Extraskeletal Ewing sarcoma mimicking a thyroid nodule.
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Adult↗
Biomedical subjects
Yi-Shing Leu
Publications and source records attributed to Yi-Shing Leu.
Change of plasma transforming growth factor-beta1 levels in nasopharyngeal carcinoma patients treated with concurrent chemo-radiotherapy.
OBJECTIVE: Our aim was to study the correlation between plasma transforming growth factor (TGF)-beta1 level and radiation-induced mucositis and dermatitis in nasopharyngeal carcinoma (NPC) patients. METHODS: Blood samples obtained from patients treated with concurrent chemo-radiotherapy (CCRT) were divided into two groups according to the pre-treatment plasma TGF-beta1 level (> or =7.5 ng/ml as group 1 and < 7.5 ng/ml as group 2). Enzyme-linked immunosorbent assay (ELISA) was used for the measurement of the TGF-beta1 level. Radiation toxicity was evaluated according to Radiation Treatment Oncology Group criteria. Data were analyzed by the generalized estimation equation method. RESULTS: TGF-beta1 levels of group 1 patients were decreased significantly (P = 0.002) at the end of the treatment. The rate of decrease was 0.12 ng/ml per fraction (P = 0.02). The average TGF-beta1 level in patients who suffered acute radiation morbidity (grade > or =2) was significantly higher (P = 0.0057) than that of those who suffered less (grade < 2). CONCLUSION: A lower pre-treatment plasma TGF-beta1 level and the grade of radiation toxicity both appeared to contribute to the elevated plasma TGF-beta1 after CCRT.
Antineoplastic Agents↗
Ileocolic free flap reconstruction, concomitant chemotherapy and radiotherapy and assessment of speech and swallowing function during management of advanced cancer of the larynx and hypopharynx: preliminary report.
CONCLUSION: The new technique of ileocolic free flap reconstruction provides a better quality of life in terms of swallowing and speech for patients who have undergone laryngopharyngectomy with concomitant chemotherapy and radiotherapy (CCRT). OBJECTIVES: To compare and contrast the swallowing and speech outcomes of patients who underwent total laryngopharyngectomy with ileocolic free flap reconstruction and to analyze the survival rate after surgery and CCRT. MATERIAL AND METHODS: This was a follow-up study of 12 patients with advanced (stages III, IVA and IVB) laryngeal and hypopharyngeal cancer who underwent major surgery, CCRT (with one exception) and ileocolic free flap reconstruction. RESULTS: All patients were able to tolerate single-stage combined management comprising total laryngopharyngectomy with or without radical neck dissection plus ileocolic free flap reconstruction and postoperative CCRT (with one exception), without immediate morbidity or mortality. Eleven patients were diagnosed with hypopharyngeal cancer and one with laryngeal cancer. The mean interval between surgery and CCRT was 34.1 days. The mean follow-up period was 16.5 months. Four patients died during the follow-up period as a result of local recurrence (n=2), distant metastasis (n=1) and suicide (n=1). One patient was alive with disease despite neck recurrence.
Adult↗
A means of achieving more surgical exposure during transoral surgery on the tongue base and vallecula.
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Humans↗
B cell lymphoproliferative disorders and VH4-34 gene encoded antibodies.
The VH4-34 represents an unusual Ig heavy chain variable region gene given that it is conserved and overexpressed despite its autoreactivity. Besides RBC 'I/i' recognition, a subset of VH4-34 encoded Igs bind and kill human B-lymphocytes via interaction with a cytoskeletally-associated ligand similar in structure to the cord RBC 'i' antigen. In vivo, secretion of VH4-34 gene encoded antibodies is minimal in healthy individuals. The turn on signal occurs in few clinical conditions such as, systemic lupus erythematosus, AIDS and infectious mononucleosis. Here we show that secretion of VH4-34 Abs is also switched on in hepatitis C and nasopharyngeal carcinoma; but not in diseases such as HPV-associated cervical carcinoma, multiple sclerosis and sarcoidosis. All syndromes with increased VH4-34 Igs appear to be associated with B cell hyperproliferation and B cell lymphotropic viruses, particularly EBV. The significance of the tightly controlled secretion of an autoreactive, conserved Ig gene is discussed.
B-Lymphocytes↗
Tongue reconstruction with free radial forearm flap after hemiglossectomy: a functional assessment.
Thirty-three patients with squamous cell carcinoma of the anteriolateral part of the tongue underwent a 50 percent resection of the tongue. The surgical defect was reconstructed with a microvascular radial forearm flap. All the flaps were especially designed to have a narrow waist, shaped like an omega in cross-section, thus allowing for a free tongue tip, and avoiding suturing the edge of the flap to the soft palate and tongue base. Sixteen patients were evaluated for swallowing and speech function at least 6 months following reconstruction. With this technique, the majority of the patients had nearly normal deglutition, although their speech was still unsatisfactory. However, the speech function in this series was better than that in other reported series.
Adult↗
Swallowing function in patients who underwent hemiglossectomy: comparison of primary closure and free radial forearm flap reconstruction with videofluoroscopy.
The swallowing function of patients who had undergone hemiglossectomy with either primary closure of the defect or radial forearm flap reconstruction was studied with videofluoroscopy. Patients with primary closure were unable to lift the tongue tip, had poor tongue-to-palate contact on initiating swallowing, had premature spilling of the bolus into the pharynx, had a large amount of barium stasis on the floor of the mouth, and had prolonged oral transit time. With flap reconstruction, patients easily could lift the tongue and make good contact with the entire palate. They were able to seal the posterior pharyngeal sphincter by elevation of the reconstructed tongue, approximating it to the soft palate, so that premature spilling of the bolus rarely happened. Their swallowing pattern was nearly normal. Although the reconstructed flap is nonfunctional, it provides bulk and helps the remaining tongue to complete the swallow. Compared with primary closure of the tongue defect, the authors suggest it is better to reconstruct it with a free radial forearm flap when more than 50% of the tongue is resected.
Adult↗
Primary closure versus radial forearm flap reconstruction after hemiglossectomy: functional assessment of swallowing and speech.
The authors compared the postoperative speech and swallowing function of six patients who underwent free radial forearm flap reconstruction after hemiglossectomy with that of six control patients who underwent primary closure of the defect. Clinical speech pathologic evaluations included the Fletcher time-to-time maximum repetition rate of syllables, multiple rhyme test, and overall quality and intelligibility of the patients' speech. Evaluation of swallowing included the duration of deglutition, bolus volume, and ingestion rate. Speech quality, including intelligibility and articulation, was better in patients with primary closure. However, the bolus volume and ingestion rate in deglutition were better in those with flap reconstruction. These results suggest that the flap adds bulk, thus improving pharyngeal clearance by maintaining the tongue-to-mouth roof contact that is necessary in the swallowing process. The nonfunctional flap, however, hinders articulation by restricting the mobility of the remaining portion of the normal tongue.
Adult↗
Hypoglossal schwannoma in the submandibular space.
Most schwannomas of the hypoglossal nerve originate from the intracranial portion, but they may extend extracranially. Solitary and extracranial schwannomas are extremely rare. We report a case of submandibular hypoglossal schwannoma along with its clinical course and management.
Adult↗
Schwannoma of the posterior pharyngeal wall.
Schwannoma arising from the posterior pharyngeal wall is extremely rare. We report a 24-year-old female patient who had suffered from dysphagia and discomfort for two months. The tumour was excised completely via the intraoral approach. No recurrence was found after the follow-up period of one year. To our knowledge, only four cases of schwannomas from the posterior pharyngeal wall have been reported, and this patient is the fifth.
Adult↗