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Mike Yao

Publications and source records attributed to Mike Yao.

9 recordsLinked to original sources
PubMed2006

Current surgical treatment of squamous cell carcinoma of the head and neck.

Historically treatment of head and neck cancers involved surgical resection followed by radiation therapy for advanced tumors. Concurrent chemoradiation therapies have shown equal survival to surgical resection with better preservation of function. However, concurrent therapy does entail significant morbidity, and recent advances have been used to minimize that morbidity. Newer tumor specific medical therapies are anticipated to be less toxic while maintaining a high degree of efficacy. For resectable cancer, transoral laser microsurgery is a new trend in surgery for complete resection of tumors with preservation of function. Advanced reconstructive techniques that allow free transfer of soft tissue and bone from all over the body improve the functional and aesthetic outcomes following major ablative surgery. With successful surgical reconstruction, dental and prosthetic rehabilitation choices are enhanced. Advances in rehabilitation of speech following removal of the larynx have improved the quality of life post-laryngectomy patients. With these newer therapies and methods of reconstruction, each patient needs to be carefully evaluated to maximize the possibility of cure and level of function, and minimize the morbidity associated with treatment. Combined chemotherapy and radiation protocols are associated with increased acute and chronic toxicities that may affect the quality of life due to the impact upon oral disease and oral function. Oral care providers must be aware of advances in cancer management and implications for patient care to effectively care for these patients.

Carcinoma, Squamous Cell↗
PubMed2006

Peep show establishments, police activity, public place, and time: a study of secondary effects in San Diego, California.

An empirical study was undertaken in San Diego, California, to test assumptions made by the government and by conservative religious policy advocates that there is a greater incidence of crime in the vicinity of peep show establishments. We asked two questions: (a) Is criminal activity in San Diego particularly acute at peep show establishments compared to surrounding control locations? and (b) Is criminal activity in San Diego disproportionately greater at or near peep show establishments between the hours of 2 a.m. and 6 a.m. compared to other times of the day? The levels of crime activity and the expenditure of police resources were examined by measuring the number of calls-for-service (CFSs) to the police within a 1,000-ft. area on either side of the peep show establishments and comparably-sized control areas beyond the immediate 1,000-foot area. A more focused late-night (2 a.m. to 6 a.m.) analysis was also undertaken. The results showed no reliable evidence of differences in crime levels between the control and test areas, nor was there any evidence of disproportionately greater amounts of crime within the 2 a.m. to 6 a.m. time period in the areas surrounding the peep show establishments. We concluded that San Diego does not have a problem with crime at the peep show establishments generally, nor is there a heightened problem with crime during the 2 a.m. to 6 a.m. period. We discuss the implications of assuming that peep show establishments are associated with negative effects in the community and the possibility of viewpoint discrimination against sex communication.

Aggression↗
PubMed2006

Management of a tracheal tear during laryngopharyngoesophagectomy with gastric pull-up.

Laceration of the posterior tracheal wall is one of the risks of transhiatal esophagectomy. Various methods of repairing such lacerations have been described; many of these methods involve a thoracotomy, but some do not. We describe a case of a posterior tracheal wall tear that occurred during a laryngopharyngectomy with a gastric pull-up. The tear was repaired with the transposed stomach and did not require a thoracotomy. The transposed stomach was used to patch the tear and block communication between the environment and the mediastinum. Bedside endoscopic examination on postoperative day 5 revealed that the tear had healed. Key management considerations in such a circumstance include having the patient breathe without positive pressure ventilation postoperatively and keeping the tracheal lumen and stoma clear during the healing process in order to prevent the development of positive tracheal pressure. With these safeguards in place, the transposed stomach approach is a safe method of repairing posterior tracheal wall tears.

Aged↗
PubMed2005

Review of current treatment practices for carcinoma of the head and neck.

