of 13-cRA given for 1 year is ineffective as chemoprevention in patients with radically treated HNSCC.

Adult↗
PubMed1990

[Chemosensitivity testing of anticancer agents in head and neck tumors. I: Comparison between head and neck squamous cell cancers and thyroid cancers].

In vitro chemosensitivity was evaluated in 28 patients with head and neck squamous cell carcinomas (12 pharyngeal cancers, 7 oral cavity cancers, 4 laryngeal cancers, 4 maxillary sinus cancers and 1 esophageal cancer) and 19 patients with thyroid cancer. Tumor fragments obtained at biopsy or surgery were exposed to anticancer drugs and assayed for succinate dehydrogenase (SD) activity. The average of SD activity in squamous cell carcinomas was 63.2% for 5-FU, 24.6% for HCFU, 26.1% for CDDP, 41.0% for ADM, 28.4% for THP-ADM, 27.1% for ACR, 27.4% for CQ and 45.3% for VLB. In thyroid cancers, the average SD activity was 73.9% for 5-FU, 16.7% for HCFU, 32.6% for CDDP, 48.3% for ADM, 38.3% for THP-ADM, 57.3% for ACR, 39.0% for CQ and 75.3% for VLB. The SD activity inhibition rate by anticancer drugs was larger in cases of head and neck squamous cell carcinomas than in cases of thyroid cancers except for HCFU. Higher sensitivity to each antitumor drug detected in cancer tissues from metastatic lymph-nodes than in tissues from primary lesions needs further investigation.

Antineoplastic Agents↗
PubMed1989

[The femoral neck pseudarthrosis following medial femoral neck fracture. An indication for the vascularized pedicled iliac crest transplant].

Revascularisation surgery was performed in six cases following medial femoral neck fracture with femoral head necrosis and non-union of the femoral neck. A corticospongiosis pelvic graft supplied by the deep circumflex iliac artery was implanted as an autologous heterotopic pedicled transplant. The operative procedure was the same in all cases, since it was possible to lift out the pelvic graft from the same side as the affected hip joint, thus making a microvascular anastomosis unnecessary. Follow-up examination after 15-27 months revealed that, in all cases, osseous consolidation of the pseudarthrosis had been achieved and that further segmental collapse of the contour of the femoral head had been prevented. The angiographic studies performed during the examination demonstrated unimpeded circulation in the pedicle of the transplants in five of the six cases, as long as 3 months after the operation. For the first time it was possible in these five cases, by means of a transplant angiograph, to demonstrate integration of the graft into the biologically weak post-traumatic transplant region.

Bone Transplantation↗
PubMedDate not supplied

Evaluation of three methods for measurement of femoral neck anteversion. Femoral neck anteversion, definition, measuring methods and errors.

A variety of methods exist for determining femoral neck anteversion. There is, however, no consistent definition or reference method by which the correctness of the measurements can be determined. In this report the precision of a specific definition of femoral neck anteversion is estimated by means of a reference method. Three different radiologic measuring methods based on fundamentally different principles are evaluated by comparison with this reference. It is concluded that: 1) The Dunlap/Rippstein method can be recommended as the standard method. 2) Computed tomography may have substantial sources of error. 3) Methods based on arbitrary projections have poor precision.

Femur Neck↗
PubMed1985

[Cases of head and neck carcinoma detected by sputum cytology--lung cancer screening and head and neck cancer].

Seven cases of head and neck carcinoma are presented. They were first noticed by sputum cytology, which was ordered to check lung cancer because of hemosputum (three cases), or in a general check-up of asymptomatic individuals. None of them had lung cancer, and three were found to have piriform sinus carcinoma, two mesopharynx carcinoma, and two vocal cord carcinoma. All seven cases were histologically diagnosed as squamous cell carcinoma. Their clinical stages were as follows; T 1 N 0, three cases; T 1 N 1, one case; T 2 N 0, two cases; T 2 N 1, one case (UICC 1978). These cases remind us that positive sputum cytology is not only a sign of lung cancer, but also of other upper aerodigestive tract malignancies. Sputum cytology may be useful for checking asymptomatic head and neck cancer patients, though it is still too costly and time-consuming to be applied to mass screening.

Adult↗
PubMed1980

The malignant gland in the neck as a presenting sign in head and neck cancer.

A retrospective study of 262 patients with malignancy in the head and neck was undertaken. 15.6 percent of these patients presented with a metastatic gland in the neck as the only symptom. Forty-four percent of the nasopharyngeal tumours presented solely with a metastatic cervical node; as did 26 percent of hypopharyngeal tumours and 24 percent of tumours of the oropharynx. The problem of a patient presenting with a suspected malignant cervical gland as the only symptom is one which demands careful evaluation.

Carcinoma, Squamous Cell↗
PubMed1996

Does neck stage predict local control after irradiation for head and neck cancer?

The impact of neck stage (N stage) on local control after treatment for head and neck cancer is controversial. This article reviews the pertinent literature. Based on this review, the authors conclude that although N stage may be inversely related to local control, the relationship is relatively weak. Hence, current data are insufficient to justify altering treatment of the primary lesion based solely on N stage.

