Ectopic thyroid tissue manifesting as a unique cause of an oropharyngeal mass.
Explore the source record for details and available documents.
Calcinosis↗
Biomedical subjects
J M van der Beek
Publications and source records attributed to J M van der Beek.
The importance of correct stage grouping in oncology. Results of a nationwide study of oropharyngeal carcinoma in The Netherlands.
BACKGROUND: In the frame of a nationwide study of oropharyngeal carcinoma in the Netherlands (1986-1990), the current International Union Against Cancer 1992/American Joint Committee on Cancer 1988 staging system was evaluated with respect to patient distribution and prognostic value. METHODS: Data related to epidemiology, treatment and survival from 640 patients referred for primary treatment were analyzed. Staging was first evaluated in a proportional-hazard regression analysis controlled for these data. Next, all possible combinations of T, N, and M were tested in a stepwise backward elimination model until all remaining indicator variables had a P value of less than 0.05. New stages were defined, based on the coefficients of the remaining indicator variables. RESULTS: The revised stages revealed two advantages compared with the UICC 1992/AJCC 1988 version: a more balanced distribution of patients (31% in Stage I, 31% in Stage II, 18% in Stage III, 14% in Stage IV, and 5% unknown in the revised staging system versus 7% in Stage I, 17% in Stage II, 24% in Stage III, 50% in Stage IV, and 2% unknown in the UICC 1992/AJCC 1988 staging system), and an improved prognostic discrimination for the disease specific survival (5-year results in the revised staging were 67% in Stage I, 42% in Stage II, 28% in Stage III, and 11% in Stage IV, versus 68% in Stage I, 64% in Stage II, 44% in Stage III and 27% in Stage IV in UICC 1992/AJCC 1988). CONCLUSION: Improvements in the current staging system in patient distribution in the stages in prognostic discrimination is feasible by regrouping the T, N, and M but without redefining the categories themselves.
Adult↗
A nationwide study of the epidemiology, treatment and survival of oropharyngeal carcinoma in The Netherlands.
Seven head and neck oncology cooperative groups in the Netherlands have reviewed the epidemiology, staging, treatment and survival of oropharyngeal carcinoma patients treated between 1986 and 1990. In all, 640 patients with squamous cell carcinoma (628, 98%) or undifferentiated carcinoma (12, 2%) referred for primary treatment were analyzed. The total group included 441 males (69%) and 199 females (31%), with a median age of 59 years (range, 30-92). Tumor distribution by subsite was the tonsillar region (372 patients, 58%), base of the tongue/vallecula (179, 28%), soft palate/uvula (62, 10%) and posterior oropharyngeal wall (27, 4%). Forty-four patients (7%) had stage I disease, 106 (17%) had stage II disease, 157 (24%) stage III, and 319 (50%) stage IV. Staging was unknown in 14 patients (2%). Radiotherapy was given to the primary tumor in 408 patients (64%), surgery and radiotherapy to 147 (23%), surgery alone to 42 (7%), other treatments to 14 (2%) and no treatment to 29 patients (4%). The 5-year overall survival was 28% and the 5-year disease-specific survival was 41%. This latter survival was 35% in males and 51% in females (P = 0.003). Five-year survival by subsite was 54% in the soft palate/uvula, 42% in the tonsillar region, 33% in the base of the tongue and 32% in the posterior oropharyngeal wall (P = 0.003). When analyzing survival by stage, 5-year survival in patients with stage I disease was 68% and decreased significantly to 27% in stage IV disease (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
An unexpected cause of upper airway obstruction.
A three-year-old boy with a swelling on the right side of his neck was suspected of having a parapharyngeal abscess after clinical examination and CT scan (computed tomography scan) of this region. Later it became clear, that the swelling was caused by an aneurysm of the internal carotid artery. This case report describes the pitfalls and difficulties encountered in the diagnostic course and treatment planning.
Airway Obstruction↗
Hypochondriasis in ENT practice.
In this study the incidence of hypochondriasis among new ENT out-patients was investigated. A validated questionnaire, which was administered twice with an interval of 3 months, was used to make the diagnosis. Medical information also played a part in the assessment. The diagnosis hypochondriasis applied to 13% of the patients who completed the entire diagnostic procedure. This group made very frequent use of a range of medical services and took a large amount of medicine. Compared with the non-hypochondriacal ENT group, the hypochondriacal group had a more negative opinion about their own health, although those in the latter group were less ill, measured by objective criteria. In order to be able to diagnose hypochondriasis in ENT practice, psychological or psychiatrical consultation is necessary.
Adolescent↗
The early stages of polyp formation.
The purpose of this study is to describe polyp formation in the mucosa of the middle ear as a possible model for the pathogenesis of nasal polyps. In 65 Wistar rats, the eustachian tube was occluded on the left side for up to 20 months; 60 right-sided, nonoccluded ears served as controls. Following occlusion, the middle ear mucosa was examined for signs of polyps. Signs of polyp formation or fully developed polyps were seen in 14 (22%) of the middle ears, and were only seen in middle ears with signs of actual or previous infection. It was established that the first stages of polyp formation include epithelial rupture, proliferation of fibrous tissue through the epithelial defect, and epithelialization of the prolapsed fibrous tissue by proliferation and migration of epithelial cells from the surrounding epithelium until there is full epithelial covering of the polyp. This report discusses whether the described middle ear model may form basis for the explanation of the pathogenesis of nasal polyps.
