Field cancerization in the aerodigestive tract--its etiology, manifestation, and significance.

Field cancerization of the mucous membranes of the aerodigestive tract frequently develops in response to tobacco and alcohol usage; it is characterized by a variety of premalignant and frankly malignant epithelial changes that may lead to the development of multiple primary cancers of the aerodigestive tract. Field cancerization can be demonstrated by supravital staining with toluidine blue or by electron microscopic study of random biopsies taken from apparently normal mucosa. Field cancerization should be taken into account in treatment planning of a patient with cancer so that all treatment options, including the use of radiation therapy, be kept open for as long as possible in the event that the patient may develop multiple primary tumors.

Argon laser and soft tissue interaction.

The interaction of the argon laser with the mucous membrane of the upper aerodigestive tract was studied. The advantages of the argon laser are a small spot that can be varied in size and intensity, selective vascular absorption, the capability of being incorporated into a flexible delivery system, and a coincident aiming beam. The acute soft tissue effects are characterized by subepithelial extension, with a variable delayed reaction between the application of the laser and a detectable break in the epithelium.

Natural history and management of keratosis, atypia, carcinoma-in situ, and microinvasive cancer of the larynx.

Keratosis, atypia, carcinoma in situ, and microinvasive cancer occurring as white or red patches on the vocal cords are part of the diathesis of cancer of the aerodigestive tract and represented a sequential continuum. Excisional biopsy is the preferred treatment for identification and potential cure of the lesion. If the margins of excision are inadequate, further treatment options are either reexcision or radiotherapy.

Premalignant changes in normal appearing epithelium in patients with squamous cell carcinoma of the upper aerodigestive tract.

Biopsy specimens of "normal" mucous membrane of patients susceptible to the effects of the carcinogens of tobacco revealed morphologic abnormalities on electron microscopic examination that were consistent with the concept that carcinogenesis is a multistep process of sequential neoplastic development extending over a long period of time. Such changes in the upper aerodigestive tract are probably tobacco induced and may be reversible if tobacco exposure is eliminated. Use of the electron microscope can provide the clinician with an accurate assay of the severity of mucosal alterations induced by tobacco.

Prognostic indicators in induction cis-platinum bleomycin chemotherapy for advanced head and neck cancer.

A complete response to induction cis-platinum bleomycin chemotherapy significantly increases the probability of local tumor control and overall disease-free survival. Factors that favor a good response to chemotherapy are tumor histology (well differentiated), location of the primary site (oral cavity and oropharynx), nodal status (N0) and size of the primary lesion (t3 better than T4). Increased cellular maturation after chemotherapy correlates with an improved clinical response.

Morphology and pathogenesis of adrenal cysts.

Adrenal cysts represent a rare condition (approximately 250 cases have been reported). We report two additional cases: the first involved a huge lesion removed surgically and thoroughly studied preoperatively; the second was an incidental autopsy finding. Detailed ultrastructural studies have been made of both cases.

Inverted papilloma and squamous cell carcinoma.

Since 1960, 15 patients with histologically proven inverted papilloma of the nose and paranasal sinuses have been treated at the University Hospital, City Hospital, and V. A. Hospital in Boston.

Histopathologic findings after cis-platinum bleomycin therapy in advanced previously untreated head and neck carcinoma.

Eleven patients with unresectable or marginally resectable (stage III and IV) cancer of the head and neck were treated according to protocol with preoperative chemotherapy, surgical resection, and postoperative radiotherapy. Chemotherapy consisted of a combination of cis-diamminedichloroplatinum (II) (cis-DDP), 120 mg/M2, and bleomycin, 15 mg/M2, given sequentially during a three week treatment period. Seven patients initially had unresectable lesions which became amenable to surgical resection after chemotherapy.

Morphology of the epithelial component of human lung hamartomas.

Unusual ultrastructural bodies were found in about one-fifth of the epithelial cell nculei in three cases of pulmonary hamartoma. Those bodies often appear to be twisted tubules with recognizable branching. Morphologically different structures are also seen in occasional nuclei.

Assay of immune cytolysis of lymphocytes and tumour cells by automatic determination of cell volume distribution.

Immune cytolysis (lysis) of cells due to the action of antibody in the presence of complement is usually substantiated by the uptake of vital dye by the cells, or by the escape of radiolabel from the cells. Immune cytolysis has now been assayed by determination of cell volume distribution with a Coulter multi-channel particle size analyser used in conjunction with a Coulter counter. For Ehrlich ascites and sarcoma-180 cells, volume degradation corresponding to vital staining was obtained only if trypsin (final concentration 625 microgram/ml) was added immediately after the usual 1 h incubation period for cells, antibody and complement.

The morphology of human papillomas of the upper respiratory tract.

Recurrent squamous papillomas of the upper respiratory tract were examined by light microscopy, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Surface of the cells is irregular and is covered by numerous stout microvilli. These are shorter and broader than those of cells of the uninvolved mucosa.

Laser surgery in otolaryngology: interaction of CO2 laser and soft tissue.

The sequence of histological change induced by CO2 laser irradiation was discussed in terms of two factors: the physiomechanical factor and the physiochemical factor. At sufficiently high heat energy levels, the immediate findings are characterized by crater formation resulting from rapid vaporization of the water and ejection of the solid component. In the immediate vicinity of the crater edge, the maximum tissue temperature rise is 65 degrees C above the 32 degrees C ambient tissue temperature and it decreases to the primary tissue temperature within a distance of 2 mm.