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Biomedical subjects

M Z Siodlak

Publications and source records attributed to M Z Siodlak.

10 recordsLinked to original sources

Disposition and tumour concentrations of platinum in hypoalbuminaemic patients after treatment with cisplatin for cancer of the head and neck.

1 Platinum concentrations in the tumour reached a peak of 3.8 +/- 1.5 micrograms g-1 wet weight tissue at the end of an 8 h intravenous infusion of cisplatin. The tumour concentrations of platinum were higher than the corresponding plasma concentrations (2.5 +/- 0.9 micrograms ml-1) and declined more slowly. 2 Patients with squamous carcinoma of the head and neck had a significantly shorter median survival time if they had low plasma albumin concentrations (less than 40 g l(-1) compared with patients in the normal range, 133 days and 768 days respectively (P less than 0.05) after treatment with cisplatin. 3 No changes in the pharmacokinetics of platinum were detected to account for this poor response of hypoalbuminaemic patients, but plasma albumin concentration was found to be negatively correlated with the first order elimination rate constant. 4 The cumulative urinary excretion of platinum in the first 24 h was not altered by lowered plasma albumin. 5 The concentration of platinum in the tumour did not correlate with the survival time of the patient, but was found to be correlated with the volume of distribution in the post-distributive phase.

Adult↗

Alternating cisplatinum and VAC ineffective in end stage squamous cell carcinoma of the head and neck.

Sixteen patients with end stage squamous cell carcinoma of the head and neck were admitted to a phase II study of alternating courses of cisplatinum (100 mg/m2) and VAC (vincristine 1.4 mg/m2, adriamycin 50 mg/m2, cyclophosphamide 750 mg/m2) given at three weekly intervals. Only two patients achieved a response (12 per cent). The median survival time was 62 days which is much the same as that of a similar group of patients who received no chemotherapy in a previous trial (70 days).

Aged↗

Induction VBM plus radiotherapy, versus radiotherapy alone for advanced head and neck cancer: long-term results.

Between 1978 and 1981, 85 patients with advanced squamous cell carcinoma of the head and neck were randomized to receive induction VBM followed by radiotherapy, or radiotherapy alone. The shortest follow-up is thus 6 years. The median survival of patients receiving induction chemotherapy was 46 weeks, that of the radiotherapy group alone was 75 weeks. As the two groups were not balanced despite randomization, multivariate methods (GLIM) were used to identify significant prognostic factors. These were: response to radiotherapy (P less than 0.001), nodal status (P less than 0.001), age (P less than 0.01), and histological grade (P less than 0.01). Neither treatment with, nor response to, chemotherapy had a significant effect on survival.

Adult↗

The stuffy nose: a comparative study of two common methods of treatment.

This study compares the efficacy of submucosal diathermy and cryotherapy in the treatment of nasal obstruction caused by engorged inferior turbinates. Subjectively they are equally effective but cryotherapy has the advantage that it can be performed under local anaesthetic and does not require hospitalization. Rhinomanometry suggests that cryotherapy causes more destruction of the submucosal vascular plexus than submucosal diathermy. Scanning electron microscopy 6 weeks postoperatively demonstrates that both treatment modalities cause widespread damage to the mucociliary epithelium.

Adolescent↗

Assessment of nasal airway patency: a comparison of four methods.

Two established methods (active posterior and passive anterior rhinomanometry) and 2 new methods (peak nasal inspiratory flow rate and apparent nasal volume) were used in 12 volunteers to assess the patency of the nasal airways under each of 4 conditions (baseline, post-exercise, nasal histamine and nasal cocaine). All methods showed the congestant effect of histamine but the peak nasal inspiratory flow and apparent nasal volume techniques were more sensitive to the 'decongesting' manoeuvres, (exercise and cocaine). Useful objective quantitative data on the patency of the nasal airways and its changes in response to stimuli can be obtained by simple, cheap and readily available techniques. Subjective sensation is a poor guide to the state of patency of the nasal airways.

Adult↗

Fine needle aspiration biopsy of neck lumps in a district hospital.

This paper examines the results of 117 fine needle aspiration biopsies performed on head and neck lumps over the first 3 years of its use in a district general hospital. The cytological diagnosis has corresponded exactly with the histological diagnosis in 51% of cases and the concurrence rate has been 84%. Fifty-seven (49%) of the 117 masses proved to be malignant and 79% of these were correctly diagnosed by needle biopsy. A further 12% of the aspirations were highly suspicious of malignancy. There were no false positive aspirations (specificity 100%) and 4 false negative results (sensitivity 93%). No complications were encountered.

Biopsy↗

Fibre optic guided nasal intubation--shouldn't we be the experts?

Difficult intubations are more common in otolaryngological practice than any other branch of medicine or surgery. The majority of these are predictable. It is the unexpected intubational failure, usually in a patient undergoing treatment for an unrelated problem, that results in tragedy. In this paper the indications for fibre optic guided intubation are discussed, and the technique described and illustrated in a case of pharyngeal obstruction secondary to an epiglottic cyst. It is suggested that our expertise to operate within the upper airway should be exploited to the advantage of our patients, and of our anaesthetic and surgical colleagues.

Airway Obstruction↗

Post-tonsillectomy secondary haemorrhage.

This paper compares the incidence of secondary haemorrhage in post-tonsillectomy patients who were discharged 48 hours after operation (2.8%) with those discharged at 24 hours (3%). There was no significant difference between the groups. A higher incidence of secondary haemorrhage in those patients in whom diathermy was used for haemostasis rather than ligatures (P less than 0.01) supports previous studies.

Adolescent↗