Biomedical subjects
N de Vries
Publications and source records attributed to N de Vries.
Relationships of vitamins A and E and beta-carotene serum levels to head and neck cancer patients with and without second primary tumors.
Second primary tumors constitute one of the most challenging problems in head and neck cancer. Their etiology is not yet fully understood. For this reason, we studied the relationships of vitamins A and E and beta-carotene serum levels in patients with head and neck cancer with and without second primary tumors. The results indicate lowered levels of beta-carotene in both groups of patients, while the levels of vitamin A and vitamin E were statistically significantly lower in patients with second tumors than in the group with a single head and neck cancer. This suggests that low vitamin A and vitamin E levels may play a role in the etiology of second tumors in head and neck cancer patients.
[(Chemo-) prevention of second tumors in patients with head and neck neoplasms].
This review discusses the possible role of chemoprevention in the improvement of survival rates and the prevention of secondary primary tumours in patients with head and neck cancer. Chemoprevention is a new treatment that is especially promising for high risk groups. The fear that the advantages of this treatment will be outweighed by the disadvantages of side-effects and toxicity has not been confirmed by current studies. Randomized studies are needed to show whether chemoprevention can reduce the frequency of second primary tumours.
[Occupation and cancer of the oral cavity, pharynx and larynx].
There is increasing evidence of an association between occupational factors and head and neck cancer. The present paper reviews the most relevant epidemiological studies published within the last 30 years. Generally these studies indicate an increased cancer risk for "blue collar workers" exposed to dust or inhaled organic and inorganic agents. Moreover, the increased risk of head and neck cancer in most studies persists after adjustment for alcohol and tobacco consumption. More detailed, clinically orientated studies are necessary to provide a better understanding of the role of occupational factors in head and neck cancer.
Local anaesthetic block therapy of posttraumatic neuralgia of the infraorbital nerve.
The pathogenesis, as well as the results of treatment in 12 patients with neuralgia of the infraorbital nerve are discussed. Patients were treated by means of local anaesthetic nerve blocks, or when this was unsuccessful, by transcutaneous nerve stimulation and or tricyclic antidepressive drugs. In this way, the results were good in previously untreated patients, while they were moderate in patients in whom an attempt to treat with surgery had been carried out earlier. We recommend the use of local anaesthetic nerve blocks as treatment of the first choice.
[Various aspects of nasal polyps].
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Toxic shock syndrome after nasal surgery: is prevention possible? A case report and review of the literature.
Toxic shock syndrome (TSS), is an acute illness with four major criteria: involvement of multiple organ systems, fever greater than 38.9 degrees C, hypotension or shock and rash with subsequent desquamation. TSS was first reported by Todd et al. in 1978, and is a rare complication of staphylococcal infection. Although it at first was thought to be a childhood disease and an illness of menstruating women using intravaginal tampons, it has now been described as a complication of minor surgery, burns and minimal skin infections (Reingold et al., 1982; Jacobson et al., 1983). More than 2800 cases have been reported at the Centers for Disease Control (CDC) in Atlanta (Reingold, 1985). Jacobson and Kasworm (1986) estimate the incidence after nasal surgery to be 16.5 per 100.000, which in fact is higher than the incidence in women of menstrual age using intravaginal tampons. TSS usually occurs within 24-48 hours after surgery, often starting with nausea and vomiting. Although the syndrome can be lethal or can have troublesome sequelae, as prolonged weakness fatigue and neuropsychological disturbances, complete recovery is often the case.
[Timely diagnosis of isolated nose fractures].
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[Functional endoscopic surgery of the paranasal sinuses].
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New bone formation in nasal polyps.
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Laryngeal cancer and lung cancer in the same patient: a retrospective study.
Fifty-four patients with laryngeal cancer and lung cancer were analyzed with regard to histology and localization of the lung cancer, the time interval between the detection of the two tumours and survival. It appeared that most lung tumours were squamous cell carcinomas, half of which were centrally localized and most occurred metachronously in the first 4 years after the laryngeal carcinoma. The survival rate was poor, due to the fact that the bronchial carcinoma usually was found beyond a curative stage. It appears that the present follow-up in laryngeal cancer patients--frequent ENT-examination, yearly chest X-ray examination--is often inadequate for early detection of lung cancer and curative treatment. It might be that by intensifying follow-up in laryngeal cancer patients by bronchoscopy, sputum cytology and more frequent chest X-ray examination, more bronchial carcinomas would be detected in a curative stage.
