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Biomedical subjects

L Schour

Publications and source records attributed to L Schour.

17 recordsLinked to original sources

A comparison of masticatory function in patients with or without reconstruction of the mandible.

BACKGROUND: The functional benefits of mandibular reconstruction following a composite resection remain unclear. Although microvascular surgical techniques have dramatically increased the predictability of bone and soft-tissue reconstruction towards presurgical anatomic norms, the specific factors responsible for improved function remain controversial. Objective measures of masticatory function need to be more clearly determined before the predictability and efficacy of reconstructive approaches is established. METHODS: We evaluated objective measures of oral function and patient reports of function in 10 reconstructed mandibulectomy patients, 10 without reconstruction, and 10 controls. Measures of oral function included bite force assessed at the first molar and incisal edge, a measure of tongue and cheek function, and patient reports of food they could eat. RESULTS: Both reconstructed and nonreconstructed patients presented decreased biting force, a more restricted diet, and compromised cheek and tongue function as compared with normals. However, reconstructed patients had significantly better measures of tongue function and ability to eat a varied diet than did nonreconstructed patients. Of the objective measures used to measure masticatory performance, bite force was poorly correlated, whereas measures of tongue function strongly correlated with successful mastication. CONCLUSION: Both reconstructed and nonreconstructed patients presented with a significant functional deficit when compared with normals, with reconstructed patients having better overall function than nonreconstructed patients.

Aged↗

Surgical management of advanced cutaneous malignant melanoma.

In the past, surgical treatment of cutaneous melanoma has been determined largely by assessment of the regional nodes by clinical palpation. More recently, an increasing number of reports indicate that measurement of the histologic thickness of primary melanomas and evaluation of the level of penetration of tumor cells into the dermis can predict the likelihood of development of nodal metastases. In addition performance of fine needle aspiration of questionably involved regional nodes has provided cytologic data regarding nodal metastases. The role of certain procedures, such as prophylactic (elective) node dissection remains clouded because adequate numbers of properly controlled studies have not been reported. However, increasing knowledge of important prognostic factors, cytologic findings from needle aspiration of regional nodes, as well as the clinical assessment of regional nodes, can all aid formulation of more rational management recommendations.

Biopsy↗

BCG-induced protection against malignant melanoma: possible immunospecific effect in a murine system.

This report documents for the first time BCG-induced protection against a murine malignant melanoma. Adult Balb/C mice recieved 0.1-cm3 doses of BCG prior to intramuscular challenge with 1 x 10-6 S-91 melanoma cells. A 65% reduction in melanoma incidence was noted in BCG-pretreated mice. The possibility of specific protection induced by the BCG against the melanoma exists, since the BCG pretreatment did not protect against challenge with 1 x 10-5 mammary carcinoma cells or 1 x 10-4 MCA fibrosarcoma cells in the same strain of mice. Lack of immunogenicity was not a factor in the inability of the carcinoma and sarcoma to be inhibited by BCG. The strenght of the BCG-induced protection against the S-91 melanoma was demonstrated by significantly decreased tumor incidence following three different log challenge doses of the melanoma. However, reduction of the sarcoma challenge dose to as few as 10-2 cells administered to BCG pretreated mice did not result in decreased tumor incidence. It was further discovered that as few as two doses of 0.1 cm3 of BCG were sufficient to produce a 70% reduction in melanoma incidence compared with the incidence in control animals (P less than .001). Lymphocyte-mediated cytotoxicity studies paralleled the results of the in vivo experiments. Lymphocytes immune to each of the three tumors showed significant cytotoxicity against their respective tumor target cells (p less than .001), while the only tumor cells that lymphocytes from BCG-pretreated mice showed significant cytotoxicity against were S-91 target cells (p less than .01). Nonspecific cytotoxicity was not a factor in the effect of BCG-immune lymphocytes against S-91 target cells, since BCG-immune lymphocytes were not cytotoxic to Balb/C fibroblasts.

