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Biomedical subjects

A B Karim

Publications and source records attributed to A B Karim.

11 recordsLinked to original sources
PubMed1992

[Neck lymph node dissection in squamous cell carcinoma originating in the head-and-neck area; the significance for the prognosis].

Neck dissection has a therapeutical as well as a prognostic relevance with respect to regional recurrence and distant metastases. Between January 1973 and July 1986 576 neck dissections in 511 patients (396 men, 115 women, among whom 486 with squamous cell carcinoma of the head and neck, and 14 with neck metastases of an unknown primary tumour) were performed at the department of Otolaryngology-Head and Neck Surgery of the Free University Hospital, Amsterdam. Patients with tumour at the margins were excluded. Recurrence-free curves were calculated according to Kaplan-Meier and the log rank test was used to test the differences. All patients underwent a comprehensive neck dissection and were irradiated postoperatively when three or more tumour-positive nodes or extranodal spread were reported by the pathologist. Endpoint for analysis was occurrence of an ipsilateral neck recurrence or of a distant metastasis. Figures were corrected for a simultaneous recurrence at a higher level. A total of 29 neck recurrences (7.2%; n = 523) and 26 distant metastases (10.7%; n = 281) were demonstrated in the 5-year follow-up period. The number of positive nodes was of prognostic significance for both events (p = 0.039 and p = 0.0027). Extranodal spread was shown only to increase the incidence of distant metastases (p = 0.017), whereas its prognostic value with regard to recurrence in the neck was nullified by the strict institution of postoperative radiotherapy. It is recommended to give radiotherapy to patients with two positive nodes and possibly to every patient with a histopathologically positive neck.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Squamous cell carcinoma of the nasal vestibule.

We reviewed 30 patients with squamous cell carcinoma of the nasal vestibule to present our experience of their management and to evaluate the prognostic factors that may influence their outcome. For T1 lesions radiotherapy remains the treatment of choice, because of the superior cosmetic result. Fifteen (68 per cent) out of 22 patients with T2 lesions were treated with primary radiotherapy. Surgery however, was eventually required in 16 (72 per cent) out of 22 patients, either as a primary treatment (seven patients) or as salvage surgery (nine patients). For the larger T3 lesions the treatment of choice is surgery followed by post-operative radiotherapy where appropriate. Regional nodal metastases at the time of presentation were a significant indicator of local and regional recurrence and of prognosis. The cause specific five-year survival for patients with an uninvolved neck (22 patients) was 100 per cent compared with 38 per cent for patients with nodal metastases at presentation (eight patients). Elective treatment for uninvolved regional nodes is not considered necessary.

Adult↗
PubMed1992

Assessment of quality of life in patients treated for low-grade glioma: a preliminary report.

In this pilot study quality of life was assessed in fourteen adult patients who were treated for a low-grade glioma with surgery and radiotherapy at least one year previously. Apart from widely used parameters, such as the neurological and functional status, the patients' cognitive functioning and actual affective status were determined. In addition the patients were interviewed to evaluate various aspects of quality of life. Generally no serious focal neurological deficits were found, although psychological examination showed serious cognitive and affective disturbances in most cases. Self report measures concerning cognitive functioning were not in all cases in accordance with objective test results. When the results of treatment in glioma patients are evaluated assessment of quality of life, including neuropsychological functioning, should be performed, especially as new therapeutic strategies are being developed.

Activities of Daily Living↗
PubMed1991

[Radiation injury presenting as tumor recurrence following irradiation for non-small-cell bronchus carcinoma].

Case records of two irradiated patients, each with an inoperable non-small cell carcinoma of the bronchus, are presented. After an initial period of 1.3 and 2.3 years, respectively, of regression of the tumour symptoms occurred, viz. severe pain due to multiple rib fractures in one and a superior vena cava syndrome in the other, suggestive of tumour regrowth. Careful comparison of results of all radiographic images and radiotherapy data suggested osteoradionecrosis as the cause of the rib fractures in one patient. The long time interval and the stabilization of the symptoms in the other made tumour regrowth unlikely. The so called late tissue reaction after radiotherapy as a possible cause of symptoms in both patients is discussed.

Aged↗
PubMed1979

A data storage and retrieval system for clinical research.

A data storage and retrieval system is presented that can be used for clinical research studies. The system is designed in such a way that the programs are independent of the application. It can be used by non-computer experts via a simple query language. Since it is bulit up in a modular way extensions can be easily made. The system is implemented on a PDP 11/70 under FORTRAN.

Computers↗
PubMed1978

Dose response in radiotherapy for glottic carcinoma.

All consecutive patients with glottic squamous cell carcinoma treated primarily by radiotherapy from 1965 through 1974 have been analyzed to reveal response of the primary tumor in relation to the dose. This study appears to indicate presence of dose response for all stages of the primary lesions (T) of the glottic carcinoma except for the smallest ones namely TIS, T1a and T1b. The total number of advanced tumors is small and selected. But they tend to indicate presence of dose response. Out of 15 selected patients with T3 and T4 glottic tumors, 5 (33%) had attained local control by primary radiotherapy; two had distant metastasis at onset of therapy, while 5 (33%) needed salvage surgery for control of the residual or recurrent disease. The ultimate success rate is 66% (10 out of 15) for the patients with advanced tumors treated with a conservative approach. An ongoing study indicates similar, if not better preliminary results with high dose radiotherapy.

Adult↗
PubMed1978

Prolonged metronidazole administration with protracted radiotherapy: a pilot study on response of advanced tumours.

In a pilot study, 2.5 g of metronidazole was administered in 3 divided daily doses for prolonged periods with protracted fractionated conventional radiotherapy. Total cumulative metronidazole dose was 94 g in 31 patients with head and neck carcinoma. In some others, lower dosage was used. Radiotherapy dose varied form 3000 rad in 5 patients to 7600 rad in 31 patients. Preliminary results with a minimum follow-up period of 6 months suggest enhanced tumour response without evident toxicity. The improved results, if sustained, may be speculatively explained by the combined or individual enhancement of effect due to the hypoxic radiosensitizer or by the high dose precision radiotherapy or by the specific elimination of the hypoxic tumour cells by cytotoxic effect of prolonged metronidazole administration. Controlled trials are now needed.

Drug Administration Schedule↗
PubMed1978

Oncologic research and computerized data retrieval.

A computer-based data retrieval system for clinical research in oncology is described. The system has been designed to enable busy clinicians to retrieve and analyze data directly without major involvement of a computer specialist. The system uses texts similar to those in daily practice. In most situations no code is printed. The other important feature of the system is its ability to analyze clinical data in the form of tables, frequency distribution, etc. It may also furnish actuarial characteristics of the total population or subpopulations. Mathematical functions are calculated easily. Amendments and updating are simple enabling follow-up data to be incorporated. The system is under use for about 2 years and appears to be a versatile tool in the field of clinical research.

Clinical Trials as Topic↗