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Biomedical subjects

H Goepfert

Publications and source records attributed to H Goepfert.

At least 181 records · Page 10Linked to original sources
PubMed1984

Does the diagnosis of depression in head and neck cancer mask organic brain disease?

Scant attention has been paid to emotional changes as possible symptoms of impaired cerebral functioning in cancer patients. A retrospective study was conducted to determine the variety of organic brain syndromes (OBS) that presented with depressive symptoms in 20 head and neck cancer patients. The impressions of referring surgeons were in error in 16 patients (80%). Twelve (60%) had unsuspected OBS, with treatment resulting in reversal of symptoms in almost half. Of the eight patients with functional disorders, four received a final diagnosis of depression. Head and neck surgeons should be aware that (1) emotional changes in their patients frequently reflect OBS, some potentially reversible, (2) because of the ages of the patients, senile dementia may be a more common occurrence in head and neck cancer than suspected, and (3) because of the difficulties of evaluating changes in higher mental functions, more neuropsychiatric consultations may be warranted for head and neck patients.

Aged↗
PubMed1984

Chondrosarcoma of the head and neck.

A review of 23 cases of chondrosarcoma of the head and neck is presented. The sites of involvement include the gnathic bones, paranasal sinuses and orbit, nasopharynx, base of skull, larynx and the cervical spine. Histologic grading of the neoplasms into I, II, and III, primarily dependent on deviation from phenotypic cartilage and mitoses, afforded excellent correlation with prognosis and survival. While increasing size of the chondrosarcoma is not always associated with higher grade tumors, rapidly growing and extensive neoplasms are usually grade II or III chondrosarcoma.

Adolescent↗
PubMed1983

Application of Epstein-Barr virus (EBV) serology to the diagnosis of North American nasopharyngeal carcinoma.

A cooperative study was established among a number of institutions in the USA to determine the clinical value of Epstein-Barr virus (EBV) serology for the diagnosis of different histopathological types of North American nasopharyngeal carcinoma (NPC) including occult primary tumors. One hundred-twenty-four patients with confirmed NPC have now been entered into the study. For each patient, anti-EBV antibody titers were determined at diagnosis and related to the histopathology as classified according to the World Health Organization (WHO). The results suggest that certain anti-EBV antibodies are of potential value for the diagnosis of undifferentiated types of NPC but not for the well-differentiated cancer. The IgA anti-VCA antibody response is the most specific for this disease and of the greatest diagnostic value when used alone or in combination with the anti-EA test. These tests have also been used successfully for the detection of occult NPC. These results indicate that these tests can be useful aids to the clinician for the diagnosis of certain histopathologic types of this disease.

Antigens, Viral↗
PubMed1983

Ectopic parathyroid hormone production by a squamous carcinoma of the tonsil.

A patient with recurrent squamous carcinoma of the neck showed hypercalcemia with the immunoreactive parathyroid hormone (PTH) level within the upper limits of normal range, this being inappropriate for the degree of hypercalcemia. An immunoreactive peak of PTH was found in the tumor tissue extract, which appeared on column chromatography to be in the region of elution of pure bovine PTH. The tumor tissue showed positive immunoperoxidase reaction for PTH compared with negative reaction when the patient had normocalcemia. These findings are strong evidence that the tumor produced a PTHlike substance.

Carcinoma, Squamous Cell↗
PubMed1983

Malignant salivary gland tumors of the paranasal sinuses and nasal cavity.

Of a total of 122 patients with minor salivary gland tumors of the nose and paranasal sinuses, 66 patients were identified who had had their therapy at the University of Texas M.D. Anderson Hospital and Tumor Institute, Houston. Adenoid cystic carcinomas and adenocarcinomas were the most frequent tumors. Eighty percent of the patients were treated for relatively advanced (T3 and T4) cancers. Low-grade and high-grade carcinomas could be identified in the two groups studied, and the pathologic grading influenced prognosis in addition to the amount of local extent and degree of invasion of the neoplasm. The adequate preoperative documentation of tumor extension is mandatory, and a team effort in the surgical resection is worthwhile. Radiation therapy remains an important adjuvant in this treatment and occasionally has been used effectively as the only modality of treatment.

Adenocarcinoma↗
PubMed1983

Major complications of radiotherapy in cancer of the oral cavity and oropharynx. A 10 year retrospective study.

