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Biomedical subjects

H K Kashima

Publications and source records attributed to H K Kashima.

At least 37 records · Page 2Linked to original sources
PubMed1988

3-D CT for cranial facial and laryngeal surgery.

Three-dimensional imaging is a new digital technology which interpolates two-dimensional computer tomography information to render a "life-like" anatomic display of the diagnostic information. We have found that this new methodology significantly improves the assessment and therapy of patients undergoing surgical procedures of the head and neck. The technique has been used in cranial-facial and laryngeal pathology, and in preoperative planning of tumor resection, particularly skull-base neoplasms. The use of three-dimensional computer tomography improves the display of the location and volume of pathology and affords accurate therapeutic and surgical planning. The choice and extent of surgery is better defined, and precise bone removal can be performed. In reconstructive surgery, an accurate prefabricated model of the bony defect can be made to aid reconstruction. Representative cases demonstrating the use of three-dimensional computer tomography in head and neck surgery, and its benefits in saving operative time and improving the postoperative result, will be discussed.

Child, Preschool↗
PubMed1987

Recurrent respiratory papillomatosis. Clinical overview and management principles.

Recurrent respiratory papillomatosis is an uncommon clinical disorder of respiratory epithelium caused by HPV. It shares the identical viral etiology with genital condyloma and in all likelihood is transmitted at the time of birth (juvenile-onset disease) and through intimate sexual contact (adult-onset disease). The recent establishment of viral etiology modifies our concepts regarding the nature of the disease, its epidemiology, and its treatment.

Adult↗
PubMed1986

Multiple primary malignancies in head and neck cancer.

Multiple primary (MP) malignancies were found in 9.7% of 1961 patients with primary head and neck cancer diagnosed at The Johns Hopkins Hospital, Baltimore, during the years 1975 to 1985. The index tumors were divided into six main groups. Out of the 190 MP malignancies, 46.9% were synchronous and 53.1% were metachronous. Seventy-four percent of MP lesions were noted during the first year after diagnosis of the index primary tumor. Patients with an index tumor in the upper aerodigestive tract had a significantly increased risk of developing a second cancer in the head and neck area. This risk was 5.94 for the oral cavity, 6.98 for the pharynx, 3.57 for the larynx, and 7.02 for the esophagus. Patients with an index tumor in the salivary gland or the thyroid gland had, respectively, a 3.59 and a 7.38 higher risk than the general population of developing a second tumor. Efforts aimed at improving the survival of patients with head and neck cancer must incorporate strategies for the prevention, early detection, and treatment of MP neoplasms.

Adult↗
PubMed1986

Multiple primary neoplasms in patients with salivary gland or thyroid gland tumors.

The exact risk of multiple primary neoplasms in patients with salivary gland or thyroid gland malignancies is difficult to ascertain from the data available in the literature. This study examines, retrospectively, 198 patients with a first malignancy of the salivary gland and 186 patients with a first malignancy of the thyroid gland, treated over a 10-year period. Fourteen cases of second tumors were found in the first group and 29 cases in the latter. Patients whose second neoplasm was a skin cancer or who had a previous neoplasm at a site other than those selected for study were excluded. The risk of a second tumor compared to the expected number of second cancers from the Combined National Cancer Institute Registry Data, and the results indicated an increased risk in males with a first malignancy of the salivary gland and in both men and women with a first thyroid malignancy. The salivary glands, larynx, and colon were the most common sites of second tumors after a first salivary cancer. The adrenals, brain, lymphatic system, and breast were the most common site after a first thyroid cancer. The previously reported association of cancers of the thyroid and the breast in females is confirmed here in men and women. The excess of brain tumors and lymphomas has not been reported previously.

Adolescent↗
PubMed1986

Compression plates in the treatment of advanced anterior floor of mouth carcinoma.

Advanced anterior floor of mouth squamous cell carcinoma has been traditionally treated with wide excision in conjunction with mandibulectomy and radical neck dissection. This has resulted in significant mandibulofacial defects with functional and cosmetic significance. Efforts at primary reconstruction in the past using bone grafts, osteomyocutaneous flaps, and other methods have yielded unsatisfactory results. A history of prior irradiation has made this problem even more refractory. We present a series of 11 patients who underwent composite resection for advanced anterior floor of mouth carcinoma (T2-T4), with primary reconstruction using a dynamic compression plating system in conjunction with local and regional tissue flaps. The clinical courses, complications, and surgical techniques are discussed. The issues of reconstruction at primary treatment, irradiation with a metal plate in the field, and the early restoration of oral function are addressed. Experience in this series shows that compression plates can be an effective method of primary reconstruction for advanced anterior floor of mouth lesions.

