Elevated CEA in breast cancer patients with overlooked medullary thyroid carcinoma.

After mastectomy and radiation for breast cancer, two patients were found to have persistent elevated CEA in their serum. This finding was erroneously attributed to occult metastases for the first patient and to local recurrence for the second. Overlooked medullary thyroid carcinoma (MTC) was the causal disease in both patients.

Wound dressing in major head and neck cancer surgery: a prospective randomized study of gauze dressing vs sterile vaseline ointment.

A total of 207 patients were randomized in a prospective comparative study of standard gauze dressing vs sterile vaseline ointment. 179 patients were evaluable. All patients received antimicrobial prophylaxis.

Antimicrobial prophylaxis for major head and neck surgery in cancer patients: sulbactam-ampicillin versus clindamycin-amikacin.

A total of 99 patients with head and neck cancer who were to undergo surgery were randomized in a prospective comparative study of sulbactam-ampicillin (1:2 ratio; four doses of 3 g of ampicillin and 1.5 g of sulbactam intravenously [i.v.

Wide vertical hemipharyngolaryngectomy with immediate glottic and pharyngeal reconstruction using a radial forearm free flap: preliminary results.

We propose a new technique of wide vertical hemipharyngolaryngectomy which combines resection of laterally localized extended pharyngolaryngeal tumors with immediate microsurgical reconstruction using a radial forearm free flap, including the tendon of the palmaris longus. It eliminates the limitations of resections, which are usually performed to avoid closure difficulties of the resulting defect. In addition, the new technique avoids the use of tumor-neighboring structures for closure, fulfilling the oncological principles of surgery performed in this region.

Vidian metastasis of adenoid cystic carcinoma.

Head and neck tumors may invade perineural space, especially the maxillary division of the trigeminal nerve and the pterygopalatine fossa (PPF). Computed tomography (CT) and magnetic resonance imaging (MRI) signs of perineural extension include essentially the obliteration of the PPF fatty content and the enlargement and erosion of neural foramina. We report a case of perividian metastasis studied with CT and MRI.

Neoadjuvant chemotherapy with cisplatin, methotrexate, bleomycin and vincristine (CABO) in patients with stage III and IV squamous cell carcinoma of the head and neck.

Forty-six patients with Stage III-IV previously untreated squamous cell carcinoma of the head and neck were treated with neoadjuvant chemotherapy with cisplatin, methotrexate, bleomycin and vincristine. The overall response rate was 70%, with a 9% complete response rate. The most frequent side effects were myelosuppression, nausea and vomiting, alopecia, neurotoxicity and stomatitis.

[Microsurgery and free flaps as indications for the reconstruction of the mouth and pharynx region following tumor resection].

This article describes the microsurgical approach of the head and neck team of the Bordet Institute. During a period of 2 1/2 years 35 free flaps, 71 Pectoralis Major and 9 local flaps were performed for oropharyngeal reconstruction. Different types of free flaps were used and analyzed: 15 latissimus dorsi myocutaneous, 8 radial forearm, 1 gastric, 3 jejunum, 2 crista iliaca osteocutaneous, 1 scapular osteomyocutaneous, 3 scapular osteo-muscular of a new type (discovered in our department), 1 serratus anterior muscular and 1 flap composed of 3 others (a latissimus myocutaneous, a serratus anterior and a scapular osteo-muscular flap).

Anaplastic small cell (oat cell) carcinoma of the tonsils: report of two cases.

Two cases of anaplastic small cell (oat cell) carcinoma of the tonsils are presented. In the first, cervical metastases preceded the manifestation of the primary tumour by 2 years. In case 2 the tonsillar carcinoma was accompanied by a bronchial tumour of the same histological type and by cervical and axillary metastases.

Papillary and follicular thyroid carcinoma. Individualization of the treatment according to the prognosis of the disease.