The past two decades have witnessed a paradigm shift in the treatment of squamous cell carcinoma of the head and neck. Innovation in chemotherapy, radiotherapy and surgery has led to the assimilation of these modalities into our treatment algorithms. This modern multipart treatment plan has led to improved survival; however, this has come at the cost of increased toxicity. New and future therapies will be more tumour specific and, ideally, less toxic. Current research centres on these tumour-specific therapies with the anticipation of improved survival with decreased toxicity. This article will review the standard of care, recent advances and unfulfilled needs in the treatment of squamous cell carcinoma of the head and neck.

Algorithms↗
PubMed2004

Essential role for hematopoietic Fas ligand (FasL) in the suppression of melanoma lung metastasis revealed in bone marrow chimeric mice.

The outcome of cancer metastasis depends on multiple interactions between the malignant cell and the host environment. Such interactions can influence primary cancer growth and metastasis by altering the balance between tumor cell proliferation and death. We have previously reported that the pro-apoptotic protein FasL could potently suppress spontaneous lung metastasis of the Fas-sensitive melanoma, K1735-P. In this report, we have constructed bone marrow chimeric mice using wt and FasL-deficient animals to delineate the source of FasL (hematopoietic or nonhematopoietic) required to control spontaneous metastatic spread from a subcutaneous tumor. Using FasL-deficient animals (gld) reconstituted with wt FasL bone marrow (wt --> gld), and wt animals reconstituted with FasL-derived bone marrow (gld --> wt), we show, for the first time, an essential role for hematopoietic-derived FasL in the suppression of K1735-P metastasis. When FasL was expressed only in the nonhematopoietic compartment (gld --> wt), K1735-P spread was ineffectively controlled with a metastatic phenotype similar to that observed in animals completely lacking FasL (gld --> gld or gld controls). These studies provide evidence for the indispensable role for FasL+ bone marrow-derived cells in the control of melanoma and offer a strategy to target FasL expression in the prevention or therapy of metastatic disease.

Animals↗
PubMedDate not supplied

Elective neck dissection during salvage laryngectomy.

PURPOSE: To evaluate the rate of occult metastases detected with elective neck dissection during salvage laryngectomy for radiation failures. METHODS AND MATERIALS: Retrospective review of 63 patients failing radiation therapy treated with salvage surgery between 1970 and 1999. Charts were reviewed for tumor stage, neck treatment, complications, surgical time, and survival. Median follow-up for patients with glottic and supraglottic cancers was 7.8 and 4.5 years, respectively. RESULTS: Thirty-one of 41 glottic cancer patients received elective neck dissections. Three (10%) of 31 had occult metastases. Recurrent staged rT3 and greater tumors showed a 20% rate of occult metastases. No survival advantage was noted between patients treated with elective neck dissection and those followed expectantly (P = .87). Cartilage invasion and perineural invasion in the larynx were associated with a higher risk of occult metastases (P < .05). Ten of 22 supraglottic cancer patients received elective neck dissections. Two (20%) of 10 had occult metastases, and a statistically significant survival advantage was not noted (P = .49). CONCLUSIONS: We recommend bilateral neck dissection at the time of laryngectomy for recurrent staged rT3/4 tumors and all patients with recurrent supraglottic cancers because of the higher rate of occult metastases.

Adult↗
PubMedDate not supplied

Localizing hyperfunctioning parathyroid tissue: MRI or nuclear study or both?

The surgical approach to primary hyperparathyroidism patients has changed recently with minimally invasive surgery becoming more common. This retrospective study reviews the relative sensitivities of dual-phase sestamibi (DP-SI) and magnetic resonance imaging (MRI) in preoperative patients. We found that MRI was more sensitive, but the difference was not statistically significant. Magnetic resonance imaging enhanced the ability to localize abnormal tissues when the DP-SI was negative. Together, both tests demonstrated a sensitivity of 92%. We recommend performing DP-SI initially, and if negative, MRI. This should provide the highest imaging sensitivity at the lowest cost.

Adolescent↗