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Biomedical subjects

P J Stoney

Publications and source records attributed to P J Stoney.

18 recordsLinked to original sources
PubMed1993

An anatomical study of vidian neurectomy using an endoscopic technique: a potential new application.

Vasomotor rhinitis is a common problem in contemporary rhinology. Although this disease has been described for decades, the pathophysiology and treatment are yet to be fully understood or described. A review of the literature of vasomotor rhinitis focusing mainly on pathophysiology and treatment is presented. Following detailed cadaver dissections a new treatment approach that takes advantage of endoscopic techniques has been proposed. Comparison with existing techniques and discussion of the pathophysiology of vasomotor rhinitis is presented. Treatment suggestions conclude the analysis, with the authors commending the endoscopic technique when symptoms merit division of the vidian nerve.

Cadaver↗
PubMed1991

Experience of pulse oximetry in children with croup.

We report our experience with 199 patients requiring admission with a diagnosis of croup over an 18 month period. The value of using pulse oximetry to monitor these children was critically examined. Twenty-nine patients with clinically significant stridor were monitored for an average of 12 hours. There was poor correlation of clinical status and respiratory rate with hypoxia as shown by the technique, with frequent dips in oxygen saturation being caused by technical problems such as movement artefact. Pulse oximetry is a useful adjunct to the clinical assessment of croup, but cannot be relied upon solely for monitoring these labile patients.

Body Temperature↗
PubMed1991

A controlled trial of azapropazone in tinnitus.

A single-blind placebo-controlled trial of azapropazone, a non-steroidal anti-inflammatory drug, is presented in 10 patients with tinnitus. Seventeen variables were assessed by questionnaire and six by a daily diary. In none of these was there a significant difference between placebo and drug. A larger trial is probably therefore not justified.

Apazone↗
PubMed1989

Attitudes to tympanometry.

A postal questionnaire revealed the widest possible spectrum of opinion regarding tympanometry. The reasons are discussed.

Acoustic Impedance Tests↗
PubMed1988

Immunochemistry and electron microscopy of head and neck rhabdomyoma.

Rhabdomyomas are rare benign tumours originating in skeletal or cardiac muscle. Extracardiac tumours are usually situated in the head and neck. Four cases are presented, three arising in the larynx and the other in the cervical region. All four cases were studied by light and electron microscopy, and in three immunohistochemical staining for myoglobin, desmin, and vimentin was carried out to study the diagnostic features of the lesions and their histogenesis.

Adult↗
PubMed1987

Factors predicting response of end stage squamous cell carcinoma of the head and neck to cisplatinum.

Cisplatinum significantly prolongs survival in end stage head and neck cancer but only 30-40% of patients respond. Many receive chemotherapy with little or no benefit and it would obviously be advantageous to determine in advance those patients likely to benefit. In 2 phase III trials of chemotherapy in end stage disease, 129 patients have been treated with cisplatinum, either alone or in 2-drug combination with bleomycin, methotrexate or 5-fluorouracil. Factors analysed in the entire group were age, sex, site, previous treatment, performance status and the use of cisplatinum in combination. A high albumen and oro- or nasopharyngeal site were significantly favourable, while a hypopharyngeal, middle ear, skin or paranasal site were all significantly unfavourable. In the separate analysis of the subgroup with recurrent disease, site of recurrence and time to recurrence were analysed in addition to the factors named above. Although similar trends to those in the entire group were observed none reached significant levels. In the subgroup with advanced previously untreated disease, histological grade was analysed in addition to the above factors. Good performance status emerged as significantly favourable. The emerging trends provide some insight regarding outcome but are not sufficiently clearcut to allow a decision to be made on who should and who should not be treated.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Health education in paediatric ENT.

A multiple-choice questionnaire was completed by 100 parents of children attending ear, nose and throat out-patients to assess their ENT knowledge. This highlighted areas of poor understanding, and was followed by the production of information leaflets and a pictorial display.

Awareness↗
PubMed1985

Cisplatinum and bleomycin for advanced or recurrent squamous cell carcinoma of the head and neck: a randomised factorial phase III controlled trial.

A phase III 2 X 2 factorial trial of cisplatinum and bleomycin in 116 patients with recurrent or advanced squamous cell carcinoma of the head and neck is reported. Thirty percent of patients proved to be unfit for chemotherapy, and of those treated progression of tumour was the commonest "response". However, 25% of patients achieved a partial or complete response, with no significant difference in response rates between the treated arms. The median number of courses received was 1 (range 0-6) and the commonest causes for discontinuation of treatment were renal toxicity and death. Bleomycin reduced survival, but not significantly so, whereas cisplatinum prolonged median survival significantly by 10 weeks. Significant predictors of survival, in addition to treatment by cisplatinum, were age, performance status, N status, number of courses and response of the tumor.

