ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1977.tb01372.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

SummaryThe purpose of this study is to investigate the relationship between preoperative signs and symptoms and the actual size of the adenoid found at operation in a group of children listed for adenoidectomy.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1977.tb01373.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Prolonged low intensity galvanic currents produce scattered but sharply cicumscribed areas of destruction in the guinea pig cochlea. As well as providing opportunities for studying possible electrically‐induced injuries during artificial auditory stimulation of the deaf, such preparations present an unusual opportunity to study the relations between patterns of compound auditory nerve action potentials and morphological changes, which could be useful in evaluating the various computer models of cochlear function at present being develope

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1977.tb01374.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Experience of a short series of 37 cases of tympanoplasty involving the use of a homograft tympanic membrane is presented, with a discussion of the problems involved. The initial results correspond to the earlier series’ anatomical success rates and indicate that these grafts will become widely used as an effective method of tympanoplast

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1977.tb01375.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Four cases of Waldenstrom's macroglobulinaemia (WM) are described in which otolaryngeal symptoms were present. Symptoms in WM are related to (a) bleeding diathesis and (b) hyperviscosity of the blood. The bleeding diathesis was manifested as epistaxis in 2 cases. In one case which came to postmortem, histological examination of the temporal bone showed complete disruption of the labyrinth by haemorrhage. Hyperviscosity probably was the source of hearing loss which took place in all 4 patients and had the following characteristics: (a) sudden onset (b) cochlear type (c) bilateral (d) sequential involvement of the two sides (e) improvement on treatment of the disease with alkylating agents or plasmapheresis. Early diagnosis of WM is thus important.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1977.tb01376.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

The application of some basic principles derived from studies of the cell cycle and proliferative kinetics of normal and malignant cells has provided a rational basis for designing cancer treatment protocols. Using this approach in advanced head and neck cancer it is possible (a) to increase the response rate, (b) to reduce toxicity and (c) to reduce in‐patient hospital stay time. Seventy‐one patients with advanced carcinoma of the head and neck were randomized for treatment between two combination schedules, one with and the other without adriamycin. Responses (more than 50% tumour regression) were 74% overall with 70% responding to the combination without adriamycin and 82% responding to the schedule containing it. The increase in response rate seen with adriamycin is not statistically significant. Prior radiotherapy significantly reduced the likelihood of response to chemotherapy. These results have major implications for adjuvant chemotherapy and suggest a possible way of increasing the survival time in this group of disea

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1977.tb01377.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Since April 1974, 60 patients with squamous cell carcinoma of the head and neck region, of poor prognosis and generally in advanced stages, were treated with the combination of a cytotoxic regimen–VBM (Vincristine, Bleomycin and Methotrexate) and radical radiotherapy. The essential feature of the combination is the administration of pulses of VBM synchronous with a course of fractionated external radiotherapy in order to achieve potentiation of radiotherapy. On average 4‐5 pulses of VBM were given during treatment, combined with radiotherapy on a Cobalt unit. The selection, preparation and management of the patients are described. Intense mucositis and intercurrent infection provide the main problems during treatment and close management is essential. Late complications have not been a serious problem. The crude actuarial survival rate at 24 months is 61%. The probability of survival without any recurrence to 24 months following initial treatment is 46%. Local control was achieved by the initial treatment in 43 patients. These results suggest that potentiation of radiotherapy and an increased therapeutic ratio has been obtained by the addition of VBM to radiotherapy and there is a possibility that the occurrence of distant metastases has been reduced or postpo

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1977.tb01378.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

The need for new methods of treatment to be compared with others by objective means is stressed. Randomized clinical trials are markedly superior to retrospective or to nonrandomized comparisons. Despite the difficulties, patients with tumours of the same stage, histology and site should be randomized between the new treatment and the best alternative in order to assess the real value of treatments as quickly as possible. Such a prospectively randomized clinical trial has been completed on 126 patients with advanced squamous cell carcinomas of the head and neck in which treatments with 7.5 MeV fast neutrons were compared with radiation from X or gamma rays (photons). The neutron treated patients received the standard dose of 1560 rads given in 12 treatments over 4 weeks and all were treated on the MRC Cyclotron at Hammersmith Hospital. Forty per cent of the photon patients were treated at Hammersmith and the rest at the collaborating hospitals. The doses ranged from 4540 to 6840 rads in periods of 4‐6 weeks. The proportion of patients whose tumours clinically completely regressed was nearly twice as great in the neutron series (77%) as in the photon series (43%) and only one tumour recurred in the neutron series compared with 15 in the photon group. The benefit to the neutron treated patients was most marked in the buccal cavity (p = 0.001), the oropharynx (p = 0.004) and cervical nodes (p = 0.01). Neutrons gave the least advantage to tumours in the hypopharynx, persisting control being seen in 9 neutron and 3 photon patients (p = 0.10). There were 4 neutron complications compared with one in the photon series and the one neutron recurrence was in this site. There were also more complications in the neutron treated oropharyngeal tumours and these were mostly aspiration following regression of large tumours which had already caused extensive damage. The actuarial percentages surviving at 1 year were 53% (neutron) and 42% (photon) and at 2 years these figures were 28% and 15% respectively. These differences are not statistically significant. Fifteen neutron treated patients, and 14 of those receiving photons, underwent surgery because they had signs of residual or recurrent tumour after the course of radiation. There were 4 fatal complications in the neutron series and 3 in the photon series; healing was normal in 8 and 9 respectively. However tumour was present in only 5 of the neutron specimens compared with 13 in the photon treated patients. Three of the 4 fatal complications in the neutron series occurred after operations where the specimen removed showed no malignanc

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1977.tb01379.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

The use of an alloplastic implant to fill the defect after resection of the central part of the mandible is described. This procedure makes the post‐operative course more acceptable for the patient, and facilitates later reconstruction by a free bone graft in the absence of recurrenc

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1977.tb01380.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1977.tb01381.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY