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Biomedical subjects

M S Strong

Publications and source records attributed to M S Strong.

At least 19 recordsLinked to original sources
PubMed1979

Induction chemotherapy in advanced squamous head and neck carcinoma with high-dose cis-platinum and bleomycin infusion.

Forty patients with advanced head and neck cancer were treated with combined Cis-platinum-Bleomycin chemotherapy. Cis-diammine dichloroplatinum (DDP) 120 mg/m2 iv was given after prehydration, with mannitol diuresis on Day 1. On Day 3, an initial loading dose of Bleomycin 15 mg/m2 was given by rapid iv push followed by continuous 24 hour intravenous infusion of Bleomycin 15 mg/m2 Day 3 through Day 10. DDP 120 mg/m2 iv was administered again on Day 22. The patients were evaluated for tumor response and resectability between Day 29 to Day 35. Of 39 patients who were evaluable, there were 8 complete responses or CR (20%) and 22 partial responses or PR (56%), for a major response rate of 76%. Nineteen patients had surgery (14 patients whose lesions were initially inoperable and 5 patients who were initially operable). Chemotherapy toxicity in 40 patients included alopecia (40), vomiting (39), mucositis (11), skin rash (10), fever (17), weight loss of more than 5 lbs. (25), WBC less than 3,000 (2), platelets less than 100,000 (1), peak serum creatinine of 2 mg% (3), severe-hearing loss (1), hypersensitivity reaction (2). Surgical complication in 19 patients were pharyngocutaneous fistulae (2), wound dehiscence (1), meningitis and brain abscess (1). There was one death secondary to nephrotoxicity. This particular combination chemotherapy when given as initial treatment, appears very effective in reduction of tumor bulk. Long-term follow-up and randomization is necessary to determine effect upon survival.

Aged↗
PubMed1979

The use of the carbon dioxide laser in the pediatric airway.

Congenital and acquired lesions of the pediatric airway present difficulties in management. Until recently, correction of these problems frequently involved an external approach to the larynx and trachea. Development of fiberoptic instrumentation, as well as the introduction of the Zeiss operating microscope, has now given the surgeon a new means to visualize the larynx and trachea. Soon after its development, the carbon dioxide surgical laser was coupled to these instruments to permit an extremely precise form of tissue excision and ablation. Its unique properties, including an extraordinary hemostatic effect, as well as minimal postoperative edema and scarring, make it an ideal tool for management of lesions of the pediatric airway. It has been employed successfully in the treatment of 177 lesions.

Bronchial Neoplasms↗
PubMed1979

Transoral management of localized carcinoma of the oral cavity using the CO2 laser.

Since 1972 we have been cautiously exploring the use of CO2 laser in the management of carefully selected cases of localized carcinoma of the oral cavity. At the present time our experience is based on the treatment of 57 patients with cancer of the oral cavity. The CO2 laser has been found to be an indispensable tool in the transoral management of T1 carcinomas, multiple superficial carcinoma, extensive leukoplakia and verrucous carcinoma. The laser allows precise excision of the lesion and involved mucosa and provides and excellent specimen for histologic verification of the margins. The morbidity of laser excision is minimal, so that a tracheotomy is not needed and patients can almost always be discharged on the following day. (Follow-up data on those patients at risk for 30 months indicate excellent control rates).

Adult↗
PubMed1979

Inverted papilloma and squamous cell carcinoma.

Since 1960, 15 patients with histologically proven inverted papilloma of the nose and paranasal sinuses have been treated at the University Hospital, City Hospital, and V. A. Hospital in Boston. Eight of these patients have been found to have squamous cell carcinoma in the pathological specimens; four of these patients have died of carcinoma. Wide surgical excision, usually through a lateral rhinotomy with exenteration of the invaded sinus as indicated, was the therapy of choice. In spite of the published incidence of carcinoma in inverted papilloma of approximately 7-24 per cent, we have found a much higher rate. We therefore, suggest that meticulous microscopic examination of multiple sections of inverted papilloma specimens be carried out in a search for evidence of squamous cell carcinoma. Inverted papilloma should be treated as a premalignant lesion by appropriate radical surgery.

Adult↗
PubMed1979

Seeding of parotid carcinoma along Vim-Silverman needle tract.

A case report of seeding of parotid carcinoma along a core biopsy needle tract is presented. Excision of the needle biopsy site at the time of definitive surgery is recommended. Aspiration needle biopsy with a fine needle is reliable, with tumor seeding less likely.

Aged↗
PubMed1978

Endocrinologically incomplete transethmoidal trans-sphenoidal hypophysectomy with relief of bone pain in breast cancer.

To assess endocrinologic completeness of transethmoidal trans-sphenoidal hypophysectomy and the relation between postoperative pituitary hormone levels and relief of bone pain, we tested pituitary reserve by measuring base-line values of follicle-stimulating hormone and luteinizing hormone, thyrotropin-relasing-factor-stimulated thyrotropin and prolactin, and levodopa-stimulated growth hormone after hypophysectomy in 15 menopausal women with metastatic breast cancer. In all 15 bone pain diminished or disappeared within 24 hours of operation. Pituitary-function testing identified only one patient as having had an endocrinologically complete hypophysectomy. Base-line gonadotropin levels and thyrotropin-releasing-factor-stimulated prolactin were the most reliable measures of residual pituitary function. We conclude that transethmoidal trans-sphenoidal hypophysectomy may not totally ablate pituitary endocrine function; effective relief of bone pain in patients with metastic breast cancer can follow this procedure despite residual pituitary function and the lack of objective tumor remission.

Bone Neoplasms↗
PubMed1978

Laryngeal carcinoma: transoral treatment utilizing the CO2 laser.

