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Biomedical subjects

P Kubilis

Publications and source records attributed to P Kubilis.

At least 19 recordsLinked to original sources
PubMed2000

American College of Cardiology/European Society of Cardiology International Study of Angiographic Data Compression Phase I: The effect of lossy data compression on recognition of diagnostic features in digital coronary angiography.

OBJECTIVES: This study intended to determine the effect of varying degrees of lossy Joint Photographic Experts Group (JPEG) compression on detection of coronary angiographic features. BACKGROUND: Compression of digital coronary angiograms facilitates playback of images and decreases cost. There are little data on the effect of compression on the accuracy of coronary angiography. METHODS: At six centers, 71 angiographers each reviewed a set of 100 angiographic sequences. The 100 sequences were divided into four, 25-sequence subsets. Each subset of 25 was displayed either as original images or at one of three compression ratios (CRs) (6:1, 10:1 or 16:1). The effect of lossy compression on the sensitivity and specificity for detection of diagnostic features was determined. The effect of compression on subjective measures of image quality graded by the angiographers was also examined. RESULTS: Lossy compression at a ratio of 16:1 decreased the sensitivity for the detection of diagnostic features (76% vs. 80% p = 0.004). The largest effect was in the detection of calcification (52% vs. 63% at 16:1 compression vs. original images, p < 0.001). Subjective indicators of image quality indicated a reduction in confidence in interpretation at CRs of 10:1 and 16:1. CONCLUSIONS: With increased ratios of lossy compression, a degradation of digital coronary angiograms occurs that results in decreased diagnostic accuracy. The sensitivity for detection of common diagnostic features was decreased, and subjective assessment of image quality was impaired. Caution is warranted in the interpretation of coronary angiograms that have been subjected to lossy JPEG compression beyond a ratio of 6:1.

Adult↗
PubMed2000

American College of Cardiology/ European Society of Cardiology international study of angiographic data compression phase I. The effects of lossy data compression on recognition of diagnostic features in digital coronary angiography.

OBJECTIVES: This study intended to determine the effect of varying degrees of lossy Joint Photographic Experts Group (JPEG) compression on detection of coronary angiographic features. Background Compression of digital coronary angiograms facilitates playback of images and decreases cost. There are little data on the effect of compression on the accuracy of coronary angiography. METHODS: At six centers, 71 angiographers each reviewed a set of 100 angiographic sequences. The 100 sequences were divided into four, 25-sequence subsets. Each subset of 25 was displayed either as original images or at one of three compression ratios (CRs) (6:1, 10:1 or 16:1). The effect of lossy compression on the sensitivity and specificity for detection of diagnostic features was determined. The effect of compression on subjective measures of image quality graded by the angiographers was also examined. RESULTS: Lossy compression at a ratio of 16:1 decreased the sensitivity for the detection of diagnostic features (76% vs. 80%P=0.004). The largest effect was in the detection of calcification (52% vs. 63% at 16:1 compression vs. original images, P<0.001). Subjective indicators of image quality indicated a reduction in confidence in interpretation at CRs of 10:1 and 16:1. CONCLUSIONS: With increased ratios of lossy compression, a degradation of digital coronary angiograms occurs that results in decreased diagnostic accuracy. The sensitivity for detection of common diagnostic features was decreased, and subjective assessment of image quality was impaired. Caution is warranted in the interpretation of coronary angiograms that have been subjected to lossy JPEG compression beyond a ratio of 6:1.

Adult↗
PubMed1999

Comparison of autologous peripheral blood stem cell dosing by ideal vs actual body weight.

In this retrospective study, we evaluated the predictability of PBSC dose for hematopoietic engraftment comparing that calculated by ideal body weight (IBW) vs another calculated by actual body weight (ABW) for each patient. Sixty-three consecutive patients treated similarly using one transplant protocol were analyzed. While all patients had data available on CFU-GM and nucleated cells (NC), data on CD34+ enumeration was present only in 34 patients. We found that 49% of the patients were greater than 25% over their IBW. In addition, least-squares linear regression was used to assess the strength of the linear relationship between the inverse of cell dose/kg of ABW or IBW and time to AGC or platelet engraftment and showed no difference in r2 values for platelet engraftment, while using dose/kg of IBW greatly improved the ability of NC (r2 improved from 0.19 for ABW to 0.35 for IBW) and CFU-GM (r2 improved from 0.35 for ABW to 0.53 for IBW) to predict time to AGC engraftment, but did not change the CD34 r2. Hazard ratios were estimated using Cox proportional hazards regression and in all instances were found greater than 1.0 indicating that the probability of engraftment increased as cell dose/kg ABW or IBW increased. Finally, our data showed that 10 patients (16%) could have had one less apheresis procedure performed to obtain their set target stem cell dose calculated per kg IBW rather than ABW. In conclusion, PBSC dose per kg IBW is as good or better predictor of engraftment of AGC and may lead to cost savings in a certain subset of patients.