[Primary tumors of the lung in patients with squamous cell carcinoma of the head and neck region: a challenge].
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Human leukocyte antigens and immunoglobulin allotypes in head and neck cancer patients with and without multiple primary tumors.
Human leukocyte antigens (HLA) and immunoglobulin (Ig) allotypes were examined in 98 patients with single head and neck cancers, and in 51 patients with multiple primary tumors. Immunoglobulin allotype Km (1) was present in 4% of patients with multiple primary tumors versus 21% in patients with a single head and neck cancer. The frequency of HLA-B8, HLA-DR3, and HLA-DQW2 in patients with multiple primary tumors and of HLA-B8, and HLA-B45 in patients with a single head and neck cancer increased significantly as compared with the control population. Those data suggest genetic influences--next to environmental factors--on the pathogenesis of multiple primary tumors in head and neck squamous cancer. It might be worthwhile to use HLA typing and Ig allotyping in the selection of patients in whom aggressive screening for second tumors is mandatory.
Case report 399: Pachydermoperiostosis (primary hypertrophic osteoarthropathy).
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Multiple primary tumors in patients with laryngeal squamous cell hyperplasia.
We analyzed retrospectively the case histories of 204 patients with squamous cell hyperplasia of the larynx for the occurrence of multiple primary tumors. All patients were grouped according to Kleinsasser's 1963 classification of laryngeal pathology. Patients with simple hyperplasia (class I) had a low risk for developing a coincidental primary tumor. The rist was 7% in patients with hyperplasia with atypia (class II) and was 15% in patients with carcinoma in situ (class III). This frequency is similar to that of our patients with glottic cancer (13%). Although no coincidental tumors were found in our female patients, the small number of females in our series made the differences in frequency between males and females not significant. This is still of interest to us because our previous study of patients with proven glottic cancers also showed that no second tumors occurred in our female patients. This difference was statistically significant. In our present study, all second tumors occurred metachronously. Our findings indicate that all patients with class III laryngeal disease (carcinoma in situ) should undergo the same aggressive search for second primary tumors, as do patients with invasive glottic cancers. This means that panendoscopy or bronchoscopy should be done at the initial work-up and also at periodic intervals during the follow-up period. We have also found that patients lacking immunoglobulin allotype Km(1) have to be followed aggressively, since these patients are at high risk of developing multiple tumors. A possible exception can be made for female patients.
Multiple primary tumours in oral cancer.
In 210 cases of oral cancer, 38 (17.6%) second primary tumours were found. Males had a higher chance of developing a second primary than females (21.4% versus 12%). The difference was not statistically significant (p = 0.11). When the index tumour was in the lower part of the oral cavity (floor of mouth, retromolar trigone, inferior alveolar process), a higher rate of second primaries was found than in cancer of the rest of the oral cavity (tongue, buccal mucosa and palate) (26.6% versus 11.5%). In male patients, this difference was statistically significant (p less than 0.05). 4 tumours were synchronous. In those 4 patients, panendoscopy would not have contributed to an earlier diagnosis. Routine panendoscopy in oral cancer therefore seems not valid.
Facial nerve paralysis following embolization for severe epistaxis (case report and review of the literature).
Embolization to treat intractable epistaxis is becoming increasingly popular. Twelve cases of facial nerve paralysis after embolization of branches of the external carotid artery have been reported. In this paper, a new case is reported. In epistaxis, embolization should be reserved for patients with contraindications to ligation or in emergency procedures.
Multiple primary tumours in laryngeal cancer.
All 748 patients with squamous cell carcinomas of the larynx treated in the Free University Hospital, Amsterdam, between 1964 and 1983 were analysed retrospectively with regards to the occurrence of multiple primary tumours. One hundred and four (14 per cent) second primary tumours were reported. Seventy-three (10 per cent) were situated in the respiratory tract and upper digestive tract. Of these 73, 64 were localized in the lung. No esophageal carcinomas were reported. Male patients, with a glottic carcinoma had a statistically higher change of developing a second primary than female patients (14.5 per cent versus 0 per cent). In both sexes more multiple primary tumours occurred in supraglottic than in glottic cancers. Only in female patients was the difference statistically significant. Because of the high rate of lung carcinomas, and since most tumours are metachronous, bronchoscopy is justified at the initial work-up and is also to be considered at regular intervals during the follow-up period.