The CO2 laser has been found to be a useful adjunct in our efforts to treat laryngeal carcinoma. Utilized endoscopically, it has been of help in establishing the proper staging, in diagnosing recurrence after radiation therapy, in reestablishing airways blocked with tumor, in debulking tumor mass prior to radiation and/or chemotherapy, and as a primary mode of excisional therapy, all accomplished with minimal morbidity. Most patients may return home the first postoperative day, eating, with serviceable voice, and requiring no tracheotomy or analgesics, all of which provide a significant cost benefit.

Carbon Dioxide↗
PubMed1978

A randomized trial of preoperative radiotherapy in cancer of the oropharynx and hypopharynx.

One hundred patients with stage II and stage III cancer of the oropharynx and hypopharynx were treated under a protocol in which they were randomly selected for treatment by surgery alone or by combined preoperative radiotherapy and surgery. The schedule of preoperative radiation therapy chosen was 2,000 rads from a cobalt 60 machine delivered in five days. Eighty-six of the patients were evaluable at three years; there was no difference in the outcome of the treatment of the two groups. A similar study is urgently needed to determine the value of postoperative radiotherapy in the management of similar cancers.

Adult↗
PubMed1978

Histopathologic findings after cis-platinum bleomycin therapy in advanced previously untreated head and neck carcinoma.

Eleven patients with unresectable or marginally resectable (stage III and IV) cancer of the head and neck were treated according to protocol with preoperative chemotherapy, surgical resection, and postoperative radiotherapy. Chemotherapy consisted of a combination of cis-diamminedichloroplatinum (II) (cis-DDP), 120 mg/M2, and bleomycin, 15 mg/M2, given sequentially during a three week treatment period. Seven patients initially had unresectable lesions which became amenable to surgical resection after chemotherapy. All eleven patients had approximately a 25 to 100 per cent reduction in tumor size. Histopathologic examination after chemotherapy showed a marked tendency towards cellular differentiation and keratin formation. Tumor necrosis was conspicuous by its absence. These histologic changes appear to be different from those seen after the use of other chemotherapeutic agents and radiotherapy. The histopathologic results closely resemble those found after the administration of bleomycin alone, although considerably accentuated.

Adenocarcinoma↗
PubMed1978

Surgical advances in the treatment of lesions of the pediatric airway: the role of the carbon dioxide laser.

Transoral microsurgery of the larynx has now made it possible to treat multiple lesions heretofore only treatable by external approach. The introduction of the surgical carbon dioxide laser has been the single greatest advance in transoral surgery of the airway in the past 15 years. This modality of therapy offers many features not found in any other known form of surgery. It is especially useful in the pediatric airway where the avoidance of edema and the need for minimal scarring is most critical. Its unique aspects make this form of treatment most desirable in the pediatric laryngotracheal region.

Carbon Dioxide↗
PubMed1978

Use of a T-tube in management of a pharyngeal fistula after laryngectomy.

Pharyngocutaneous fistula is a frequent complication after total laryngectomy, and may cause the patient to remain hospitalized for long periods of time while efforts are made to close the defect. We describe a case in which a gallbladder T-tube was used to hasten closure of a recalcitrant fistula, and we have since used this often as an adjunct to the customary methods of management of this complication.

Drainage↗
PubMed1977

The morphology of human papillomas of the upper respiratory tract.

Recurrent squamous papillomas of the upper respiratory tract were examined by light microscopy, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Surface of the cells is irregular and is covered by numerous stout microvilli. These are shorter and broader than those of cells of the uninvolved mucosa. The villi often seem umbilicated at the apex; the remainder of them, however, are rounded. The epithelium participating in the formation of papillomas shows some maturation of the cells but this does not progress normally. The predominating area is the thickened spinous layer representing the bulk of the lesion. The basal layer shows mildly increased activity but the basement membrane is intact. The cells often are very closely packed but in some areas, more particularly in the deep layer, they are loosely arranged. The intercellular space contains a moderately electron-dense finely fibrillar material. No abnormal mitoses are found. The neighboring univolved epithelium often shows increased growth activity and some inflammation. The larygneal papillomas propably represent an overgrowth of epithelium which may develop following hindered desquamation caused and/or heralded by a chronic inflammatory condition probably of viral origin and may be preceded by epithelial metaplasia and hyperplasia.

Adult↗
PubMed1976

Occult tumors of the infratemporal fossa: report of seven cases appearing as preauricular facial pain.

Seven patients had occult malignant neoplasms either originating in or extending to the infratemporal fossa. Common symptoms were facial pain centered over the temporomandibular joint and facial numbness. These symptoms were sometimes associated with middle ear effusion and trismus. Multiple biopsies are often necessary to establish the diagnosis. The average delay in diagnosis from first symptom was 14 months. Infratemporal fossa neoplasia belongs in the differential diagnosis of facial pain.

Aged↗
PubMed1975

Diagnosis of carcinoma of the larynx: a review of current methods.

There is a need to establish the diagnosis of cancer of the larynx as early as possible. Delay in making the diagnosis should occur rarely if all of the available methods are fully utilized. Having established the presence of a carcinoma it should be possible to define the site and extent of the tumor; only with this additional information can the best treatment be selected. The use of a fiber-optic laryngoscope or a telescopic laryngoscope (Gould) has made examination of the "difficult larynx" more satisfactory. X-ray examination, with or without contrast material, has provided useful information regarding extent of the tumor, particularly with regard to its relation to the glottis. Microscopic laryngoscopy has proven to be a most reliable way to identifying "the early lesion" and of establishing the extent of an established tumor, especially if supravital staining is applied and the microsurgical laryngeal mirror and laryngeal caliper are used. The most difficult diagnosis to make at the present time is the presence of residual tumor after radiation, when the tumor does not present on the surface. The solution to this problem will not be found easily.

Fiber Optic Technology↗