Adolescent↗
PubMed1999

Clinical significance of nephrotoxicity in patients treated with amphotericin B for suspected or proven aspergillosis.

The records of 239 immunosuppressed patients receiving amphotericin B for suspected or proven aspergillosis were reviewed to determine rates of nephrotoxicity, dialysis, and fatality. The mean and median durations of treatment were 20.4 and 15.0 days, respectively. The creatinine level doubled in 53% of patients and exceeded 2.5 mg/dL in 29%; 14.5% underwent dialysis; and 60% died. A multivariate Cox proportional hazards analysis showed that patients whose creatinine level exceeded 2.5 mg/dL (hazard ratio [HR], 42.02; P<.001), allogeneic bone marrow transplantation (BMT) patients (HR, 6.34; P<. 001), and autologous BMT patients (HR, 5.06; P=.024) were at greatest risk for requiring hemodialysis. Use of hemodialysis (HR, 3. 089; P<.001), duration of amphotericin B use (HR, 1.03 per day; P=. 015), and use of nephrotoxic agents (HR, 1.96; P=.017) were associated with greater risk of death, whereas patients undergoing solid organ transplantation were at lowest risk (HR, 0.46; P=.002). These data indicate that elevated creatinine levels during amphotericin B treatment are associated with a substantial risk for hemodialysis and a higher mortality rate, but the risks vary in different patient groups.

Adolescent↗
PubMed1999

Effect of inhaled beta 2 adrenoceptor agonist, albuterol sulphate, on performance of horses.

This study was designed to test the hypothesis that a specific beta 2 adrenergic receptor agonist, albuterol sulphate, when delivered by metered-dose inhaler (MDI) would affect the performance of Thoroughbred horses during incremental exercise testing. Six conditioned Thoroughbred horses were randomly assigned to one of 2 treatment groups: Group 1 horses received placebo and Group 2 received albuterol. Each horse received both treatments in a crossover design with a 3 week interval between trials. Horses inspired albuterol (900 micrograms) or placebo over a 5 min period followed by an incremental, peak oxygen consumption (VO2peak) exercise test. Facial arterial blood gases (PaO2, PaCO2), pHa, temperature, haemoximetry (O2Hb, COHb, MetHb, RHb) and electrolytes (Na+, K+, iCa2+, Cl-) were measured. Heart rate (HR), VO2peak, CO2 production (VCO2), plasma lactate, speed at failure, exercise duration, and urine levels of albuterol and metabolites (Alburine) were monitored. The Paratrend7 intravascular sensor provided continuous arterial blood gas data. Mixed effects linear modelling using generalised least-squares estimation was used to assess treatment and speed main effects interaction. Significant differences (P < 0.01) were found between placebo and albuterol-treated horses for total run time (mean +/- s.e. 405.8 +/- 8.8 vs. 430.5 +/- 6.7 s) and run time from completion of 8 m/s until fatigue (169.3 +/- 8.6 vs. 187.3 +/- 6.7 s), as well as VO2peak (121.7 +/- 3.7 vs. 130.3 +/- 3.8 ml/kg/min), respectively. In conclusion, inhaled albuterol sulphate has a small but significant effect on the performance of fit Thoroughbred horses during incremental, VO2peak exercise testing.

Administration, Inhalation↗
PubMed1999

Preradiotherapy computed tomography as a predictor of local control in supraglottic carcinoma.

