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Biomedical subjects

E L Applebaum

Publications and source records attributed to E L Applebaum.

At least 19 recordsLinked to original sources
PubMed1992

Meningeal carcinomatosis producing bilateral sudden hearing loss: a case report.

Meningeal carcinomatosis is characterized by diffuse infiltration of the leptomeninges by metastatic cancer in patients usually with a previous history of malignancy. Primary tumors are usually adenocarcinomas of the breast or lung, or malignant melanoma. Meningeal carcinomatosis can present with headache and/or a variety of cranial neuropathies. We report a case of meningeal carcinomatosis presenting as a complete, bilateral, sudden hearing loss without other cranial nerve findings--a previously unreported presentation. Our patient also exhibited an unusual primary tumor site (esophagus) and histopathology for meningeal carcinomatosis. The case was impressive for the subsequent abrupt onset of a series of cranial neuropathies and the rapid deterioration in the patient's condition.

Acute Disease↗
PubMed1991

The submandibular triangle in squamous cell carcinoma of the larynx and hypopharynx.

A 15-year retrospective analysis was carried out at the University of Illinois College of Medicine, Chicago, reviewing the tumor staging and pathology data of 239 patients treated for carcinoma of the larynx and hypopharynx requiring laryngectomy alone, laryngectomy with neck dissection, or laryngopharyngectomy and neck dissection. Surgery was the primary treatment modality in 205 of the 239 cases, with the remaining 34 having surgery to treat radiation therapy failure. Primary tumors were located within the supraglottic region, the glottic region and, less commonly, the pyriform sinus. Ninety-five of the 239 patients either presented with or developed nodal metastases following initial treatment. Of these, only two had tumors within the lymph nodes of the submandibular triangle. This data corroborates impressions that tumors of the larynx and hypopharynx rarely metastasize to the submandibular triangle and that sparing this area during neck dissection for lesions of the larynx would seem justified.

Carcinoma, Squamous Cell↗
PubMed1991

Indications for and techniques of tracheotomy.

Although the operation has been practiced for centuries, the modern technique of tracheotomy was introduced and popularized in the beginning of the 20th century. The initial indication for tracheotomy was limited to impending airway obstruction resulting from trauma, but current indications are broader. Tracheotomy is one of four methods available to intubate the trachea and is associated with physiologic changes that are dependent on the duration of tracheotomy. Although surgical in nature, it is employed to relieve or prevent airway obstruction and to offer ventilatory support. Tracheotomy may be performed as an elective or an emergency procedure. Ideally, it is done in a controlled situation. However, when performed in an emergency setting, variations of the procedure, such as minitracheotomy or cricothyroidotomy, may be temporarily substituted. Preferably, tracheotomy is performed in an operating room; however, it may be carried out successfully in an intensive care unit as well.

Airway Obstruction↗
PubMed1990

Further studies on the effects of magnetic resonance imaging fields on middle ear implants.

We investigated the effects of magnetic resonance imaging (MRI) fields on 21 stapedectomy prostheses and other middle ear implants and two different receiver-stimulator modules from 22-channel cochlear implants. None of the middle ear implants was displaced by the magnetic field, except for one platinum-stainless steel stapedectomy piston. Magnetism was not induced in any of the middle ear implants subjected to prolonged exposure in the MRI scanner. We conclude that MRI could pose a hazard to patients who have had stapedectomy using certain platinum-stainless steel piston prostheses and to patients with cochlear implants. Magnetic resonance imaging should pose no hazard to patients who have had the other middle ear implants reported on in this and our previous investigation.

Cochlear Implants↗
PubMed1989

Radiotherapy or surgery for subclinical cervical node metastases.

This retrospective study compared elective neck dissection with elective neck radiotherapy for the control of subclinical nodal metastases. Four hundred ninety-eight patients with head and neck primary cancers and no clinically apparent neck metastases on initial presentation comprised the study population. Each patient was followed up for at least 5 years to detect failure to control neck metastases and control of the primary tumor at the time of neck recurrence. Analysis of neck recurrences occurring in patients with control of the primary tumor showed that there was no statistically significant difference between elective radiation therapy to the neck and elective neck dissection for oral cavity, oropharyngeal, and laryngeal cancers. The only statistically significant difference was noted for hypopharyngeal cancers, with radiation therapy being more effective than surgery.

Carcinoma, Squamous Cell↗
PubMed1989

Implantation of a recurrent laryngeal nerve stimulator for the treatment of spastic dysphonia.

Spastic dysphonia, a rare speech disorder, is characterized by strained phonation with excessively adducted vocal cords. Recurrent laryngeal nerve section, botulinum toxin injection into the vocalis-thyroarytenoid muscle complex, and other techniques have been used to treat this disorder. We have used percutaneous electrical stimulation of the recurrent laryngeal nerve with good results. Previous dog studies demonstrated the relative safety of an implantable recurrent laryngeal nerve stimulator. In this study, we directly stimulated the recurrent laryngeal nerve and vagus nerve in a dog without change in cardiorespiratory status. A Medtronic peripheral nerve stimulator was implanted in a patient with abductor spastic dysphonia. The cuff electrode was positioned around the recurrent laryngeal nerve and stimulation resulted in improvement in her voice. Extensive cardiopulmonary monitoring did not reveal any adverse response to stimulation and there was no discomfort to the patient. On the basis of the good results of this preliminary study, further study with long-term follow-up is under way.

Adult↗
PubMed1989

[Epiglottitis in the adult. A proposition for a clinical classification and therapeutic strategy].

Because lack of criteria for staging and treatment of epiglottitis can lead to unnecessary morbidity and mortality, we have introduced a staging system for early classification and appropriate management of adult epiglottitis patients. We retrospectively staged 20 adults with epiglottitis to see in their final outcome would have been altered using our protocol. We found that staging and management according to our protocol were appropriate and possibly could have reduced mortality from 10% to nearly 0%.