Head and Neck Neoplasms↗
PubMed1998

[Early phase II study of S-1 in patients with advanced head and neck cancer. S-1 Cooperative Study Group (Head and Neck Working Group)].

In developing new anticancer agents, the most important thing is the balancing of antitumor activity and toxicity. To achieve high activity and low toxicity, S-1 was designed, in which tegafur, prodrug of 5-FU, was combined with two classes of modulators. CDHP, inhibitor of 5-FU degradation in liver and Oxo, inhibitor of 5-FU phosphoribosylation in digestive tract, respectively. This cooperative study with 15 nation-wide institutes was conducted to evaluate the antitumor activity and toxicity of S-1 in patients with advanced head and neck cancer from Jan. 1994 to March 1996 in Japan. Out of 26 patients, CR was achieved in 1 and PR in 11 with a response rate of 46.2%, while adverse events of grade 3 were as follows: hemoglobinemia (7.7%), leukocytopenia, neutropenia, stomatitis and anorexia (3.8%), each. Neither grade 4 adverse event nor treatment-related deaths were observed. Based on these findings, it was concluded that S-1 is a useful anticancer agent with the low grade toxicities for treatment of the patients with advanced head and neck cancer, and the effects of CDHP and Oxo found in preclinical studies might be also reflected in these results.

Administration, Oral↗
PubMed1994

[Rare complications of soft tissue infections in the head and neck area: deep neck phlegmona, thrombophlebitis and mediastinitis with pericardial effusion].

Cervical phlegmona is a rare occurrence associated with infections of the ENT region. Spreading of the infection can cause thrombophlebitis, mediastinitis and cardiac tamponade. Three recently treated patients are reported who showed serious complications due to harmless primary infections of the oral cavity, oropharynx or throat. The clinical course of the diseases with the sometimes difficult examinations undertaken and the performed treatment are outlined. Computed tomography and radiography of the lung were useful in confirming the diagnosis, establishing that the infection had spread into deep neck spaces and into the mediastinum. Surgical therapy including extensive surgical drainage of the deep neck spaces and of the mediastinum, multiple antibiotic therapy, and intensive care, resulted in survival of the patients.

Adult↗
PubMed2005

Human papillomaviruses in lymph node neck metastases of head and neck cancers.

CONCLUSION: The results of this study corroborate earlier findings that human papillomavirus (HPV)16 is the most prevalent type of HPV in squamous cell carcinomas of the head and neck (SCCHNs) and reinforce a possible influence of HPV on SCCHN progression by showing that the majority of HPV-positive patients harbor HPV16 (or HPV33) both in their primary tumors and in lymph node neck metastases (LNNMs). OBJECTIVE: HPVs are causally associated with carcinomas of the uterine cervix and have also been linked to a subset of SCCHNs. In order to further investigate the predicted causative role of HPV in SCCHNs, we analyzed pairs of primary tumors and LNNMs or LNNMs alone for the presence of HPV DNA using polymerase chain reaction (PCR). MATERIAL AND METHODS: DNA was extracted from fresh frozen tissue samples of primary tumors and the corresponding LNNMs of 18 patients and from LNNMs alone in 17 patients. For the detection and typing of HPV, PCR was performed using both type-specific and consensus primer pairs, followed by Southern hybridization and, in selected cases, sequencing of the PCR products. RESULTS: Of the 35 patients investigated, 22 (63%) were found to have HPV DNA in their tumors: HPV16 DNA in 21 cases and HPV33 in 1. The highest HPV prevalence was detected in tumors of Waldeyer's tonsillar ring (8/9 patients; 89%). Of the 18 patients in whom primary tumors and LNNMs were analyzed, 7 (39%) were HPV-positive in both samples (HPV16, n = 6; HPV33, n = 1), in 3 (17%) the primary tumors were HPV-negative and the LNNMs HPV16-positive and in 1 (5.5%) the primary tumor contained HPV16 and the LNNM was negative. Interestingly, of the 7 patients in whom LNNMs had been detected only several months after diagnosis and treatment of the primary tumors, only 1 showed infection with HPV (HPV33).

Adult↗
PubMed1999

Bladder neck suspension using percutaneous bladder neck stabilization to the pubic bone with a bone-anchor suture fixation system: A new extraperitoneal laparoscopic approach.

A 39-year-old woman with type 1 genuine stress urinary incontinence was treated using a novel extraperitoneal laparoscopic bladder neck suspension procedure with a bone-anchor suture fixation system. Operative time and blood loss were 2.5 and 50 g, respectively. The patient showed a remarkable improvement on chain cystography and in subjective and objective well-being with no complications, even 12 months after surgery. Extraperitoneal laparoscopic bladder neck suspension using the bone-anchor suture fixation system is an easy and feasible procedure.

Adult↗
PubMed2004

Management of N0 neck in head and neck cancer: current controversies.