Adult↗
PubMed1985

Malignant transformation in non-irradiated recurrent respiratory papillomatosis.

The clinical, radiographic and post mortem findings occurring in a 6-year-old female with a four-year history of recurrent respiratory papillomatosis (RRP) are described. At autopsy, there were two separate foci of malignant transformation (malignant degeneration) in the bronchioloalveolar papillomata. This patient is the youngest in whom such changes have been described. Malignant transformation is a rare occurrence and is usually seen in older patients with longstanding papillomatosis, therapeutic irradiation, or a history of smoking. Pulmonary spread represents the majority of cases with "spontaneous" malignant transformation.

Age Factors↗
PubMed1985

Computed tomography of the neck.

The capabilities of CT to distinguish between soft tissue structures of varying densities, bone and air, coupled with the added advantage of utilizing intravascular contrast, particularly suits this method of examination to the study of head and neck disorders. With improved equipment permitting thinner sections and shorter exposure times, applications in head and neck diagnosis are increased. CT is used in the evaluation of salivary gland enlargements, staging of known tumors, the evaluation of a variety of neck swellings and in the assessment of laryngeal and facial trauma. In some cases, CT alone may be the only imaging procedure necessary, while in other situations, CT may comprise an important portion of comprehensive imaging evaluation.

Head and Neck Neoplasms↗
PubMed1984

Documentation of upper airway obstruction in unilateral vocal cord paralysis: flow-volume loop studies in 43 subjects.

Upper airway impairment of variable severity occurs in unilateral vocal cord paralysis (UVCP). Among 43 subjects with UVCP all had voice disturbance, 22 had symptoms of airway impairment, and 27 had some disturbance of swallowing. The severity of the airway impairment was evaluated by flow-volume loop spirogram which demonstrated reduced inspiratory flow rates (maximal and midvital capacity). Clinical recovery from paralysis or intracordal Teflon injection was accompanied by improvement in inspiratory flow rates. Airway impairment is most severe in subjects having UVCP due to intrathoracic disorder or intraoperative nerve interruption. Vocal cord position did not correlate with the severity of airway disturbance. The FVC and FEV1 determinations were normal in 33 and 29 cases, respectively, whereas the VI-50 and VE-50/VI-50 were normal in only 11 and 7 instances. This selective restriction of inspiratory flow rates and the abnormally low VE-50/VI-50 ratio was observed regularly. The sensitivity and reproducibility of the flow-volume loop examination support the utilization of this test to evaluate the nature and severity of upper airway impairment; consecutive examinations can be utilized to monitor the clinical course or outcome from treatment.

Adult↗
PubMed1984

Computed tomography in the evaluation of cervical thorotrast granuloma.

Two cases of cervical thorotrast granulomas (thorotrastomas) were evaluated with computed tomography. Computed tomography provided delineation of the precise extent of disease and the relationships of the larynx and carotid vessels to the thorotrastoma. This was helpful in planning surgical management. Computed tomography is of use in determining the extent of thorotrastomas and in planning their treatment.

Extravasation of Diagnostic and Therapeutic Materi↗
PubMed1983

Tracheal involvement in laryngeal papillomatosis.

A review of 39 laryngeal papilloma patients at The Johns Hopkins Hospital revealed an incidence of subglottic and tracheal extension much higher than previously reported. Subglottic disease was present in 69% of patients and tracheal involvement in 26%. Factors associated with distal spread were the presence of subglottic papillomas, history of tracheostomy, total number of endoscopic resections, and the duration of disease. The relationship to the presence of viral antigen was cited. Detection and elimination of all papillomas is felt to be the key for the prevention of distal spread. The strategy of management is described.

Adult↗
PubMed1982

Carbon dioxide laser therapy of recurrent squamous papilloma of the conjunctiva.

Juvenile squamous papilloma of the conjunctiva may exhibit "malignant" behavior with multiple recurrences presenting difficulty in management. We have successfully treated a child with the carbon dioxide laser who had failed three previous surgical excisions, cryotherapy (twice), and chemotherapy. The carbon dioxide laser permits a precise form of tissue excision with minimal trauma, edema, and scarring, and offers a safe alternative approach to the management of these lesions.

Child, Preschool↗