Adult↗
PubMed1988

Intracranial and intratemporal meningiomas with primary otologic symptoms.

Intratemporal extensions of cerebellopontine angle (CPA) meningiomas are unusual and primary intratympanic meningiomas are extremely rare. The initial symptoms of both types are otologic. The presenting symptoms of even large meningiomas of the cerebellopontine angle can also be otologic. In this article we report the clinical features, diagnosis, and management of five CPA meningiomas, three combined intratemporal and CPA meningiomas, and one primary intratympanic meningioma.

Adolescent↗
PubMed1988

Cholesteatoma of the middle ear and mastoid. A comparison of CT scan and operative findings.

High-resolution CT scanning accurately depicts the status of the structures of the temporal bone, allowing delineation of pathology prior to surgical exploration of ears with cholesteatoma. It provides information concerning location and extent of disease as well as possible anatomic variations and complications that may be encountered. The main advantages of CT scanning over polytomography are superior soft-tissue contrast resolution and improved spatial detail at a reduced radiation dose for the patient.

Bone Diseases↗
PubMed1987

Primary culture of squamous head and neck cancer with and without 3T3 fibroblasts and effect of clinical tumor characteristics on growth in vitro.

Twenty-one tumors from patients with squamous cell carcinoma of the head and neck (SCC H/N) were cultured with and without 3T3 fibroblasts in order to determine whether, on the basis of improved tissue culture medium, 3T3 cells could be deleted without altering growth and cloning efficiency. Thirty-five additional primary SCC H/N specimens, cultured in the presence of 3T3 fibroblasts, were studied to assess the effect of tumor differentiation, site of primary tumor, and site of specimen procurement on growth. The authors conclude that 3T3 cells remain essential for optimal growth and cloning efficiency. Also, 3T3 cells improved the number of successful cultures by 33% to 100% depending on the plating density, and cloning efficiency was improved by 50% in the presence of 3T3 cells. Growth did not correlate with tumor differentiation or site of origin of the tumor specimen. Culture of specimens from the primary site resulted in growth significantly more frequently than culture of specimens obtained from metastatic neck nodes.

Carcinoma, Squamous Cell↗
PubMed1987

Histological and morphological observations of the paravestibular canaliculus.

The paravestibular canaliculus was studied by light microscopy in serial sections of the temporal bones from otosclerotic patients who underwent fenestration or stapes surgery. In all examined 23 specimens (13 cases), the endolymphatic duct and sac were observed to be normally developed with no pathological findings. The paravestibular canaliculus was found in 14 of the specimens (60.9%). Its course was traced from the proximal to the distal area in 12 specimens, and it appeared to merge into the distal portion of the endolymphatic sac in 7 of them. Twelve of the paravestibular canaliculi contained one vein, and 3 contained several veins. No artery was found. The paravestibular canaliculus was observed to originate from small vascular channels around the vestibule in the otic capsule, lateral to and near the internal aperture of the vestibular aqueduct.

Adult↗
PubMed1986

Porphyrin fluorescence and photosensitization in head and neck cancer.

Indistinct margin demarcation and autofluorescence are problems in fluorescence delineation of porphyrin-containing head and neck squamous cell cancer (HNSCC). We studied the time course and in vivo localization of porphyrin fluorescence in a squamous cell cancer hamster model and in human HNSCC. After intravenous injection, a gradient in fluorescence intensity developed rapidly until tumors fluoresced above a lower-intensity mucosal background. Hamster tumor and ulcerated HNSCC without porphyrin injection demonstrated autofluorescence grossly indistinguishable from fluorescence in porphyrin-injected tumors. However, fluorescence microscopy revealed autofluorescence to be a surface phenomenon and showed injected porphyrin localized in tumor stroma. We conclude that autofluorescence must be considered when interpreting porphyrin fluorescence. In addition, empirically designed photodynamic therapy can be effective in selected HNSCC. Data from animal experiments provide useful guidelines for the delivery of this therapy.

Aged↗
PubMed1986

Nonsquamous tumors of the nose and paranasal sinuses.

Nonsquamous tumors of the nose and paranasal sinuses are an uncommon group of neoplasms. Information is only available from case reports and short series. Therefore, conclusions concerning natural history and response to therapy are uncertain for tumors in these sites. The need for complete and timely evaluation of new and changing clinical signs must be emphasized. For each tumor, maximal interaction among the clinician, radiologist, and pathologist is needed to reach the correct diagnosis and plan effective therapy. This interaction is especially important for the deceptively benign-appearing tumors listed in Table 2. These tumors behave biologically in an unpredictable fashion, and long-term follow-up is mandatory.

Adenocarcinoma↗
PubMed1986

Culture of squamous head and neck cancer on 3T3 fibroblasts following isokinetic velocity sedimentation.

Growth in culture of squamous head and neck cancer is hampered by microbial contamination, low plating efficiency, and cellular heterogeneity within tumors. Furthermore, clumps of cells must be removed if plating efficiency is to be accurately determined. Isokinetic velocity sedimentation was applied to 44 primary tumor specimens in an effort to minimize these problems. Seven fractions were evaluated for cell number, clump number, cell viability, clonogenic growth, plating efficiency, and microbial overgrowth. Unseparated specimens were simultaneously cultured. Microbial growth was significantly associated with the highest gradient fraction. Clumps were significantly associated with the lowest gradient fraction. Colony formation was significantly associated with middle gradient isokinetic velocity sedimentation, although seven specimens grew only when fractionated, suggesting the possibility of inhibitor cells within the tumor specimen.

Carcinoma, Squamous Cell↗