Squamous cell carcinomas of the upper aerodigestive tract are characterized by a high frequency of lymphogenic metastatic spread. The neck should be included in the treatment concept because almost 25% of all patients develop occult lymph node metastases. The only exception are early carcinomas of the lower lip and the vocal cords. Since currently for high risk patients no prognostic markers or other factors for occult metastatic spread are available, treatment strategies have to include the exact knowledge of direction and extent of regional lymphatic drainage. Based on this prerequisite, concepts for selective cervical lymph node dissection in case of the clinical N0 situation were developed which may also be used for an individually optimized radiotherapy. Intensity modulated radiotherapy (IMRT) bears a high potential for an optimized irradiation in case of potential occult metastatic spread of carcinomas of the upper aerodigestive tract. Without compromising local control rates IMRT allows a considerable reduction of permanent xerostomia by sparing at least one major salivary gland. The significant scientific purpose for the N0 neck, however, will remain the identification of high-risk patients, e.g. by means of tissue and/or serum-related markers, which carry a high risk of local and distant metastases.

Carcinoma, Squamous Cell↗
PubMed2006

Surgical modifications in bladder neck reconstruction and vesicourethral anastomosis during radical retropubic prostatectomy to reduce bladder neck contractures.

PURPOSE: We describe surgical modifications in radical retropubic prostatectomy (RRP) which have significantly reduced the incidence of bladder neck contractures (BNC). MATERIALS AND METHODS: Between March 1994-July 2005, 977 men underwent a RRP by a single surgeon. Group I comprised 548 patients operated upon July 1994-December 1999, without the modifications described below. Group II comprised 429 men operated upon January 2000-December 2004, with the following surgical modifications: 1) reconstruction of the bladder neck (BN) to a diameter of 28 French; 2) placement of the posterior (6 o'clock) vesicourethral suture on mild traction before placing this suture into the bladder, allowing inspection and, if necessary, replacement of any of the previously placed sutures; 3) bladder displacement when tying the vesicourethral sutures which allows the sutures to be tied under direct vision and prevents incorporation of extraneous tissue. Data were retrospectively analyzed. RESULTS: Demographic data were comparable between groups. In group I, 31/548 (5.7%) developed a BNC compared to 1/429 (0.2%) in Group II, p < 0.001. Urinary continence (no pads/maximum of one light pad for security in 24 hours) at 12 months in the 32 patients who developed a BNC was worse when compared to patients who did not develop a BNC (58% versus 80%, p = 0.003). After excluding the patients who developed a BNC, continence rates were comparable between both groups. The positive margin rate at the BN was not adversely affected by these modifications. CONCLUSIONS: Simple, easily applied modifications to the management of the BN and vesicourethral anastomosis can substantially reduce the incidence of BNC.

Adenocarcinoma↗
PubMed2006

Reductions in degree of mineralization and enzymatic collagen cross-links and increases in glycation-induced pentosidine in the femoral neck cortex in cases of femoral neck fracture.

INTRODUCTION: Enzymatic and glycation-induced nonenzymatic cross-links play important roles in the expression of bone strength. The cross-link pattern is affected by tissue maturation and senescence. The aim of our study was to understand the distinctive posttranslational modifications of collagen in areas with different degrees of mineralization with and without hip fracture. METHODS: Sixteen female cases of intracapsular hip fracture (78+/-6 years) and 16 age- and gender-matched postmortem controls (76+/-6 years) were included in this study. A sample of each femoral neck cortex was fractionated into low (1.7 to 2.0 g/ml) and high (>2.0 g/ml) density portions. The contents of enzymatic cross-links (dihydroxylysinonorleucine, hydroxylysinonorleucine, lysinonorleucine, pyridinoline, and deoxypyridinoline) and nonenzymatic cross-links (pentosidine) and the extent of lysine (Lys) hydroxylation were determined in each fraction. RESULTS: In the controls, there was no significant difference in the contents of enzymatic cross-links between low- and high-mineralized bone fractions whereas pentosidine content was significantly higher in high-mineralized bone compared with low-mineralized bone (p=0.0014). When comparing enzymatic cross-link contents between controls and fracture cases, a trend toward lower (p=0.0961) cross-link content in low-mineralized bone and a significant reduction (p<0.0001) in high-mineralized bone were observed. Pentosidine content of low-mineralized bone was significantly higher in fracture cases than in controls (p<0.0001). The extent of Lys hydroxylation was significantly higher in fracture cases than in controls (p<0.001). The higher hydroxylation of Lys in collagen from fracture cases relative to controls was associated with significantly higher values of hydroxylysine-derived cross-link such that the enzymatic cross-link patterns correlated with the extent of Lys hydroxylation in the collagen molecules. CONCLUSIONS: These results suggest that reductions in the degree of mineralization and enzymatic cross-links and excessive formation of pentosidine may play an important role in explaining poor bone quality in osteoporosis.

Aged↗
PubMed2004

Are patients with a nonunion after a femoral neck fracture more osteoporotic than others? BMD measurement before the choice of treatment?: A pilot study of hip BMD and biochemical bone markers in patients with femoral neck fractures.

The incidence of nonunion is high after a femoral neck fracture. If reliable predictors were available, fractures that heal well could be subjected to internal fixation while fractures that do not could undergo an arthroplasty. In this pilot study of 28 patients, those with a low hip BMD on admission had a higher risk of developing non-union.

Absorptiometry, Photon↗