Inhibitory effect of warfarin on the metastasis of the PAIII prostatic adenocarcinoma in the rat.

The PAIII rodent metastatic prostatic adenocarcinoma model was employed to evaluate the effects of dietary warfarin, a prototypic antagonist of thrombin generation on the lymphatic and pulmonary metastases of the tumor from the tail site of subcutaneous transplantation in male Lobund Wistar (LW) rats. In addition, the anticoagulant effects of warfarin were determined in the same animals. Warfarin, administered in the diet at concentrations equivalent to 0.

Metastatic spread of the PAIII prostatic adenocarcinoma after implantation in the tail of the rat.

The spontaneous metastatic spread of a suspension of PAIII prostatic adenocarcinoma cells from the tail site of implantation was analyzed over a period of 5 weeks in male Lobund-Wistar (LW) rats. Following subcutaneous injection of the PAIII cells, the tumor metastasized through the primary lymphatic drainage. PAIII microfoci were evident in the gluteal and iliac lymph nodes prior to colonization of the lungs.

Growth hormone regulation in two types of aerobic exercise of equal oxygen uptake.

Five normal men, aged 23 to 35 years, participated in two bouts of continuous aerobic cycling separated by five days. The first type of exercise (EI) was cycling at a pedalling frequency of 50 rev X min-1 with a load which produced a steady state O2 uptake of approximately 40% of the subjects' VO2max. The second type of exercise (EII) was cycling at a pedalling frequency of 90 rev X min-1 with a load such that an equal steady state VO2 was reached and maintained.

Iodine 125 suture implants in the management of advanced tumors in the neck attached to the carotid artery.

Between 1975 and 1982, 38 patients with locally advanced head and neck cancer attached to the carotid artery underwent surgical excision followed by iodine 125 vicryl suture implant in the neck. Most patients had neck masses that were greater than 6 cm and stage IV disease without clinically evident distant metastases. Twelve patients had received no previous therapy while 26 underwent an implant for recurrent disease.

Surgery of the incompetent nasal valve.

One of the causes of nasal airway obstruction during inspiration is an incompetent nasal valve. An incompetent valve is one that collapses during quiet normal breathing due to narrowing of the valve area, a loss of upper and/or lower lateral cartilage support, or a combination of these. The most common etiology is a previous rhinoplasty; trauma and aging are other causes.

192Ir pharyngoepiglottic fold interstitial implants. The key to successful treatment of base tongue carcinoma by radiation therapy.

Twenty-eight patients with squamous carcinomas of the base tongue were seen and evaluated in a conjoint Head and Neck Tumor Board at Stanford between 1976 and 1982. Fourteen patients were treated by combined external beam and interstitial irradiation, 11 of whom had Stage III and IV carcinomas (American Joint Committee). An initial dose of 5000 to 5500 rad was first delivered by external beam irradiation in 5 to 5.

Hormonal and metabolic response to three types of exercise of equal duration and external work output.

Five normal men, aged 20-30 years, participated in three types of exercise (I, II, III) of equal duration (20 min) and total external work output (120-180 kJ) separated by ten days of rest. Exercises consisted of seven sets of squats with barbells on the shoulders (I; Maximal Power Output Wmax = 600-900 W), continuous cycling at 50 rev X min-1 (II; Wmax = 100-150 W) and seven bouts of intermittent cycling at 70 rev X min-1 (III; Wmax = 300-450 W). Plasma cortisol, glucagon and lactate increased significantly (P less than 0.

Heat myringotomy.

Heat myringotomy using a commercially available, battery powered device produced an opening in the tympanic membrane that persisted 1 to 3 weeks. The procedure was performed to treat chronic otitis media with effusion (COME) in lieu of ventilation tubes in 10 pediatric and 15 adult ears under office iontophoretic anesthesia. These patients were followed for a minimum of 3 months to assess efficacy.

Combined surgery and postoperative irradiation in the treatment of cervical lymph nodes.

One hundred seventy-three patients with squamous carcinomas of the laryngopharynx, oral cavity, and oropharynx received planned, combined resection of the primary neoplasm and radical neck dissection (when N1, N2, or N3 lymphadenopathy was present) followed by megavoltage irradiation to the primary sites and bilateral cervical regions between 1975 and 1982. Radical neck dissections were performed in all patients with N2 and N3 cervical lymphadenopathy, in 90% of those with N1 necks, but in only 4% whose necks were staged NO. Neck failures occurred in 10%, 22%, 19%, and 38% of patients with stages N0, N1, N2, and N3 necks, respectively.

Body cooling in human males by cold-water immersion after vigorous exercise.

Five male subjects were immersed to neck level in a whole-body water calorimeter (water temperature 19 degrees C) on two occasions. One immersion was preceded by 30 min of exercise on a treadmill at 80% of the subjects' maximum heart rate, while the other was preceded by no exercise (control). Ventilation, oxygen consumption, hand-grip strength, and heat loss (measured by calorimetry) results showed no significant differences between resting and exercise trials.

Growth hormone responses during intermittent weight lifting exercise in men.

Five normal male volunteers performed two intermittent weight lifting exercises of equal total external work output and duration (20 min) with identical work-rest intervals but different load and frequency of movements. Exercise I consisted of seven sets of seven vertical leg lifts at 85% of the subject's Seven Repetition Maximum (SRM) and, 5 days later, seven sets of 21 vertical leg lifts with one-third of the previously used load (Exercise II). Blood was sampled throughout the exercise and recovery periods for growth hormone, lactate, and glucose analysis.

Effect of anaerobic and aerobic exercise of equal duration and work expenditure on plasma growth hormone levels.

Growth hormone (GH) and lactic acid levels were measured in five normal males before, during and after two different types of exercise of nearly equal total duration and work expenditure. Exercise I (aerobic) consisted of continuous cycling at 100 W for 20 min. Exercise II (anaerobic) was intermittent cycling for one minute at 285 W followed by two minutes of rest, this cycle being repeated seven times.

Oral melanoacanthoma. Review of the literature and report of ten cases.

Melanoacanthoma is a simultaneous benign proliferation of two cell types--the keratinocyte and the melanocyte. It is a rare lesion; only twenty cases have been reported on skin and three cases intraorally. This article reports a series of ten cases of intraoral melanoacanthoma.

Intraoperative iodine 125 implants. Their use in large tumors in the neck attached to the carotid artery.

Twenty-nine patients with large masses attached to the carotid artery underwent surgical resection, preservation of the artery, and intraoperative iodine 125 implantation via an absorbable suture. Eighteen were treated for recurrent neoplasms, having failed prior surgery and/or irradiation therapy. Eleven were treated primarily.

Squamous cell carcinoma of the base of the tongue.

The squamous cell carcinomas of 119 patients treated between 1958 and 1980 were retrospectively reclassified according to the 1977 American Joint Committee for Cancer Staging-End Results Reporting guidelines. Analysis of the information was performed with an interactive computer program that allows the analysis of a large number of medical factors with numerous variables. The following factors show the statistically significant improved survival rates: well-differentiated histopathologic findings, small T-stage lesions, and clinically negative neck disease.

125Iodine implants as an adjuvant to surgery and external beam radiotherapy in the management of locally advanced head and neck cancer.

125Iodine seeds either individually placed or inserted into absorbable Vicryl suture carriers were utilized in conjunction with surgery and external beam radiotherapy in an attempt to increase local control rates in patients with (1) advanced oropharyngeal and laryngopharyngeal cancers (T3-T4, N2-N3), (2) massive cervical lymphadenopathy (N3) and an unknown primary site and (3) locally recurrent head and neck cancers. Forty-eight patients were treated with 55 implants. The carotid artery was implanted in 15 patients, while seven patients had seeds inserted into the base of the skull region, and another three patients had implants near cranial nerves.

"How I do it"--otology and neurotology. A specific issue and its solution. Advantages of the T-tube for short and long-term middle ear ventilation.

The T-tube has several advantages that should be considered when selecting a ventilation tube. First, it remains in place much longer than the average tube; thus allowing the physician, rather than chance, to determine when the tube should be removed. Second, it can be removed painlessly without an anesthetic when indicated.

Lateral laryngeal suspension: a new procedure to minimize swallowing disorders following tongue base resection.

Fourteen patients who underwent composite resections for oropharynx and tongue base cancers had lateral laryngeal suspensions in order to improve postoperative swallowing ability, minimize the surgical defect, and decrease shifting of the mandible after composite resection. Eleven of these patients had significant base of tongue resections (30-90%) and 3 had oropharyngeal resections. Thirteen (93%) were able to eat by mouth, 14 patients (100%) had a normal airway, and 14 (100%) had intelligible speech.

Heat myringotomy for the treatment of serous otitis media.

A new heat myringotomy device is described that produces a 2-mm myringotomy which remains open three to four weeks without the need for a ventilation tube. The device can be used in the office in young children under iontophoretic anesthesia and may eliminate the need for tube insertion in 50% of chronic serous otitis media cases.

Discharge planning and decision making.

Current advances in discharge planning have focused on comprehensive assessment, levels of care, and reducing the length of hospital stays. However, evidence also indicates the importance of involving patients and their families in making decisions about long-term care. This article identifies nine factors related to the patients' involvement in decision making.

Effect of mastoid cavity modification on middle ear sound transmission.

The modified radical mastoidectomy and intact canal wall mastoidectomy are the two most popular procedures used today for the treatment of chronic middle ear and mastoid disease. Their effects on the anatomy of the middle ear and mastoid cavity are quite different and it might also be expected that they would modify middle ear sound transmission in different ways. This paper describes experiments with human temporal bones and a middle ear computer analog model that attempt to define acoustic differences produced by cavity modifications in these two procedures.

Magnetic intranasal splints.

A magnet-containing silicone rubber intranasal splint is described for use following septoplasty. The splints hold the septal flaps in place by magnetic attraction and eliminate the need for packing. They produce minimal discomfort, are easily inserted and removed, and allow nasal breathing while in place.

The lateral port control pharyngeal flap: a versatile approach to velopharyngeal insufficiency.

The surgical therapy for velopharyngeal incompetence has always been a challenging problem. In spite of the surgical choices of palatal pushback, pharyngeal flap, pharyngoplasty, muscle transfers, and pharyngeal wall implants, the reported failure rate has varied from 10% to 50%. A group of ten patients with velopharyngeal insufficiency is presented, two posttonsillectomy and adenoidectomy, three secondary to congenital deficiencies, and five following palatal and pharyngeal paralysis secondary to severe closed head injuries.