Multiple primary malignancies in head and neck cancer.

Multiple primary (MP) malignancies were found in 9.7% of 1961 patients with primary head and neck cancer diagnosed at The Johns Hopkins Hospital, Baltimore, during the years 1975 to 1985. The index tumors were divided into six main groups.

Chemotherapy for salivary gland cancer.

Because of the scarcity of such lesions, little is known about the efficacy of chemotherapy for advanced salivary gland cancers. Although surgery and irradiation are the mainstays of treatment, patients with recurrent tumors and those with unresectable or metastatic cancer are not candidates for this usual approach. Ten patients with recurrent, metastatic, or unresectable salivary gland tumors were treated with combination chemotherapy, primarily with cisplatin, doxorubicin hydrochloride (Adriamycin), and cyclophosphamide, or cisplatin with 5-fluorouracil.

Clinical evaluation of patients with metastatic squamous carcinoma of the neck with occult primary tumor.

Between 1976 and 1982, we systematically evaluated 33 patients with a diagnosis of metastatic squamous carcinoma of the neck (excluding the supraclavicular fossa) from an occult primary tumor. In 11 patients the primary lesion was identified by physical and indirect mirror examinations, in four by examinations done under anesthesia and panendoscopies, and in an additional three by random biopsies. Primary lesions were in the nasopharynx (five patients), hypopharynx (five), tonsillar fossa (three), epiglottis (two), lateral oropharyngeal wall (one), the base of the tongue (one), and the anterior tonsillar pillar (one).

Compression plates in the treatment of advanced anterior floor of mouth carcinoma.

Advanced anterior floor of mouth squamous cell carcinoma has been traditionally treated with wide excision in conjunction with mandibulectomy and radical neck dissection. This has resulted in significant mandibulofacial defects with functional and cosmetic significance. Efforts at primary reconstruction in the past using bone grafts, osteomyocutaneous flaps, and other methods have yielded unsatisfactory results.

Multiple primary neoplasms in patients with salivary gland or thyroid gland tumors.

The exact risk of multiple primary neoplasms in patients with salivary gland or thyroid gland malignancies is difficult to ascertain from the data available in the literature. This study examines, retrospectively, 198 patients with a first malignancy of the salivary gland and 186 patients with a first malignancy of the thyroid gland, treated over a 10-year period. Fourteen cases of second tumors were found in the first group and 29 cases in the latter.

Response of cranial nerve abnormalities in nasopharyngeal carcinoma to radiation therapy.

Eighteen of 36 patients (50%) with the diagnosis of nasopharyngeal carcinoma had cranial nerve deficits before definitive radiotherapy. Within this group of 18 patients, there were 34 cranial nerve abnormalities and four Horner's syndromes. Overall, 62% of cranial nerve deficits recovered completely (CR) and 32% recovered partially (PR), for a total response rate of 94% to definitive radiotherapy.

Lesions of the oral mucous membranes.

This article has not attempted to exhaustively review mucosal diseases of the oral cavity. We have, however, described some oral mucous membrane lesions which need to be kept in mind during the head and neck examination.

Class structure and spatial polarization: an assessment of recent urban trends in Latin America.

"In this paper, we review those major trends characteristic of peripheral urbanization as they are reflected in the recent Latin American experience. Such trends include: urban primacy and the relative absence of secondary city systems, the character and dynamics of the informal sector, housing deficiencies and state housing policy, and the recent rise of popular organizations oriented toward self-sufficiency or militant demand-making. These trends are important because they represent the form in which continuity and change of peripheral class structures are reflected in space, both at the national and local levels.

Functional endoscopic sinus surgery. Theory and diagnostic evaluation.

The keys to functional endoscopic sinus surgery are an understanding of the underlying mechanisms of paranasal sinus disease and the ability to diagnose the causes accurately. Previously unrecognized causes of recurrent acute sinusitis and of chronic sinus symptomatology can now be identified by careful diagnostic evaluation. Systematic nasal endoscopy and high-resolution computed tomographic imaging provide complementary diagnostic information that can allow for the recognition of problems not identifiable by other means.

Molecular cloning of staphylococcal enterotoxin B gene in Escherichia coli and Staphylococcus aureus.

We have cloned the Staphylococcus aureus entB gene in Escherichia coli, using pBR322 as the vector plasmid; however, no detectable staphylococcal enterotoxin B (SEB) was produced by the E. coli clones. When the entB gene was placed downstream from the strong lambda phage promoter, PR, SEB was synthesized at readily detectable levels in E.

Interferon sensitivity of fibroblast cell cultures derived from patients with neoplasms of the head and neck.