In an attempt to determine the late effects and associated morbidity of radiotherapy on normal tissue, patients with squamous carcinoma of the oral cavity and oropharynx were retrospectively reviewed. Between 1964 and 1975, 569 patients with cancer of the floor of the mouth, oral tongue, tonsil, and retromolar trigone region of the anterior faucial pillar had their primary lesions treated by radiotherapy alone for cure. One hundred twenty-eight of the patients were evaluable for this study. Bone and soft tissue morbidity were graded according to the late radiation scoring scheme of the radiation therapy oncology group of the European Organization on Research and Treatment of Cancer, tallying only grade 4 changes. Patients were further classified according to site of tumor, age, sex, tumor stage, histologic grade, and dental status--none of which had a positive correlation with complications. Of 31 evaluable patients with cancer of the floor of the mouth (median follow-up 136 months), 71 percent (22 of 31 patients) had at least one complication involving bone (osteonecrosis, pathologic fracture) or mucus membrane (ulcer). Sixty-one percent (25 of 41 patients) with primary cancer of the oral tongue had grade 4 sequelae (median follow-up 112 months). In 26 patients with cancer of the tonsil, 13 (50 percent) had grade 4 sequelae (median follow-up 113 months). This included 11 patients with clinical and radiographic evidence of osteonecrosis, 6 of whom required mandibulectomy. Patients with cancer of the retromolar trigone region of the anterior faucial pillar fared the best (median follow-up 122 months). Late sequelae were noted in 40 percent (12 of 30 patients). The morbidity attendant to cure by radiotherapy included at least one significant complication of bone or soft tissue in 40 to 70 percent of the patients, depending on the location of the primary tumor. There was also a positive correlation with dose of radiation received.

Adolescent↗
PubMed1983

The immune restorative effect of Isoprinosine administration on the local graft-versus-host reaction of cancer patients.

The immunorestorative effect of Isoprinosine (ISO) in vivo on T-cell-induced local graft-versus-host reaction (GVHR) was analyzed in 60 cancer patients randomized into three groups: 20 patients received 1 g/day ISO orally for 7 days, 20 patients received 4 g/day ISO for 7 days, and 20 patients received no treatment for 7 days. The local GVHR was assessed before and after the 7 days of treatment (or no treatment). A significant augmentation of the local GVHR was observed among the ISO-treated patients (44.1 +/- 19.1 vs 61 +/- 37.1 for 1 g ISO, P less than 0.05; 42.1 +/- 20.1 vs 58.9 +/- 23.8 for 4 g of ISO, P less than 0.01). This was not so for patients who received no treatment (38.5 +/- 20.4 vs 38.3 +/- 21.2; P greater than 0.1). Nine patients treated with 1 g of ISO and 5 treated with 4 g of ISO/day, who were initially characterized by a negative local GVHR (less than 50 mm3), converted to a positive reaction (greater than or equal to 50 mm3) compared to none of the patients who received no treatment. Two patients treated with 1 g of ISO and 2 patients treated with 4 g, who initially had a positive GVHR, demonstrated further augmentation (greater than or equal to 50% increase) in the GVHR after 7 days of treatment. In 2 patients (one in each treated group) the ISO induced a suppression of the GVHR from positive to negative. Incubation of the patients' lymphocytes in vitro with ISO (100 micrograms/ml X 1 hr) failed to induce augmentation of the GVHR and did not correlate with the in vivo effect in the same patients. These results demonstrate an immunomodulatory effect of ISO in cancer patients and lend further support to the use of this drug as an immunomodulating therapy among cancer patients.

Animals↗
PubMed1983

Impact of therapy for differentiated carcinoma of the thyroid: an analysis of 706 cases.

A retrospective analysis of clinical and pathological data was conducted on 706 patients (514 females and 192 males) treated for differentiated thyroid carcinoma at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston from 1951 to 1975 and followed to 1981. The histological diagnoses were mixed papillary/follicular carcinoma (66.7%), papillary carcinoma (14.6%), follicular carcinoma (15.3%), or Hurthle cell carcinoma (3.4%). Patients diagnosed before the age of 40 yr lived significantly longer than those diagnosed over the age of 40 yr, and females lived longer than males. According to survival analyses and disease-free intervals, the order of increasing aggressiveness of the tumors was papillary, mixed, follicular, and Hurthle cell. Total thyroidectomy was associated with longer disease-free intervals and fewer recurrences. The 136 patients who received ablative 131I after surgery had fewer recurrences than a matched group who did not, but the disease-free interval and survival rate showed no significant difference. Further classification showed that patients with follicular and mixed tumors, and those who underwent total thyroidectomy benefited from 131I. There were 78 deaths attributed to thyroid cancer in the whole group. Approximately two thirds occurred in the first 10 yr after diagnosis. In conclusion, total thyroidectomy is recommended, when feasible, for differentiated thyroid cancer, followed by ablative 131I therapy, at least for follicular and mixed varieties.