Animals↗

Squamous cell carcinoma of the oral cavity--chronic oral ulcerative disease as a possible etiologic factor.

This report documents the association of carcinoma of the oral cavity with chronic oral ulcerative disease in two patients. This association has not previously been documented in the surgical literature. Both patients in this report had chronic oral ulcerative disease preceding their cancers; however, the common etiologic factors for oral cancer were not detected in either case. Oral lichen planus and pemphigus vulgaris should be considered as potentially premalignant lesions and should be treated accordingly.

Aged↗

The role of the spleen and immunity in the metastatic pattern of a murine reticulum cell sarcoma.

A reticulum cell sarcoma (RCS) which initially metastasizes selectively to the spleen in C3H/HeN mice has been studied. Previous reports indicated that removal of the spleen results in widespread metastases of this tumor. The current experiments utilized a parabiotic system to determine the effect of additional splenic tissue on the gross and microscopic metastatic pattern of this RCS. The results were that the addition of a second spleen in the parabiotic group was followed by a significant decrease in visceral metastases compared with the splenectomized group. Parabiotic animals with splenectomized partners and sham-operated animals did not significantly differ from control (single) animals, with all three of these groups showing visceral metastatic spread intermediate between the parabiotic and splenectomized groups. The protective effect of additional spleen against visceral metastases was found not to be immunologic, since immunosuppression of mice by irradiation produced a metastatic pattern similar to that of control animals.

Animals↗

Staging laparotomy in the treatment of metastatic melanoma of the lower extremities.

Twenty-six consecutive patients with melanoma of the lower extremities metastatic to the superficial inguinal lymph nodes were subjected to laparotomy. No patient had preoperative evidence of tumor dissemination past the superficial inguinal nodes. However three patients (12%) had metastases to the liver or para-aortic lymph nodes documented at laparotomy and were not subjected to iliac and obturator lymph node dissection. One of these patients had concomitant local recurrence of melanoma at the ankle. The other two patients had superficial inguinal lymph nodes at least 5 cm in diameter, although two other such patients with similar 5 cm lymph nodes did not have positive intra-abdominal findings. The remaining 23 of the 26 patients underwent ipsilateral iliac and obturator lymph node dissection, which proved positive in 3/23 patients (13%). Of these 23 patients undergoing iliac and obturator node dissection, 18 had clinically positive (and microscopically positive) superficial inguinal nodes prior to their dissection, while the remaining 5 patients had clinically negative (but microscopically positive) superficial inguinal nodes. The three cases of positive dissected iliac and obturator nodes occurred among the 18 patients with clinically positive superficial inguinal nodes (17%). Among the 5 patients with clinically negative, microscopically positive superficial groin nodes, there was no detectable deep inguinal nodal spread (or hepatic or para-aortic involvement).

Adolescent↗

Malignant melanoma: specific immunity induced by bacillus Calmette-Guérin in BALB-c mice.

Previous treatment of BALB/c mice with bacillus Calmette-Guérin (BCG) will significantly protect them against intramuscular challenge of S-91 melanoma but not against a mammary carcinoma or a methylcholanthrene-induced sarcoma. Lymphocyte-mediated cytotoxicity studies correlate with in vivo data in showing that BCG-immune lymphocytes are specifically cytotoxic to S-91 melanoma target cells but not to the carcinoma or sarcoma target cells.

Animals↗

Radical treatment of recurrent cytosarcoma phylloides.

Malignant cystosarcoma phylloides is a rare breast cancer which frequently recurs locally before metastasizing. Local recurrence of cystosarcoma phylloides is unlike adenocarcinoma of the breast since it does not necessarily indicate systemic metastases; and, therefore, aggressive surgery can cure a number of patients with locally recurrent tumor. The present report is an extreme example of a patient with locally recurrent malignant cystosarcoma phylloides, and it illustrates the value of radical surgery in controlling this disease which had previously recurred 21 times. Fifteen months following sternal resection, the patient enjoys her longest tumor-free interval in 16 years.

Breast↗