Biomedical subjects

T S Sheen

Publications and source records attributed to T S Sheen.

43 records · Page 3Linked to original sources

PubMed1997

Salvage neck dissection for cervical recurrence of nasopharyngeal carcinoma.

OBJECTIVE: To evaluate the effectiveness of salvage neck dissection as part of a multidisciplinary treatment approach in persistent or recurrent metastatic nasopharyngeal carcinoma, after failure of initial radiotherapy at the regional site. DESIGN: A retrospective study of 31 patients treated during a 14-year period from March 1981 through May 1995, with a maximum follow-up of 152 months. Factors evaluated include patients' sex, age, and initial stage of tumor, mobility and number of nodal recurrences, surgical and pathological findings, and postoperative irradiation. SETTING: Academic tertiary referral center. PATIENTS: Twenty-six men and 5 women were studied; one patient had neck dissection to both sides of the neck on separate occasions, for a total of 32 operations. All patients had pathologically proved nasopharyngeal carcinoma and had been previously treated at the primary site and both sides of the neck with definitive radiotherapy. INTERVENTION: Patients underwent a radical, modified radical, or level I-sparing radical neck dissection. MAIN OUTCOME MEASURE: Surgical morbidity, time to recurrence at the regional site, and survival time. RESULTS: Clinically, there was a disease predilection of 81% at levels II and V. Surgical morbidity was minimal. Regional control was achieved in 20 (65%) of the patients, and the overall 5-year survival was 67%. Tumor involvement of the posterior triangle musculature and spinal accessory nerve was associated with failure to control neck disease. Extracapsular nodal extension correlated with a poor survival outcome. CONCLUSION: Control of regional disease by salvage neck dissection when radiotherapy has failed is both safe and effective in properly selected patients.

Adult↗

PubMed1997

Transverse process of the atlas(C1)--an important surgical landmark of the upper neck.

BACKGROUND: The internal carotid artery, the internal jugular vein, and the spinal accessory nerve are the main structures that are preserved in conservative neck dissections. In the upper neck, one surgical landmark used to find these structures is the transverse process of a cervical vertebral body. There is controversy about the origin of the transverse process in the upper neck. METHODS: We applied three-dimensional computerized tomography (3-D CT), an intraoperative navigational system and cadaver dissection of the neck to clarify the controversy. RESULTS: The origin of the transverse process was from the atlas (C1). CONCLUSIONS: The transverse process of the atlas is an important surgical landmark in the upper neck. The neurovascular bundle is located anteriorly. The transverse process of the axis (C2) is less prominent and is situated antero-inferior to the spinal accessory nerve where the nerve emerges from the posterior border of the internal jugular vein.

Cadaver↗

PubMed1997

Postirradiation laryngeal osteosarcoma: case report and literature review.

BACKGROUND: Laryngeal sarcoma is a rare disease entity. In review of the literature, chondrosarcoma is the most common sarcoma, followed by fibrosarcoma. Osteosarcoma is very rare; there are only seven cases reported in the literature. Postirradiation sarcoma is a late complication of radiotherapy. Osteosarcoma is the most common type in this group. The larynx is often involved in the radiation field of treatment for head and neck malignancies. However, postirradiation laryngeal osteosarcoma has not yet been reported. METHODS: We present a 56-year-old man who under went radiotherapy for nasopharyngeal carcinoma 32 years ago and later developed a laryngeal osteosarcoma. RESULTS: The patient underwent total laryngectomy but died 1 year and 9 months later with locally extensive disease. CONCLUSIONS: We report the first case of postirradiation laryngeal osteosarcoma. In addition to surgical treatment, adjunctive therapies should be considered for this group of patients.

Fatal Outcome↗

PubMed1995

Nasopharyngeal carcinoma with dermatomyositis. Analysis of 12 cases.