A retrospective study of a continuous series of 152 patients is presented: the patients were treated between 1 January 1955 and 31 December 1981 for a papillary or a follicular thyroid carcinoma. The prognostic index, proposed by the EORTC Thyroid Cancer Cooperative Group in 1979, was calculated for each patient. According to the survival curves and recurrences after treatment, the study shows a clear-cut difference in prognosis if the prognostic index is below 50 or is equal to or above 50.

Antimicrobial prophylaxis for major head and neck surgery in cancer patients.

A total of 113 patients were randomly allocated to receive either ticarcillin plus clavulanic acid (total dose, 20.8 g) or clindamycin (total dose, 2.4 g) plus amikacin (total dose, 1 g) as perioperative antimicrobial prophylaxis for major head and neck surgery.

[Thyroglossal cysts].

We reviewed the records of 33 patients who underwent surgery for removal of a thyroglossal duct cyst at the Bordet Institute between 1970 and 1983. All patients had complete resection of a midline cervical lesion. In 27 cases the provisional diagnosis at presentation was confirmed by histological examination after surgery.

Detection of antibodies to proteases used in laundry detergents by the radioallergosorbent test.

Two proteases, Esperase and Alcalase, derived from Bacillus licheniformis and B. subtilis, respectively, are used in laundry products. In testing for the prevalence of IgE antibodies to these enzymes in sera among 300 laundry product workers, we experienced two problems in the establishment of a reliable RAST for these antigens.

Facial edema and eosinophilia. Evidence for eosinophil degranulation.

Two patients had recurrent facial edema and peripheral blood eosinophilia. One patient showed a marked increase in the serum level of the eosinophil granule major basic protein. In both patients, skin biopsy samples showed nonspecific mononuclear cell inflammation with few eosinophils.

[Immediate hypersensitivity to quinine].

Systemic anaphylactic reaction with shock was observed after ingestion of an antipyretic combination product containing quinine. That quinine was responsible for the reaction was proven by immediate skin tests and by oral challenge tests. The demonstration of specific IgE's by a radioallergosorbent test (RAST) provided evidence for an immediate hypersensitivity mechanism.

Leukocyte histamine release to suxamethonium in patients with adverse reactions to muscle relaxants.

In an earlier study we confirmed the usefulness of intradermal skin tests and histamine release in diagnosis of patients reactive to muscle relaxants, and we suggested an IgE-mediated reaction rather than an idiosyncratic mechanism. In a later study, we studied the relationship between (Formula: see text) that is one of the muscle relaxants producing the most frequent adverse reactions under anesthesia. Histamine release was measured in five patients with increasing concentrations of suxamethonium in the presence or absence of human serum albumin in Tris buffer.

Aspirin intolerance and asthmal induction of a tolerance and long-term monitoring.

Acetylsalicylic-acid (ASA) intolerance is well recognized as a possible cause for exacerbating asthma. It has been postulated that if this could be overcome, long-term aspirin administration could improve asthma symptoms and enable reduction of the use of other anti-asthmatic drugs. We succeeded in inducing an ASA tolerance in nine corticosteroid-dependent asthmatics, and this tolerance lasted at least 1 month and at most 1 year.

Charcot-Leyden crystal protein and eosinophil granule major basic protein in sputum of patients with respiratory diseases.

Sputum eosinophilia is characteristic of bronchial asthma, and sputum specimens from patients with asthma contain eosinophil-derived substances including Charcot-Leyden crystals (CLC) and the eosinophil granule major basic protein (MBP). Prior observations have indicated that an elevated sputum level of MBP is associated with asthma. To determine whether CLC protein was also elevated in asthma, we measured by specific radioimmunoassays the quantities of MBP and CLC protein in sputum specimens from 106 consecutive patients with various respiratory diseases and in sputum specimens from 10 patients hospitalized for asthma.

[Nerve tumor of the neck. Apropos of a case report].

A rare case of nervous tumor of the neck is presented. Differential diagnosis is evoked in the discussion. A total removal of the tumor is to be realized with or without nerve reconstruction.