Aged↗
PubMed1985

Adenoid cystic carcinoma: the results of radical surgery.

A personal series of 267 salivary tumours seen in a 20-year period was reviewed. Thirty-six patients with a previously untreated histologically proven adenoid cystic carcinoma of the major and minor salivary glands were submitted to radical surgery. The 5-year survival was 73%; no patient died of disease or suffered a recurrence of disease beyond the 5-year mark, suggesting that radical surgery achieves good results and largely pre-empts the notorious pattern of repeated recurrence. Only 8% of the patients died solely of primary recurrence, suggesting that the place of supraradical surgery is likely to be very limited.

Carcinoma, Adenoid Cystic↗
PubMed1982

Granulomatosis of bone from high density polyethylene.

Granulomatous reaction by bone to high density polyethylene can occur if the rate of wear and the volume of the resulting wear products is abnormally great. The phenomenon was found in 6 of 11 patients who had had a Monk soft-top prosthesis inserted more than two years before.

Aged↗
PubMed1977

A circadian variation of melphalan (L-phenylalanine nitrogen mustard) toxicity to murine bone marrow: relevance to cancer treatment protocols.

The toxicity of Melphalan to murine bone marrow was assessed by automated Coulter counts of femoral marrow nucleated cells. A significant dose-response slope (p less than 0.001) was shown and also a significant variation along the 24 h scale. With food available ad libitum and light from 06.00 to 18.00 hours, the minimum marrow depression occurred around 16.00 hours. Extrapolating these findings to human chemotherapy it would appear that prescription of the drug during the early part of the activity span (usually breakfast) will minimize marrow depression. This differs from a human study in which Melphalan was given at 'bedtime' as an adjuvant to mastectomy in breast carcinoma and in which there was leucopenia at some stage of treatment in all 103 patients. It is recommended that in future cancer therapy protocols test for circadian variability of white cell depression by varying treatment times systematically along the 24 h scale.

Animals↗
PubMedDate not supplied

Lymph node metastases in adenoid cystic carcinoma.

The clinical characteristics of 76 patients with adenoid cystic carcinoma seen during a 22-year period are described. Lymph node metastases at presentation or later occurred almost exclusively in men, and the five-year rate of "node-free" survival was 62 per cent for men and 95 per cent for women. Node metastases were more common in poorly differentiated tumors, but site and stage of the primary disease did not affect the metastatic rate. Surgery scarcely improved the rate of survival of patients with nodal metastases. The authors were unable to confirm previous observations that embolic nodal metastases at a distance from the primary tumor do not occur.

Carcinoma, Adenoid Cystic↗
PubMedDate not supplied

Surgical approaches to tumors of the parapharyngeal space.

The authors' experience with 58 patients with parapharyngeal tumors is presented. Forty-nine patients were operated on using an external approach. Mandibulotomy was required in fewer than 10 per cent of procedures. The main features of the operation include identification of the facial nerve in all cases, division of the posterior belly of the digastric muscle and styloid apparatus, and excision of the styloid process. No patient died, and morbidity was acceptable and confined to malignant or locally invasive tumors.

Humans↗
PubMedDate not supplied

A randomized phase III trial of cisplatinum, methotrexate, cisplatinum + methotrexate, and cisplatinum + 5-fluoro-uracil in end-stage head and neck cancer.

In a previous phase III trial of chemotherapy for patients with end-stage squamous cell carcinoma of the head and neck we have shown that Bleomycin shortened the survival period, compared with untreated controls. The survival of patients treated with Cisplatinum and Bleomycin did not differ significantly from untreated patients, but Cisplatinum significantly prolonged survival. A further similar trial is reported here, the four treatment arms were Methotrexate alone, Cisplatinum alone, Cisplatinum + Methotrexate, and Cisplatinum + 5-Fluoro-uracil. The response rates were: Methotrexate alone 19%, Cisplatinum alone 40%, Cisplatinum + Methotrexate 31%, and Cisplatinum + 5-Fluoro-uracil 33%. The median survival time for the Cisplatinum alone group, 260 days, was significantly longer than the 80 days for the Methotrexate alone group. The median survival times for Cisplatinum + Methotrexate (160 days) and for Cisplatinum + 5-Fluoro-uracil (200 days) did not differ significantly from that for Cisplatinum alone.

Antineoplastic Combined Chemotherapy Protocols↗