Adenocarcinoma↗
PubMed1982

Neuroblastomas and neuroendocrine carcinomas of the nasal cavity: a proposed new classification.

The histologic characteristics of 29 nasal tumors previously diagnosed as neuroblastomas, unclassified carcinomas, or unclassified malignant neoplasms were reviewed. Electron microscopy was performed in 17. Nine tumors were neuroblastomas; six of these were classical neuroblastomas while the other three exhibited olfactory differentiation in addition to the classical neuroblastoma component. Areas of ganglioneuroblastoma were found in the metastasis of one of the three olfactory neuroblastomas. Twenty tumors were classified as neuroendocrine carcinoma because all showed a neuroendocrine pattern with remarkably uniform cells growing from benign glandular epithelium; membrane bound granules were present in the cytoplasm of cells of the ten cases in this group examined by electron microscopy. The mean age of the patients with neuroblastomas was 20 years; survival in this group was 75% at five and seven years, respectively, and 67% at ten years. Recurrences, metastasis, and death occurred within 3 years of diagnosis. There was a low percentage (25%) of multiple recurrences. The metastases were located in cervical lymph nodes, brain and spine. The mean age of the patients with neuroendocrine carcinoma was 50 years. Survival was 100% at five years, 88% at seven years, and 77% at ten years. Recurrences and metastasis in 70% of the cases occurred later than the third year. Multiple recurrences were present in 54% of the cases. The metastases affected lymph nodes, brain and spine in all cases except in one in which lungs and femur were involved. In the latter case adenocarcinoma was also present in addition to the neuroendocrine carcinoma. Three patients died, all more than five years from the time of diagnosis. No correlation was found between staging and prognosis in either group, except for Stage I disease.

Cell Differentiation↗
PubMed1982

Clinical effects of closed suction drainage on wound healing in patients with head and neck cancer.

This study was undertaken to determine what optimal levels of suction pressure were necessary to provide good drainage volume and obliteration of any dead space and also to determine the prevalence of clotting and complications secondary to various levels of suction pressure. The patients were grouped by their degree of nutritional depletion, prior radiation exposure, the types of surgical procedures undergone, and the results of tests using four levels of suction pressure. Three of the suction pressure values were obtained with a wall suction and one was obtained using a portable closed system. All wall suction pressure levels were certainly comparable with the portable unit. However, the portable unit provided continuous suction pressure when the patients were ambulatory and was not associated with any statistically significant increase in wound complications or equipment failure.

Head and Neck Neoplasms↗
PubMed1982

Chemotherapy of locally aggressive head and neck tumors in the pediatric age group. Desmoid fibromatosis and nasopharyngeal angiofibroma.

Our experience with the use of systemic chemotherapy in the management of locally aggressive head and neck tumors in the pediatric age group (desmoid fibromatosis and nasopharyngeal angiofibroma) is presented. Objective decreases in the size of tumors was found in all patients with desmoid fibromatosis was treated with chemotherapy before definitive surgical resection was performed. The changes noticed on examination correlated with the histologic and radiologic findings. Two patients with recurrent juvenile nasopharyngeal angiofibromas showed striking therapeutic improvement in their residual tumor mass as witnessed by radiographic studies and biopsies. Toxicity and side effects of the treatment are discussed.

Antineoplastic Agents↗
PubMed1982

Squamous cell carcinoma of the pyriform sinus.

This is a review of 418 patients with cancer of the pyriform sinus who had complete treatment at University of Texas M. D. Anderson Hospital, treated over a 28-year time span. Treatment modalities used included radiation therapy, surgery, and planned combined treatment, primarily in the form of surgery and postoperative radiation therapy. Superficial lesions, with no impairment of laryngeal motility, are suitable for irradiation therapy planned for cure. (The policies of treatment have changed throughout the years). Analysis is made comparing the results of the larger groups of patients treated by surgery only, or surgery followed by postoperative radiation therapy. There is a significant lower incidence of failure above the clavicle in the combined treatment group, and a better 5-year survival. Rate of recurrences and the specific sites of failure above the clavicles are discussed, as well as the means of preventing such. The causes of death between 2 and 5 years are presented.

Aged↗