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Biomedical subjects

M Merkel

Publications and source records attributed to M Merkel.

At least 55 records · Page 3Linked to original sources

Computed tomography of upper aerodigestive tract squamous cell carcinoma. Assessment following induction chemotherapy.

One hundred forty-seven previously untreated patients with stage III or IV upper aerodigestive tract squamous cell carcinomas were examined by computed tomography (CT) prior to treatment. Computed tomography was used to observe the tumor response in 72 patients receiving induction chemotherapy (100 mg/sq m of cisplatin on days 1 and 21 and 135 mg/sq m of bleomycin sulfate on days 3 through 10). The CT findings in ten patients were correlated with serial histologic examination of the operative specimens. Our study indicates that CT is useful in following tumor response to chemotherapy, provided the physician is aware of the limitations of scanning as outlined herein.

Carcinoma, Squamous Cell↗

Computed tomographic assessment of squamous cell carcinoma of oral and pharyngeal cavities.

Computed tomographic (CT) scans were prospectively obtained on 68 patients with previously untreated stages III and IV squamous cell carcinoma of the oral and pharyngeal cavity. We report herein the results of CT evaluation of primary disease arising in these sites, improvements in contrast-enhancement techniques, and CT assessment of the patient's condition after radiation or chemotherapy treatment.

Biopsy↗

Total columnar-lined esophagus: a case for congenital origin?

We describe a patient with a long history of hiatal hernia, who at autopsy was found to have an esophagus that was totally lined by columnar epithelium. To our knowledge, this is the first documented case of an esophagus totally lined by columnar epithelium in an adult. Recent articles have emphasized the acquired nature of Barrett esophagus, also known as lower columnar-lined esophagus. Several reports have shown the ascent of columnar mucosa from the lower to middle esophagus over time. The failure of the columnar epithelium lining the esophagus to revert back to squamous type, once the irritating stimulus is removed, casts doubt on the metaplastic nature of this lesion. We believe that Barrett esophagus in a condition characterized by persistence of fetal-type epithelium and that our case represents such an occurrence.

Barrett Esophagus↗

Computed tomographic evaluation of regional lymph node involvement in cancer of the oral cavity and oropharynx.

To evaluate the efficacy of computed tomography (CT) in the identification of metastatic cervical node involvement from cancer of the oral cavity and oropharynx, 61 consecutive, previously untreated patients with T2 or greater squamous cell carcinoma of these sites were studies prospectively by CT, followed within 1 month by surgery to the primary and neck as initial treatment. The CT scan of each patient was evaluated according to the location, size, and appearance of visible nodes, and each feature was correlated with the histopathologic findings of all 83 neck specimens. A significant relationship was found between CT findings (node size, node appearance, and multiplicity of nodes) and the pathologic status of the neck using Chi-square contingency table analysis (overall chi 2 = 30.928, p less than 0.001). This data supports the role of CT in the evaluation of patients with cancer of these sites.

Adult↗

Cricoarytenoid subluxation, computed tomography, and electromyography findings.

A case of cricoarytenoid subluxation secondary to endotracheal intubation and documented by computed tomography (CT) and electromyography (EMG) is reported. Successful endoscopic reduction of the displaced arytenoid is confirmed by CT. The normal anatomy and physiology of the cricoarytenoid joint is presented and the literature regarding this rarely reported injury is reviewed. Based on this review and the case reported, a treatment plan is proposed.

Arytenoid Cartilage↗

Bone tunnel enlargement after anterior cruciate ligament reconstruction with semitendinosus tendon using Endobutton fixation on the femoral side.

We evaluated 29 knees with a minimum follow-up of 2 years after anterior cruciate ligament (ACL) reconstruction using doubled autogenous semitendinosus tendons. On the femoral side, a 5-mm Mersilene tape (Ethicon, Norderstedt, Germany) with an Endobutton (Acufex Microsurgical, Mansfield, MA) was used. The tendon was fixed on the tibial side with two staples. Regarding the IKDC score, 66% of the patients were graded as normal or nearly normal. The anterior laxity side-to-side difference (KT 1000, man-max-drawer) was under 3 mm in 55% and under 5 mm in 90%. Radiographs taken in the lateral and anteroposterior projections of the knee showed sclerotic bone tunnel margins. The diameter of the bone tunnels were measured, corrected for magnification, then compared with the original reamed diameter to determine any change in size. Enlargement of at least 2 mm was identified in 72% of the femoral tunnels and 38% of the tibial tunnels. No correlation was found concerning the enlargement of the tunnel and the IKDC score or the residual joint laxity. We conclude that using an Endobutton-Mersilene construct in ACL reconstruction leads to femoral and tibial bone tunnel enlargement at follow-up of 2 years.

Anterior Cruciate Ligament↗

Computed tomography in the assessment of mandibular invasion by intraoral carcinoma.

A critical factor in the pretreatment evaluation of patients with carcinoma of the oral cavity or oropharynx is the presence or absence of bone invasion. A prospective study was performed to compare the sensitivity and specificity of plain radiographs and computed tomography in detecting mandibular invasion by cancer arising in these sites. Forty-three consecutive patients with previously untreated oral cavity or oropharyngeal carcinoma were evaluated preoperatively by intraoral radiographs (dental occlusal views and panoramic radiographs) and CT, and the results were compared with postoperative pathologic findings. Of the 11 cases in which pathologic examination confirmed bone invasion, conventional x-ray films were positive in seven (63.6%). Computed tomography confirmed bone invasion in all 11 (100%) of these patients. In addition, the CT scan was more specific than conventional x-ray films in detecting bone invasion. Based on the findings in this study, we strongly recommend CT as the only radiographic study necessary to evaluate intraoral carcinoma prior to treatment.

Aged↗