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Biomedical subjects

J P Jeannon

Publications and source records attributed to J P Jeannon.

13 recordsLinked to original sources

Is Ki67 a marker for the transformation of laryngeal dysplasia to carcinoma?

CONCLUSION: Ki67 is not a reliable marker of malignant transformation in laryngeal dysplasia. OBJECTIVES: No reliable means of predicting which cases of laryngeal dysplasia will undergo malignant transformation currently exists. Our aim was to evaluate Ki67, a marker of cell proliferation, as a potential marker for the transformation of laryngeal dysplasia to squamous cell carcinoma. PATIENTS AND METHODS: Eighty consecutive cases of previously untreated patients with a histological diagnosis of laryngeal dysplasia from 1987 to 1993 were identified from the pathological archives. Standard immunohistochemical techniques were used to identify Ki67-positive cells and activity was scored on a scale of 0-4 using defined criteria. RESULTS: Of the 80 cases there were 24 females and 56 males with a mean age of 56 years (range 29-80 years). Twenty cases subsequently transformed to a squamous cell carcinoma. For each Ki67 score (0-4), the rate of malignant transformation was: 0, 1 of 6 patients (17%); 1, 7 of 33 patients (21%); 2, 5 of 22 patients (23%); 3, 4 of 13 patients (31%); and 4, 3 of 6 patients (50%). A higher Ki67 score seemed to correlate with a higher likelihood of malignant transformation but this did not reach statistical significance (p=0.17, Pearson chi(2) test). Considering a score of 3 or 4 as positive for predicting malignant transformation produced a test of relatively high specificity (80%) but poor sensitivity (35%).

Adult↗

Acquired idiopathic laryngomalacia treated by laser aryepiglottoplasty.

Laryngomalacia is the most common paediatric airway problem presenting as stridor in the neonate. This congenital anomaly is thought to be caused by inward inspiratory collapse of the supraglottic larynx due to a prolapsed, tall and tubular epiglottis with flaccid aryepiglottic folds. The natural history of this condition usually results in spontaneous resolution by the second year of life. Although acquired cases of adult laryngomalacia have been reported, a search of the literature has yet to show any cases of idiopathic laryngomalacia. We present two cases of idiopathic acquired laryngomalacia in adults.

Aged↗

Expression of MUC1 and MUC2 glycoproteins in laryngeal cancer.

The aim of this study was to examine the expression of MUC1 and MUC2 glycoproteins in laryngeal cancer and to determine if mucin expression is related to prognosis. The study included laryngeal specimens from 57 patients comprising of 36 laryngeal carcinomas and 21 normal controls. High MUC1 expression was found in both carcinomas and normal control groups (P = 0.689, Fisher's exact test). High levels of MUC2 expression were only detected in carcinomas versus controls (P = 0.009, Fisher's exact test). Using multivariate analysis neither MUC1 nor MUC2 expression significantly related to survival. MUC1 expression however, did correlate with T stage. Advanced T stage was associated with prognosis (P = 0.001).

Adult↗

Altered MUC1 and MUC2 glycoprotein expression in laryngeal cancer.

The purpose of this study was to determine whether mucin expression is altered in laryngeal cancer. MUC1 and MUC2 mucin expression was examined in biopsy specimens from 80 patients that comprised 23 laryngeal dysplasias, 36 laryngeal carcinomas, and 21 normal larynx control specimens. High MUC1 expression was found in all 3 groups (P = 0.689, Fisher exact test). However, significantly higher levels of MUC2 expression were detected in carcinomas compared with dysplasias and control specimens (P = 0.009, Fisher exact test). Altered MUC2 expression may be an important step in carcinogenesis in laryngeal cancer.

Adult↗

Expression of cyclin-dependent kinase inhibitor p21(WAF1) and p53 tumour suppressor gene in laryngeal cancer.

The prognostic value of the expression of the cyclin-dependent kinase inhibitor p21 and the p53 tumour suppressor gene was examined using immunohistochemistry in 60 patients with laryngeal cancer. Multivariate analysis using Cox's proportional hazard method, showed that p21 expression (P = 0.02) and advanced T stage (P = 0.003) significantly predicted survival. It was concluded that p21 expression may be a useful prognostic indicator in laryngeal cancer.

Aged↗

Percutaneous (Portex) tracheostomy: an audit of the Newcastle experience.

The purpose of this study was to audit the results of percutaneous tracheostomies performed by ENT surgeons in Newcastle. During a 3-year period, 298 tracheostomies: 196 percutaneous and 102 open were studied. A complication rate for percutaneous tracheostomy was found to be 10% compared to 8% for open, this difference was not statistically significant chi 2 = 0.279, P = 0.598 (DF = 1). The indications for percutaneous tracheostomy were mainly limited to respiratory support for intensive care unit patients, whereas the majority of open tracheostomies were performed in the operating theatre. The results of this audit suggest that percutaneous tracheostomy is the method of choice for respiratory support in the intensive care unit and is as safe as the open technique.

England↗

Malignant peripheral nerve sheath tumour of the spinal accessory nerve.

A 50-year-old man presented with a left-sided neck mass. Clinical examination revealed a large fluctuant 7 cm x 7 cm mass in the left posterior triangle. Magnetic resonance imaging (MRI) revealed an encapsulated soft tissue lesion. He underwent exploration of the neck and a 14 cm by 8 cm mass enfolding the accessory nerve was identified and completely excised. Histological examination of the surgical specimen showed features in keeping with a malignant peripheral nerve sheath tumour (MPNST). We present the clinical and pathological features of this condition.

Accessory Nerve Diseases↗

Immunohistochemical detection of oestrogen and progesterone receptors in salivary tumours.

The purpose of this study was to determine the oestrogen and progesterone receptor status of a selection of salivary tumours. Using immunohistochemistry, we detected nine oestrogen receptor and six progesterone receptor positive tumours from a sample of 36. One acinic cell carcinoma and two mucoepidermoid carcinomas demonstrated positivity for both receptors. We suggest that there may be role for oestrogen manipulation in the management of some salivary tumours.

Female↗

Audit of regional screening guidelines for vestibular schwannoma.

An audit of 334 patients who underwent magnetic resonance imaging (MRI) as investigation for a possible diagnosis of vestibular schwannoma was carried out to assess adherence to previously agreed screening guidelines. This represents one year's activity. A posterior fossa tumour was identified in 12 patients. Scan requests were judged to be inappropriate for 28 cases. The issues surrounding the screening for acoustic neuroma are discussed.

Adult↗

Vocim analysis of laryngeal images: is breathiness related to the glottic area?

The aim of this study was to determine the relationship between glottic space and breathy voice. Using a new computerized method of analysing the glottic area of video images with the Vocim computer system, 16 patients with a vocal cord palsy and 31 with non-organic dysphonia were examined. The quality of the breathy voice was assessed and correlated with the size of the glottic space during phonation. There was a positive (r = 0.70) correlation between glottic area and breathy voice in vocal cord palsy. There was no correlation (r = 0.002) in non-organic dysphonia. Therefore in this study population, for vocal cord palsy, glottic area is the dominant feature in determining voice quality. This relationship is not maintained in non-organic dysphonia.

Glottis↗

Temporal bones for dissection. A diminishing asset?

In this prospective study, the author studied four local ENT departments to discover how many temporal bones were being harvested. The results show that only eight per cent of routine post mortems have temporal bones removed.

Autopsy↗