Animals↗
Immunocytochemical detection of basement membrane antigens in the histopathological evaluation of laryngeal dysplasia and neoplasia.
Immunocytochemical detection of intrinsic components of the basement membrane (type IV collagen and laminin) was performed in biopsies of carcinoma in situ, dysplasia and hyperplasia of the laryngeal mucosa. We found a distinct and continuous basement membrane, containing both laminin and type IV collagen, at the border between epithelial cells and mesenchymal stroma in normal as well as in hyperplastic and dysplastic mucosa. In contrast, irregular discontinuities were found in some cases of carcinoma in situ and in invasive carcinoma. In addition, immunoreactivity for intracytoplasmic basement membrane components was noticed occasionally in neoplastic epithelial cells. In areas of inflammation, infiltration of leucocytes into the epithelium was occasionally accompanied by sharply defined small interruptions of the basement membrane. Our results indicate that immunohistochemical detection of basement membrane components can be of value for the demonstration of microinvasive growth in laryngeal cancer.
Antigens↗
The structure of the middle ear epithelium of the rat and the effect of Eustachian tube obstruction.
The middle ear cavity of the rat is lined with ciliated and squamous epithelium. The arrangement of the ciliated cells, interspersed with secretory cells, in distinct tracts and their continuity with the ciliated epithelium of the Eustachian tube, suggests the existence of a mucociliary transport system for cleaning the middle ear cleft. The secretory cells produce either neutral or sulphated glycoproteins, dependent on their location. In addition to these secretions, the epithelium of the lower part of the Eustachian tube is bathed with secretory products of seromucous glands. Also in the areas with squamous epithelium, numerous small secretory cells, the character of which is only identifiable with the electronmicroscope, are present. It is concluded that the middle ear lining can be considered as a locally modified respiratory epithelium. Blockade of the mucociliary transport system, supposedly a crucial aetiological factor in secretory otitis media, by obstruction of the Eustachian tube, induces pathogenic behaviour of microorganisms normally present in the middle ear. This results in either a transient or a longstanding infective middle ear disease, associated with a large variety of changes of the mucosa, especially with respect to the secretory activity. The data obtained indicate that the increased secretory activity encountered in secretory otitis media cannot be attributed to the isolated effect of tubal occlusion, but rather to an infective process.
Animals↗
The role of microorganisms in experimental eustachian tube obstruction.
Explore the source record for details and available documents.
Animals↗
The mucoperiosteum of the middle ear in experimentally induced sterile otitis media.
The effect of Eustachian tube obstruction has been studied in germ-free rats. This model proved to be a reliable approach by which to study the isolated effect of tubal occlusion without the interference of infection. The effects on the middle ear structures are characterized mainly by stratification and hyperplasia of the epithelium, a transient increase in the periosteal activity, tympanosclerotic-like changes and accumulation of cholesterol in the middle ear fluid. No increase in the number of secretory elements could be registered during an observation period of 2 years.
Animals↗
Effect of tubal occlusion on bone formation in the middle ear of the rat.
The effect of experimental occlusion of the Eustachian tube in rats have been studied. Only in germ-free animals it has been possible to eliminate infection as a complicating factor. The formation of new bone in the wall of middle ear and bulla was apparent soon after occlusion, even in the absence of infection. These findings suggest that tubal occlusion causing serous otitis media can lead to extensive changes in the bone lining the middle ear cavity and this could explain the condensation of bone found in ears without any apparent sign of infection.
Animals↗
Successful methotrexate therapy in oral florid papillomatosis.
Oral florid papillomatosis is a rare syndrome, which was first described under this name by Rock & Fisher in 1960. The same syndrome had been previously described as papillomatosis mucosae oris carcinoides by Scheicher-Gottron (1958). It is a benign condition, capable of malignant degeneration. Surgical excision and electrocoagulation are the most widely used therapeutic methods, despite the fact that relapse of symptoms after treatment by these methods is common. The literature comprises a few reports on favourable therapeutic effects obtained with small doses of methotrexate. This paper describes a patient with multifocal, very extensive form of oral florid papillomatosis, in whom both surgical excision and electrocoagulation were regarded as inadequate in view of the extensiveness of the lesion. Chemotherapy with methotrexate proved to be effective and resulted in complete remission. No relapse has occurred during a follow-up period of over 2 years. The value of chemotherapy with methotrexate in the treatment of an extensive form of oral florid papillomatosis is emphasized.
Aged↗
The effect of experimental tubal obstruction on the middle ear. Preliminary report.
The rat was used as a model for studying the effect of tubal obstruction on the middle ear. Animals raised under conventional conditions, SPF- and germ-free animals were used. The predominant findings were: (1) Tubal occlusion causes an effusion of serous fluid into the middle ear cavity and promotes the pathological behaviour of pathogen and non-pathogen symbionts of the middle ear cavity. (2) The germ-free animal is an excellent model for studying the isolated effect of tubal obstruction without the interference of infectious disease. (3) The middle ear reacts towards tubal obstruction by a tendency to resorb and to organize the fluid by phagocytosis and fibrosis of the cavity. Transformation of the epithelium into mucus-producing cells was observed only in those animals which developed a middle ear infection after occlusion. (4) The final result shows a near-totally obliterated middle ear cavity resembling the atelectatic middle ear in humans.
Animals↗