PURPOSE: To determine the utility of pretreatment computed tomography (CT) for predicting primary site control in patients with supraglottic squamous cell carcinoma (SCC) treated with definitive radiotherapy (RT). MATERIALS AND METHODS: Pretreatment CT studies in 63 patients were reviewed. Minimum length of follow-up was 2 years. Local recurrence and treatment complications resulting in permanent loss of laryngeal function were documented. Tumor volume was calculated using a computer digitizer, and pre-epiglottic space (PES) spread was estimated. The data were analyzed using a combination of Fisher's exact test, logistic regression modeling, and multivariate analyses. Five-year local control rates were calculated using the product-limit method. RESULTS: Local control rates were inversely and roughly linearly related to tumor volume, although there seemed to be a threshold volume at which primary site prognosis diminished. Local control was 89% in tumors less than 6 cm3 and 52% when volumes were > or =6 cm3 (P = .0012). The likelihood of maintaining laryngeal function also varied with tumor volume: 89% for tumors less than 6 cm3 and 40% for tumors > or =6 cm3 (P = .00004). Pre-epiglottic space involvement by tumor of > or =25% was associated with a reduced chance of saving the larynx (P = .0076). Multivariate analyses revealed that only tumor volume independently altered these end points. CONCLUSION: Pretreatment CT measurements of tumor volume permits stratification of patients with supraglottic SCC treated with RT alone (which allows preservation of laryngeal function) into groups in which local control is more likely and less likely. Pre-epiglottic space spread is not a contraindication to using RT as the primary treatment for supraglottic SCC.

Carcinoma, Squamous Cell↗
PubMed1999

Evaluation of toxicosis of liposome-encapsulated cis-bis-neodecanoato-trans-R,R-1,2-diaminocyclohexane platinum (II) in clinically normal cats.

OBJECTIVE: To determine adverse effects of single and multiple doses of liposome-encapsulated cis-bis-neodecanoato-trans-R,R-1,2-diaminocyclohexane platinum (II) (L-NDDP) administered IV to healthy adult cats. ANIMALS: 10 healthy adult cats. PROCEDURE: 8 cats were given a single dose of L-NDDP (at rates of 75, 100, 150, or 200 mg/m2), and 2 cats were given liposomal lipid (1,500 mg/m2). Six of the 10 cats were given doses of L-NDDP at the maximum tolerated dosage (100 mg/m2) or a lower dosage (75 mg of L-NDDP/m2) at 21-day intervals, for a total of 4 treatments. Hematologic and serum biochemical analyses, urinalyses, and physical examinations were used to monitor effects of L-NDDP. RESULTS: All cats had transient pyrexia, lethargy, vomiting (1 to 3 times/24 h), inappetence, and an acute species-specific infusion reaction that was prevented by administration of atropine-diphenhydramine. Dose-limiting toxicosis was evident as a 10-day course of lethargy, intermittent vomiting, and diarrhea. In cats given multiple doses, dose-related thrombocytopenia, cumulative myelosuppression, transient increased hepatic transaminase activity, and mild to moderate hepatic hydropic degeneration and proximal renal tubular lipidosis in excess of lipidosis expected for this species were detected. Bone marrow hypoplasia was detected in some cats that received higher doses (cumulative dosages of 300 or 400 mg of L-NDDP/m2). CONCLUSION: Cats can safely be given L-NDDP at potentially therapeutic dosages without inducing renal or pulmonary toxicoses. CLINICAL RELEVANCE: Because L-NDDP has better tumoricidal activity than cisplatin (in vivo and in vitro) and is not cross resistant, it may be similarly or more efficacious than cisplatin in humans and dogs.

Animals↗
PubMed1998

Influence of pulse oximetry and capnography on time to diagnosis of critical incidents in anesthesia: a pilot study using a full-scale patient simulator.

OBJECTIVE: Many studies (outcome, epidemiological) have tested the hypothesis that pulse oximetry and capnography affect the outcome of anesthetic care. Uncontrollable variables in clinical studies make it difficult to generate statistically conclusive data. In the present study, we eliminated the variability among patients and operative procedures by using a full-scale patient simulator. We tested the hypothesis that pulse oximetry and capnography shorten the time to diagnosis of critical incidents. METHODS: A simulator was programmed to represent a patient undergoing medullary nailing of a fractured femur under general anesthesia and suffering either malignant hyperthermia, a pneumothorax, a pulmonary embolism or an anoxic oxygen supply. One hundred thirteen anesthesiologists were randomly assigned to one of two groups of equal size, one with access to pulse oximetry and capnography data and the other without. Each anesthesiologist was further randomized to one of the four critical incidents. Each anesthetic procedure was videotaped. The time to correct diagnosis was measured and analyzed. RESULTS: Based on analysis of 91 of the subjects, time to diagnosis was significantly shorter (median of 432 s vs. >480 s) for the anoxic oxygen supply scenario (p = 0.019) with pulse oximetry and capnography than without. No statistical difference in time to diagnosis was obtained between groups for the other three critical incidents. CONCLUSIONS: Simulation may offer new approaches to the study of monitoring technology. However, the limitations of current simulators and the resources required to perform simulator-based research are impediments to wide-spread use of this tool.

