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Biomedical subjects

H L Coates

Publications and source records attributed to H L Coates.

15 recordsLinked to original sources
PubMed1997

Management of pseudo-aneurysm of a lateral aberrant internal carotid artery.

A 4-year old boy scheduled for insertion of ventilation tubes suffered significant aural hemorrhage following incision of the tympanic membrane. Examination under anaesthetic resulted in further hemorrhage. Investigation by carotid angiography revealed an anomalous internal carotid artery coursing through the middle ear with a small pseudoaneurysm. Subsequent management of this patient and review of the literature is presented.

Aneurysm, False↗
PubMed1978

Epstein-Barr virus-associated antigens in nasopharyngeal carcinoma.

Thirty-five sera from American patients with nasopharyngeal carcinoma were examined for Epstein-Barr virus (EBV)-associated antigens and compared with 85 sera from patients with other head and neck cancers, 80 sera from patients with lymphoma, and 47 sera from healthy control subjects. There was a definite correlation between the presence of nasopharyngeal carcinoma and the level of antibody titers to EBV. In particular, two tests that detected antibody to early antigen and antibody to viral capsid antigen in the serum IgA fraction were highly specific for the presence of nasopharyngeal carcinoma. There was a significant decrease in these antibody titers with clinical remission of the disease in treated patients with nasopharyngeal carcinoma. Clinically, these tests should have important application in the management and follow-up of patients with nasopharyngeal carcinoma.

Antigens, Viral↗
PubMed1978

An immunologic basis for detection of occult primary malignancies of the head and neck.

After extensive evaluation of patients with metastatic neck disease and clinically undetectable primary cancer of the head and neck, the clinician is often faced with the difficult question of subsequent management. In this study, sera from 11 patients with clinically occult carcinoma and metastatic lymphadenopathy were studied for Epstein-Barr virus-associated antigens. These were compared with 35 sera from patients with known nasopharyngeal carcinoma at all stages of disease and treatment and with 212 sera from control patients with other head and neck tumors, patients with lymphoma, and normal controls. There was a significant correlation between high antibody titers to Epstein-Barr virus, especially in the serum IgA fraction, and the presence of nasopharyngeal carcinoma. Thus, identification of occult nasopharyngeal carcinoma by immunologic means may have important application in the selective management of the patient with an unknown head and neck primary malignancy.

Antibodies, Viral↗
PubMed1978

Clinical evaluation of EBV serology in American patients with nasopharyngeal carcinoma.

There is now extensive immunological, biological and biochemical evidence to support a possible etiological relationship between EBV and NPC in patients from different geographical locations. Besides providing information on the question of etiology, the results from immunological investigations suggest that antibodies to some of the EBV-associated antigens might also be of clinical importance in the diagnosis and prognosis of NPC. To determine the possible clinical application of EBV serology to American NPC, sera from patients seen at the Mayo Clinic and the National Institutes of Health were examined for antibodies to EBV-associated antigens in an effort to identify those parameters which most reliably distinguish NPC from other types of cancer. The results show that high antibody titres to EBV-induced EA and the presence of antibody to EBV antigens in the IgA immunoglobulin fraction were the two most specific discriminating parameters, although neither was infallible. These findings are discussed in relation to future studies that are needed in order to determine the potential clinical value of EBV serology to the diagnosis and prognosis of NPC.

Antibodies, Viral↗
PubMed1976

Carcinoma of the supraglottic larynx. A review of 221 cases.

Between 1962 and 1971, 221 patients (197 men and 24 women) with carcinoma of the supraglottic larynx were treated at our institution. Most of the patients were in the sixth and seventh decades of life. In 89% of the patients, the epiglottis was involved. One hundred ninety patients underwent surgery, 161 for cure initially and 29 for salvage after radiation failure. Definitive surgery included laryngectomy in 117 patients and conservation procedures in 40. Fifty-five patients were treated by radiation for cure. Survival rates after laryngectomy or supraglottic laryngectomy were similar, but radiation therapy carried a poorer prognosis than did definitive surgery. Routine neck dissection was not necessary in all patients with supraglottic carcinoma.

Aged↗
PubMed1976

Clinically suspect pulmonary embolism after vein stripping.

Clinically suspect but nonfatal pulmonary embolism followed vein surgery in 16 of 4,080 patients operated on over a 10-year period from 1962 to 1971, an incidence of 0.39%. The presence of superficial thrombophlebitis, previous or recent thromboembolic disease, or chronic deep venous insufficiency was a statistically significant factor in patients who had embolism. Prophylactic postoperative anticoagulant treatment in those with a thrombotic background appears justified.

Adult↗
PubMed1975

Symposium. ENT for nonspecialists. Serous otitis media.

