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Biomedical subjects

J J Bradfield

Publications and source records attributed to J J Bradfield.

6 recordsLinked to original sources
PubMed1996

Rapid progression of head and neck squamous carcinoma after hyperbaric oxygenation.

We present four head and neck cancer patients who apparently had rapid progression of clinically occult disease during or soon after undergoing hyperbaric oxygenation. This led us to review existing knowledge about the interaction of HBO with tumors. The literature can be summarized as follows: 1. HBO is a useful tool in several situations commonly encountered by head and neck surgeons-infections, radionecrosis, and wound-healing problems. 2. The use of HBO as a hypoxic cell sensitizer during radiation therapy has been extensively studied, with evidence supporting only marginal advantage to this logistically difficult undertaking. 3. Most reports regarding the interaction of HBO with transplanted tumor cells suggest no effect on tumor growth or metastases. 4. Studies of chemically induced carcinogenesis are less conclusive. Some evidence supports a role for HBO in enhancing growth of preexisting tumors. Better understanding of the interaction of HBO with existing tumors is required to ensure that informed choices-weighing potential risks and benefits of HBO treatment--may be made by head and neck surgeons and their patients. Further research into the interaction between HBO and tumor cells is warranted.

Adult↗
PubMed1996

Allergic fungal sinusitis.

Allergic fungal sinusitis is a non-invasive disease, first described in the early 1980s. We review our experience with 25 patients treated at the University of Texas Medical Branch, Galveston. All patients were treated surgically, using endoscopic techniques in 17, and combined endoscopic and external procedures in eight. Histological evidence of tissue invasion was absent in all 25 patients, in spite of extensive destruction of the skull base in four. Dematiaceous fungi were the most common cultural isolate. Fifteen patients were available for more than 6 months post-operative follow-up. None of the eight patients who developed recurrent disease had been treated with post-operative systemic steroids. Four of the seven patients who remained disease-free had received steroids. Clinical trials to test the efficacy of systemic steroids in the prevention of disease recurrence are clearly warranted.

Administration, Topical↗
PubMed1996

Effect of hyperbaric oxygenation on existing oral mucosal carcinoma.

Hyperbaric oxygen therapy (HBO) is used to treat some complications of head and neck carcinoma treatment. Several patients treated with HBO have had rapid growth of a clinically cured squamous cell carcinoma. Prior studies have produced conflicting evidence about the effect of HBO on tumor growth. This study was undertaken to determine the effects of HBO on established squamous cell carcinoma. Forty Golden Syrian hamster cheek-pouch carcinomas were induced with the established chemical carcinogen 9,10-dimethyl-1,2-benzanthracene. Twenty hamsters underwent 30 HBO dives for 60 minutes each to 2.81 atm, while 20 served as controls. At necropsy, animals receiving HBO therapy had significantly smaller tumors (P < .05) and showed a trend toward fewer cervical metastases (P < .06). HBO therapy with coexistent carcinoma inhibited the established tumor's growth.

Animals↗
PubMed1995

Complications of endoscopic sinus surgery in a residency training program.

Endoscopic sinus surgery (ESS) is now taught in most otolaryngology residency programs in the United States. However, this is technically challenging surgery and concerns exist regarding patient safety early in the surgeon's learning curve. The authors reviewed 193 cases of ESS performed by residents, under faculty supervision at our program, between 1987 and 1992. Sixty-seven percent of patients underwent bilateral anterior ethmoidectomy, 40% had bilateral total ethmoidectomy, and 44% had bilateral middle turbinate reduction. The overall complication rate was 22% and included one major complication. Synechiae accounted for 50% of minor complications. There was no correlation between middle or inferior turbinate reduction and the formation of synechiae. Posterior ethmoidectomy was not associated with a significant increase in complications. We conclude that ESS can be safely performed by otolaryngology residents in carefully structured and supervised training programs.

Adolescent↗
PubMed1990

Advanced head and neck cancer: low-dose, split-course radiation therapy and simultaneous infusion of 5-fluorouracil and cisplatin.

Twenty-three patients with advanced untreated head and neck cancer, nine patients with recurrent cancer, and six patients with recurrent cancer who underwent surgery and had postoperative persistence of tumor were treated with three 2-week courses of irradiation (1,500 cGy in 10 fractions each) concurrently with cisplatin and a 5-day infusion of 5-fluorouracil. A fourth 2-week course of irradiation (2,000 cGy in 10 fractions) brought the final tumor dose to 6,500 cGy. Twenty patients in the untreated group and three patients in the recurrent group (33%) had a complete response. There were 10 local recurrences in the untreated group (43%), seven in the recurrent group (78%), and three in the persistent group (50%). At 17 months after the start of treatment, the survival rate for the untreated patients was 51%, for the patients in the recurrent group it was 11%, and for the patients in the persistent group it was 20% (P = .03). Most patients experienced toxicity, including nausea, vomiting, weight loss, and mucositis. Clinical trials are necessary to determine whether simultaneous chemotherapy and radiation therapy is an improved method of treatment for advanced head and neck cancer.

Antineoplastic Combined Chemotherapy Protocols↗