Anesthesia, General↗
PubMed1998

Antibiotic prophylaxis after basilar skull fractures: a meta-analysis.

Antibiotic prophylaxis after basilar skull fractures remains controversial. Previous studies have not clearly delineated the utility of prophylactic antibiotics in this setting. We undertook this study to determine if antibiotic prophylaxis after basilar skull fractures prevented meningitis. We performed a formal systematic review of previously published studies after a computerized search with use of the MEDLINE data base (1970-1996). Fourteen studies were identified, and 12 studies met the criteria for inclusion. Study design and quality were assessed by two independent investigators with use of a predetermined protocol. A total of 1,241 patients with basilar skull fractures were included; 719 patients received antibiotics, and 522 patients did not receive antibiotics. Overall results suggest that antibiotic prophylaxis did not prevent meningitis among patients with basilar skull fractures (odds ratio [OR] = 1.15; 95% confidence interval [CI] = 0.68-1.94; P = .678). Patients with basilar skull fractures and cerebrospinal fluid leakage were analyzed separately (OR = 1.34; 95% CI = 0.75-2.41; P = .358), as were children (OR = 1.04; 95% CI = 0.07-14.90; P = 1.000). Antibiotic prophylaxis after basilar skull fractures does not appear to decrease the risk of meningitis.

Antibiotic Prophylaxis↗
PubMed1997

The effect of age and weight on the response to formalin inactivated, alum-adjuvanted hepatitis A vaccine in healthy adults.

Formalin-inactivated, alum-adsorbed, hepatitis A vaccine was evaluated in 100 healthy adults who were stratified at enrollment into two age groups: 18-39 years: n = 50; 40-65 years: n = 50. All individuals received vaccine at 25 U of viral antigen. After stratification, both groups were randomized to receive either vaccination at 0 and 24 weeks or vaccination at 0.2 and 24 weeks. Subjects were bled for serology at 0, 2, 4, 24, 28 weeks and 1 year. The seroconversion rate and geometric mean titer (GMT = mIU ml-1) after one dose of vaccine was lower for older subjects [second week: < 40 years: 15/25 (60%) (GMT: 12.9). > 40 years: 5/22 (23%) (GMT: 6.1): fourth week: < 40 years: 20/22 (91%) (GMT: 29.0), > 40 years: 16/23 (70%) (GMT: 14.3)]. After a second dose at 2 weeks the seroresponse improved so that there were no longer differences between age groups [24 weeks: < 40: 21/22 (95%) (GMT: 123.9), > 40: 22/23 (96%) (GMT: 106.1)]. A third dose at 24 weeks resulted in a 20-40-fold increase in GMT in both age groups. As a separate evaluation height, weight, skin fold thickness, and body mass index (BMI) were assessed by logistic regression for their ability to predict serologic response. Serologic response was significantly associated with lower weight (P = 0.032) and BMI (P = 0.024) but not with height or skin fold thickness. Hepatitis A vaccine was well tolerated, with no serious adverse experiences. Adults older than 40 years appear to respond less well than younger adults to a single dose of 25 U of hepatitis A vaccine but equally well after two doses of vaccine. The slower antibody response to hepatitis A vaccine in overweight individuals was not attributable to skin adipose tissue.

Adolescent↗
PubMed1997

In vivo animal tests of an artifact-free contrast agent for gastrointestinal MRI.