Serous otitis media is a capricious entity that can cause conductive deafness. The condition is most common in children, who often cannot describe the attending symptoms of deafness, fullness, and pressure. The basic contributing factor is inadequate function of the eustachian tube. Function improves as the child approaches 12 years of age. Underlying factors such as infections, adenoidal hypertrophy, and allergic states also must be managed. The otitis media may be treated medically or surgically.

Acute Disease↗
PubMed1975

Glandular tumors of the palate.

Salivary gland tumors of the palate originate in the minor salivary glands located in the glandular zone of the palate. Approximately 7 per cent of all tumors of the salivary gland occur in the palate, and approximately one-half of such tumors are cancers. The salivary gland tumor is more often found in the hard palate. Of the 90 salivary gland tumors of the palate reported herein, 49 per cent were benign, and all were pleomorphic adenomas. Of the cancers, 70 per cent were cylindromas, 15 per cent mucoepidermoid cancers, and the remaining 15 per cent included acinic cell carcinomas, undifferentiated carcinomas, and papillary adenocarcinomas. There is a 50 per cent likelihood of a lump in the palate in the glandular zone being a cancer. The simplistic diagnosis of a cyst should be considered only after other lesions have been excluded. The recommended form of treatment is surgical excision. Fenestration of the palate is a potential consequence of excision in 30 to 60 per cent of patients, depending upon whether or not the lesion is benign or malignant. The results of surgical treatment are good, but fenestration shoud be accepted as a necessary result of adequate treatment. Surgical treatment of cylindromas continues to be most difficult and demands the utmost of that intangible essence known as surgical judgment. Radiotherapy has been considered as a palliative agent for the treatment of inoperable and recurring cancers, especially cylindromas.

Adenocarcinoma↗
PubMedDate not supplied

Granular cell tumors of the larynx.

Granular cell tumors of the larynx are relatively uncommon, always benign, and most commonly located in the posterior portion of the larynx. They are easily identified and should be differentiated from other lesions. A possible problem in the differential diagnosis is the presence of pseudoepitheliomatous hyperplasia, which overlies the granular cell tumor and which may mimic squamous cell carcinoma. Careful histopathologic differentiation is important because the laryngeal granular cell lesion should be managed conservatively, with transoral local excision usually being adequate. The histogenesis of these lesions remains in doubt, with a neural or epithelial derivation being the most likely possibility.

Adult↗
PubMedDate not supplied

Immunovirologic assessment of American patients with nasopharyngeal carcinoma and occult primary tumors.

The Epstein-Barr virus (EBV) is closely associated with nasopharyngeal carcinoma, suggesting an etiologic relationship. We have under-taken studies (1) to quantitate the relationship between antibody titers to EBV-associated antigens and nasopharyngeal carcinoma in American patients since most of the patients in previous studies were of either Asian or African descent and (2) to determine the relationship between antibody titers and the clinical course of the disease. Sera from patients with primary or recurrent nasopharyngeal carcinoma and from patients in remission, from patients with various other head and neck tumors (including occult primary lesions and lymphomas), and from normal controls were titrated for IgG antibodies to viral capsid antigen (VCA) and early antigen and IgA antibodies to VCA, using indirect immunofluorescence procedures previously detailed. High titers of antibodies to EBV-induced early antigens and VCA in the IgG fraction and VCA in the IgA fraction were frequently found in the sera of patients with nasopharyngeal carcinoma. A significant reduction in these titers was observed with clinical remission of the disease in treated patients. Preliminary findings suggest that EBV serology may be useful in the evaluation and treatment of patients with nasopharyngeal carcinoma and also in patients with cervical metastases from clinically occult promary sites in order to identify those with occult nasopharyngeal carcinoma.

Antibodies, Viral↗
PubMedDate not supplied

Chondrosarcoma of the nasal cavity, paranasal sinuses, and nasopharynx.

Thirteen patients, six men and seven women, were seen at the Mayo Clinic with chondrosarcomas of the nasal cavity, paranasal sinuses, or nasopharynx in a 25-year period. Nasal obstruction, discharge, and bleeding were the major symptoms and a nasal mass was the most common sign. The typical chondrosarcoma is low in grade but malignant and it arises in the nasal cavity as a large, pale, glistening mass. Local excision was employed initially in seven patients and five had local recurrence. Definitive block excision cured four of six patients and the two others had a protracted clinical course and ultimately died of the disease. Long-term follow-up shows that chondrosarcomas are insidious, locally progressive tumors. Radiotherapy, used for palliation after recurrence, failed to produce any cures. Lateral rhinotomy and block excision are advocated as the primary treatment.

Adolescent↗