OBJECTIVES: To evaluate the incidence rate of nasopharyngeal carcinoma with dermatomyositis, the influence of dermatomyositis on clinical course, and complications and survival of patients with nasopharyngeal carcinoma after radiotherapy. DESIGN: A retrospective study of 12 patients with nasopharyngeal carcinoma associated with dermatomyositis, with a maximum follow-up of 228 months. SETTING: Academic tertiary referral center. PATIENTS: There were 6441 new patients with nasopharyngeal carcinoma who were seen at the National Taiwan University Hospital, Taipei, during the period from 1970 through 1993. Twelve patients were found to have dermatomyositis. MAIN OUTCOME MEASURE: Clinical manifestations of nasopharyngeal carcinoma with dermatomyositis. RESULTS: Twenty-seven (26%) of 104 patients with dermatomyositis had an associated malignancy. Twelve of these patients were diagnosed as having nasopharyngeal carcinoma. The typical skin manifestation of dermatomyositis was found in all 12 patients. Myopathy occurred in 10 patients. Three patients died of recurrence of nasopharyngeal carcinoma, one died of a second malignancy, one died of upper gastrointestinal bleeding, and one became unavailable for follow-up. The other six patients have had disease-free survival, with a mean follow-up period of 100.5 months (range, 5 to 228 months). The 1-year survival rate was 83.8%, and the 5-year survival rate was 69.4%. CONCLUSIONS: In Taiwan, dermatomyositis is associated with an increased incidence rate of nasopharyngeal carcinoma. A search for nasopharyngeal carcinoma in patients with dermatomyositis should be performed in areas prevalent for nasopharyngeal carcinoma. If present, nasopharyngeal carcinoma can precede, occur concurrently with, or follow the diagnosis of dermatomyositis. Treatment of nasopharyngeal carcinoma may affect myositic or cutaneous disease. The prognosis and survival rates of nasopharyngeal carcinoma remained unaffected by dermatomyositis. No complications were noted owing to the radiotherapy used to treat dermatomyositis.

Adult↗

PubMed1995

Soluble interleukin-2 receptor as a clinical parameter for nasopharyngeal carcinoma.

We evaluated whether the serum soluble interleukin-2 receptor (sIL-2R) may be a parameter to monitor the efficacy of treatment for nasopharyngeal carcinoma (NPC). There were 177 NPC patients and 24 healthy controls. The level of sIL-2R was measured with a sandwich ELISA kit. Higher levels of sIL-2R than for controls were found in NPC patients before treatment and in patients with distant metastasis (p < 0.001). There was, however, no difference in sIL-2R levels between controls and NPC patients after radiotherapy in relapse-free or in primary relapse. The sIL-2R levels in sequential testing revealed good correlation with clinical response. The sIL-2R levels were found to be elevated when distant metastasis was detected. Two patients had elevated sIL-2R level up to 5 months before clinical detection of metastasis. These results indicate that serial measurements of sIL-2R levels are worthwhile for NPC patients in their clinical course. The sIL-2R level proved to be an adjunct clinical parameter to monitor the efficacy of treatment of NPC.

Adult↗

PubMedDate not supplied

Complete esophageal stricture resulting from a neglected foreign body.

We present a patient with an esophageal foreign body complicated by severe esophageal stricture, which progressed to complete stricture after a period of follow-up. Transthoracic resection of the stricture with end-to-end anastomosis seemed to be a successful treatment in this transmural stricture. The treatment of esophageal stricture is well discussed.

Child, Preschool↗

PubMedDate not supplied

Pyogenic granuloma--an uncommon complication of nasal packing.

Nasal packing is a very common procedure in the otolaryngologic service for nasal bleeding and postoperative hemostasis. However, a pyogenic granuloma complicated from nasal packing has not been reported in the literature. A 50-year-old man underwent nasal packing by use of vaseline gauze due to nasal bleeding. Two weeks later, a dark brown nasal tumor was found in his nasal cavity. He underwent partial turbinectomy for removal of the tumor. The pathology demonstrated a pyogenic granuloma. It is the first case of a confirmed pyogenic granuloma complicated from nasal packing in the literature. To prevent complications and decrease the discomfort, we strongly recommend the use of inflatable balloons or nontraumatic materials for nasal packing.

Epistaxis↗