Interferon (IFN) is a protein with antiviral activity that has been shown to inhibit the growth of many different types of cells. We have measured the IFN sensitivity of nine cell cultures isolated from patients with squamous cell carcinoma and one with malignant melanoma of the head and neck. Normal-appearing fibroblast cultures isolated from these tissues appear quite sensitive to the antiviral effects of IFN.

Naturally occurring quantitative variants of acid phosphatase-1 in Drosophila melanogaster.

We have examined 111 wild Drosophila melanogaster lines for cis-acting quantitative variants of the Acph-1 gene, which codes for acid phosphatase-1 (ACPH). Three variants with obvious, reproducible phenotypes were isolated. All variants acted equally on all tissues and developmental stages examined.

A low copy number, copia-like transposon in maize.

Bs1, a transposable element that moved into the maize Adh1 gene following barley stripe mosaic virus infection, is shown to be present in 1-5 copies in all maize and teosinte lines tested. Bs1 sequences do not hybridize with the genome of barley stripe mosaic virus. The insertion of Bs1 is bounded by 304-bp perfect direct repeats, similar in structure to Ty1 in yeast, copia and related elements in Drosophila, and vertebrate pro-retroviruses, but different from all other known plant transposons.

Prophylactic efficacy and tolerance of low-dose intranasal interferon-alpha 2 in natural respiratory viral infections.

The prophylactic activity of intranasal human interferon-alpha 2 (HuIFN-alpha 2) was determined in a randomized, double-blind, placebo-controlled study. Healthy, working adults self-administered sprays of HuIFN-alpha 2(1.25 X 10(6) IU; n = 142) or placebo (n = 145) twice daily.

Mitomycin and fluorouracil with concomitant radiotherapy in head and neck cancer.

Forty-two previously untreated patients with predominantly stage IV (35) head and neck squamous cell carcinoma were treated preoperatively with mitomycin and fluorouracil and concomitant radiotherapy with 5,000 to 6,000 rad using a split-course technique. Toxic reactions were acceptable. Five patients developed severe mucositis.

Infralabyrinthine approach to skull-base lesions.

New surgical techniques have extended the head and neck surgeon's domain to include various skull-base lesions. The infralabyrinthine approach incorporates these techniques and can be used to resect benign and malignant tumors involving the base of the temporal bone. Lesions of the internal carotid artery near the carotid foramen are also readily accessible.

Esthesioneuroblastoma: diagnosis and management.

Esthesioneuroblastoma is an uncommon nasal tumor originating from cells of neural crest origin. An increased awareness of this neoplasm by clinicians and pathologists has led to an increase in its diagnosis. In the Department of Otolaryngology--Head and Neck Surgery at the University of Virginia Medical Center, 22 cases have been treated.

Treatment of advanced esthesioneuroblastoma with high-dose chemotherapy and autologous bone marrow transplantation. A case report.

A 46-year-old woman presented with an advanced unresectable esthesioneuroblastoma which failed to respond to radiation therapy and one course of chemotherapy. She underwent treatment with high-dose chemotherapy (cyclophosphamide, doxorubicin, and vinblastine) followed by autologous bone marrow transplantation. The major toxicity from the regimen was severe oropharyngeal mucositis.

Use of the Satinsky clamp for excision of anterior tongue lesions.

The use of Satinsky atraumatic vascular clamps in the resection of lesions of the tongue is described. This technique provides for extirpation of tongue lesions in a hemostatically controlled, dry operative field. The application of these clamps does not appear to alter significantly the histopathologic findings at the resected tumor margins, as is found with extensive dissection using electrocautery.

Involucrin in laryngeal dysplasia. A marker for differentiation.

Involucrin is a major structural subunit of the cross-linked protein envelope that encases keratin in maturing squamous cells. Intracytoplasmic involucrin is identifiable via immunoperoxidase techniques as these cells migrate from the basal layer to the more superficial layers of the stratified epithelium. Normal squamous epithelia and mildly dysplastic epithelia show uniform staining in the suprabasal and superficial layers of the mucosa but show no staining in the basal layer.

Computerized axial tomography of the esophagus to determine the suitability for blunt esophagectomy.

Computerized axial tomographic (CT) scans were performed on 16 patients over an 18-month period to determine which patients were candidates for removal of their esophageal tumors by blunt esophagectomy. Blunt esophagectomy was offered only to those patients whose tumors were confined to the esophageal wall on CT scan. Thirteen patients were able to undergo blunt esophagectomy, with only one complication, a tracheal injury, which was repaired.

Staging of cervical lymph node metastasis. Comparison of two systems.

In 1977 the American Joint Commission (AJC) revised its system for classification of cervical lymph node metastasis producing a variation from the staging system of the International Union Against Cancer (UICC). A review of 356 evaluable patients was carried out to determine if the AJC or UICC system was prognostically superior. The primary sites of study were the supraglottic larynx in 181, tonsil in 98, and pyriform sinus in 77.