ISSN:0148-6403    

DOI:10.1002/hed.2890020202

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1979

数据来源: WILEY

摘要:

AbstractA retrospective review of 500 patients with primary hyperparathyroidism seen from 1951 to 1975 was conducted; the effect of routine screening of calcium and phosphate levels (initiated in 1968) on the incidence and spectrum of the disease was analyzed. The majority of the patients (77%) were diagnosed in the eight‐year period after routine biochemical screening was instituted. Comparing the group of patients diagnosed before the advent of biochemical screening and those diagnosed since screening was instituted, we found: (1) a small but significant increase in the number of asymptomatic patients diagnosed (from 2% to 12%); (2) no change in the incidence of related medical disorders, i.e., nephrocalcinosis and hypertension; (3) no change in the incidence of primary hyperplasia and adenoma; and (4) no change in the mean serum calcium level, the mean age at diagnosis, or the number or location of the involved parathyroid glands. Although routine calcium screening has identified significantly more cases of primary hyperparathyroidism, screening apparently does not enable diagnosis at an earlier stag

ISSN:0148-6403    

DOI:10.1002/hed.2890020203

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1979

数据来源: WILEY

摘要:

AbstractEleven of 12 patients treated for invasive melanomas of the conjunctiva at the UCLA Hospitals from 1955 to 1976 revealed data sufficient for evaluation. Of these 11 cases, 4 died from 3 to 13 years after treatment as a result of the disease. The plan presented for surgical management of melanosis is based on histologic criteria and on the anatomic location of the tumor. In this series, such management ranged from local excision of noninvasive melanotic lesions to orbital exenteration with parotidectomy and radical neck dissection for invasive melanomas that involved the palpebral conjunctiva or caruncle. Extended follow‐up is needed in all patient

ISSN:0148-6403    

DOI:10.1002/hed.2890020204

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1979

数据来源: WILEY

摘要:

AbstractIn a review of 80 patients with hypopharyngeal squamous‐cell carcinoma, 43 patients were found to have had lesions arising in the pyriform sinus, 34 had lesions arising on the postcrolateral wall of the hypopharynx, and 3 had lesions in the postcricoid area. Therapeutic modalities included radical radiation therapy in 56 patients, radiation plus surgery in 13 patients, and planned combined therapy in 11 patients. The five‐year determinate survival rate of all the patients was 20%. Patients with posterolateral wall tumors had a 23% rate of cure, but those with pyriform sinus tumors had only a 13% rate of cure. The five‐year determinant survival rate was 12.5% for patients undergoing radical radiation therapy, 15.4% for those undergoing unplanned radiation and surgery (salvage therapy), and 55.6% for those with planned combined therapy. Over 40% of the patients had a recurrence of their disease; an additional 20% developed distant metastatic spread which usually occurred within the first year. The type of therapy did not alter the rate of recurrence but did affect the rate of distant metastatic spread, with planned combined therapy greatly improving control of the primary lesion. This study suggests that, even with advanced disease, the most effective therapy for hypopharyngeal carcinoma is planned combined radiation therapy and su

ISSN:0148-6403    

DOI:10.1002/hed.2890020205

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1979

数据来源: WILEY

摘要:

AbstractThe complete care of a patient with head and neck cancer should attend to the emotional as well as the physical aspects of the disease; usually the physical component of the disease is emphasized, while care of the emotional response of the patient and family is rarely addressed. There is no single, caring way to respond or cope with the emotional aspects of this disease. Nonetheless, it should be underscored that communication between the providers of health care (i.e., physician, nurse, aid, therapist, etc.) and the patient and family should be maintained during all phases of care. This article describes an approach to providing emotional support to cancer patients and their families during the phases of initial diagnosis and treatment, posttherapy, rehabilitation, recurrence, dying, and death. The emotional response of the health care provider in these circumstances is also addressed.

ISSN:0148-6403    

DOI:10.1002/hed.2890020206

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1979

数据来源: WILEY

摘要:

AbstractJuvenile nasopharyngeal angiofibroma (JNA) is a histologically benign, locally invasive tumor of the nasopharynx that is found primarily in the pubescent male. While most authors recommend surgical excision for smaller, localized extracranial tumors, opinion varies on the management of more aggressive tumors with intracranial extension. The authors present their experience over the past 15 years with 15 cases of JNA with intracranial extension, and formulate a plan of management. A combined otolaryngologic/neurosurgical approach is recommended in order to assess the extent of the tumor and to isolate feeding vessels. Lateral extension into the middle cranial fossae should be resected in continuity with the nasopharyngeal component, which is approached from below in a separate operative field. Medial extensions are transected, verified angiographically three months after surgery, and irradiated. The results of therapy are presented, and a case of dural penetration by JNA is described.

ISSN:0148-6403    

DOI:10.1002/hed.2890020207

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1979

数据来源: WILEY

摘要:

AbstractWhile surgery and radiation therapy remain the time‐tested modalities for the treatment of cancer in the head and neck, recent experimental and clinical experience has documented the effectiveness of cryosurgery as an adjunct in the treatment of selected neoplasms in individual patients. A review is provided of the theory of freezing as a method of cell destruction, and experimental and clinical experience illustrate the principles and application of cryosurgery to head and neck tumor

ISSN:0148-6403    

DOI:10.1002/hed.2890020208

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1979

数据来源: WILEY

ISSN:0148-6403    

DOI:10.1002/hed.2890020209

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1979

数据来源: WILEY

摘要:

AbstractThe embryology of the face is presented with respect to changes affecting the mandible, maxilla, upper and lower lips, palate, nose, and oral cavity. The embryonic development of the teeth and salivary glands is also included. Various facial clefts, including cleft lip and cleft palate, are discussed, in addition to some congenital anomalies affecting the nose and oral cavity.

ISSN:0148-6403    

DOI:10.1002/hed.2890020210

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1979

数据来源: WILEY

摘要:

AbstractRadiotherapy is frequently employed in the management of head and neck neoplasia, either as an adjunct to surgery or as the sole treatment modality. Consequently, radiation alopecia—a well‐known complication of high‐dosage radiotherapy—is seen often. Longer patient survival, especially with earlier discovery of the malignancy and more refined treatment regimens, will provide the surgeon with the opportunity to treat radiation alopecia by means of the punch graft technique of hair transplantation. The technique is substantially similar to that employed in treating male pattern baldness, although the approach to the recipient and donor areas must be modified. A successful case report is documented and a modified approach is high

ISSN:0148-6403    

DOI:10.1002/hed.2890020211

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1979

数据来源: WILEY