A variety of shortcomings are associated with most currently used gastrointestinal contrast agents for magnetic resonance imaging (MRI). Artifacts resulting from peristalsis and other motions in the abdominal region are produced by many positive contrast agents (which increase signal intensity). Although this is not a problem for negative contrast agents (which decrease signal intensity), some negative contrast agents produce magnetic susceptibility artifacts that are especially pronounced at high field strength and with gradient echo pulse sequences. These susceptibility artifacts are produced by both paramagnetic and diamagnetic agents. It has been demonstrated in phantoms, however, that susceptibility matching can be used to produce contrast agents with desirable relaxation and contrast properties but without deleterious susceptibility artifacts. We now report results of animal tests of such an oral contrast agent, consisting of a suspension of superparamagnetic iron oxide particles and diamagnetic barium sulfate particles, compared to individual suspensions of the iron oxide and of the barium sulfate. Iron oxide was the least effective and the matched susceptibility mixture was the most effective for the intestine, which has traditionally been the most difficult region of the GI tract to visualize clearly. Matched susceptibility mixtures, which are inherently able to yield images free of susceptibility artifacts without compromising contrast, show promise of being improved oral negative contrast agents for use in gastrointestinal MRI.

Administration, Oral↗
PubMed1996

Risk factors for neonatal sepsis.

OBJECTIVE: To determine the associations between maternal characteristics, intrapartum events, and neonatal sepsis by multivariate analysis. METHODS: We enrolled 823 women from a high-risk population and analyzed maternal and neonatal demographic and outcome variables with univariate analysis and multivariate logistic modeling. RESULTS: Two-hundred sixteen women (26%) were colonized with group B streptococci, 82 (10%) developed chorioamnionitis, and 141 (17%) delivered prematurely. Culture-proven neonatal sepsis or meningitis was found in 15 of 833 (1.8%) neonates, and 101 of the remaining 818 (12.3%) infants were suspected to have sepsis or pneumonia. Multivariate analysis of risk factors for proven neonatal sepsis demonstrated a statistically significant association with decreasing gestational age, duration of internal monitoring for more than 12 hours (odds ratio [OR] 7.2, 95% confidence interval [CI] 1.6-32.2), maternal group B streptococcal infection (OR 4.2, 95% CI 1.4-13.1), chorioamnionitis (OR 4.4, 95% CI 1.2-16.1), and endometritis (OR 6.4, 95% CI 1.2-34.2). CONCLUSION: Through the use of multivariate modeling, we determined that chorioamnionitis or endometritis, preterm delivery, group B streptococcal colonization, and a prolonged duration of internal monitoring are independent risk factors for neonatal sepsis. We postulate that the presence of a foreign body that traverses the birth canal may facilitate ascending peripartal infection.

Confidence Intervals↗
PubMed1996

Characterization of glutaminase in the developing rat small intestine.

As a primary substrate in the small intestine, glutamine is a very important source of energy. Glutaminase (GA) is the enzyme involved in the deamination of glutamine to glutamate, which is utilized for energy production via the TCA cycle. Although the enzymatic activity of GA in the small intestine is known to undergo maturational changes, the tissue localization of the protein and its mRNA, the intracellular processing of this enzyme and levels of its mRNA in the small intestine at different maturational stages have not yet been described. In this study, using immuno-histochemical staining, we confirm previous studies using other techniques that suggested GA is localized in the epithelial layer of the rat small intestine. Some GA is also found in cells of the lamina propria and crypt epithelium. Using in situ hybridization studies, we have corroborated the presence of the protein in the epithelial cells of the villi by localizing the mRNA of this protein to the same layer and its precursor layer in the crypt region. An ontogenic analysis of GA mRNA and protein from rat small intestines, using RNA dot blots, gel blots and protein immunoblotting revealed differences in immunoreactive GA protein and mRNA during maturation. Immunoreactive GA and steady-state levels of GA mRNA increased around the 3rd wk of life, coincident with weaning and the endogenous glucocorticoid surge. Whether these findings have nutritional or pathophysiological implications remains speculative.

Age Factors↗
PubMed1996

Ontogeny of glutamine synthetase in rat small intestine.

Glutamine synthetase (GS) is a key enzyme involved in the endogenous biosynthesis of glutamine, an amino acid known to be essential for small intestinal metabolism and function. This study describes the ontogeny of rat small intestinal GS from fetal life through adulthood with enzyme activities, protein immunoblotting, and steady state levels of GS mRNA by RNA gel blots and dot blots. Enzyme activities progressively increased from 21 d of fetal life to 32 d postnatally, then decreased in adulthood. The amount of GS immunoreactive protein in the small intestine increased from fetal life to 10-day-old infants and persisted into adulthood. GS mRNA, as quantified by dot blots was highest at 19 d postnatally. The ontogenic changes in rat small intestinal GS appear to correspond temporally with rapid growth and weaning. The steady increase in GS enzyme activity up to 32 d of age with a subsequent drop in adulthood is not paralleled by an increase in GS mRNA or protein. These findings suggest an apparent complex regulation of the enzyme activity at a transcriptional or translational levels.

Aging↗
PubMed1995

Improved survival of patients with chronic myelogenous leukemia undergoing allogeneic bone marrow transplantation.

A total of 28 patients with chronic myelogenous leukemia (CML) in chronic phase (CP) received bone marrow allografts from HLA-matched siblings at the University of Florida between August 1984-July 1992. The present study compares the disease-free survival (DFS) for those patients who were transplanted before or after August 1988 using the same conditioning regimen. The analysis shows significant difference in 3-year DFS for those patients transplanted post- vs. pre-August 1988 (69.6% vs. 20%, respectively; P = 0.006). A decrease in pneumonitis due to different etiologies from pre-August 1988 (6/13, 46%) to post-August 1988 (1/15, 7%) was statistically significant (P = 0.029). A decrease, although statistically insignificant, in the overall incidence and severity of acute and chronic graft vs. host disease (GVHD) after August 1988 was also noticed. This study indicates significantly improved outcome for patients with CML in CP who have been treated in the University of Florida after August 1988. Better supportive care and prophylaxis for GVHD most likely contributed to such improvement.

Adult↗
PubMed1995

Hypomagnesemia in renal transplant patients: improvement over time and association with hypertension and cyclosporine levels.

Hypomagenesemia is frequently encountered early after kidney transplantation, especially in patients receiving cyclosporine (CsA). However, there have been no studies addressing the natural history of this disorder in adult transplant recipients. We conducted this investigation to study the change in the prevalence of hypomagnesemia over time in renal transplant patients as well as to determine the factors associated with this change. Three patient groups were studied: 24 CsA-treated patients followed longitudinally at 1, 3 and 6 months post-transplant (Group 1a, 1b, 1c); 33 CsA-treated patients at least 2 years post-transplant (Group 2; mean follow-up 55 +/- 25 months); and 31 non-CsA-treated patients at least 2 years post-transplant (Group 3; mean follow-up 132 +/- 57 months). The following parameters were monitored: serum and urine magnesium levels; serum potassium; creatinine clearance; fractional excretion of magnesium; and trough CsA levels. In group 1 patients, longitudinal follow-up showed a significant linear trend for improvement in the serum magnesium over time (1.6 +/- 0.3, 1.7 +/- 0.2, 1.8 +/- 0.2 mg/dl; p = 0.0015) as well as a decline in the whole blood CsA level (316 +/- 103, 251 +/- 82, 194 +/- 67 ng/ml; p = 0.0015) at 1, 3 and 6 months, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Can pretreatment CT predict local control of T2 glottic carcinomas treated with radiation therapy alone?

PURPOSE: To determine whether pretreatment CT can predict local control of T2 squamous cell carcinoma of the glottic larynx treated with radiation therapy alone. METHODS: Pretreatment CT studies were retrospectively evaluated by two head and neck radiologists in 28 patients with T2 squamous cell carcinoma of the glottic larynx treated with definitive radiation therapy. All patients were followed for a minimum of 2 years. A tumor score was calculated based on the CT findings of tumor involvement of the following areas: the anterior commissure, the contralateral true vocal cord, the arytenoid face, the interarytenoid region, the laryngeal ventricle, the paraglottic space at the true and false vocal cord levels, and the subglottic region. Tumor volumes based on pretreatment CT were measured in each patient using a computer digitizer. Statistical analysis was performed using the independent sample t test, Wilcoxon's rank sum test, and Fisher's Exact Test. RESULTS: There was no statistically significant relationship between tumor volume or tumor score and outcome of the T2 glottic tumors treated with definitive radiation therapy in this series. The overall local control rate was 82%. There were no treatment complications that resulted in loss of laryngeal function. CONCLUSIONS: Like low-volume supraglottic and T3 glottic carcinomas, T2 glottic squamous cell carcinoma is likely (82%) to be controlled with definitive radiation therapy. Failure to control the primary tumor is attributable to factors other than volume, which may not be detectable on CT, such as tumor-host biological factors. Pretreatment CT, however, is beneficial for detecting submucosal spread across the ventricle and subglottic extension, which might contraindicate vertical hemilaryngectomy and might not be apparent on endoscopic examination.

Carcinoma, Squamous Cell↗