Diagnosis and treatments for recurrent malignant tumors involving the carotid artery / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the diagnosis and treatment of the malignant tumor involving carotid artery.</p><p><b>METHODS</b>A total of 23 cases of recurrent malignant tumors involving the carotid artery were included in this study. For the primary cancers, 8 of 23 cases were laryngeal carcinomas, 10 hypopharyngeal carcinomas, 2 thyroid carcinomas, 1 tonsil carcinoma, 1 parotid gland carcinoma, and 1 hypopharyngeal sarcoma with the invasion of cervical esophagus. Detailed evaluation on each case was performed before treatment. The relations of recurrent tumors with neck blood vessels were determined with enhanced CT/CTA. Of 23 cases with recurrent malignant tumors involving the carotid artery, 16 cases received surgery and 7 cases received the palliative treatment without operation.</p><p><b>RESULTS</b>Seven patients with palliative treatments died of hemorrhage from the invaded neck blood vessels, systemic failure or pulmonary metastasis in six months. Of 16 cases with surgery, recurrent tumors were completely excised in 14 cases and there were residual tumor tissues on artery walls in 2 cases. Within 16 surgical cases, 2 cases died of neck hemorrhoea after one week because of infection, 2 cases died of lung metastasis 8 months later, 3 cases died of neck local recurrence 1 year later, 2 cases died of lung metastasis after 2 years, 1 case died of neck local recurrence 2 years later and 1 case died of a heart attack 2 years later. The rest 5 cases were alive.</p><p><b>CONCLUSIONS</b>Enhancement CT/CTA can used in the evaluation for recurrent malignant tumors involving the carotid artery. Surgical treatments can be applied to some selected patients, which can improve the quality of life and survival time of the patients.</p>

Experience of successful remedy of hemorrhage after treatment of head and neck neoplasms / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To discuss the effective emergency treatment to patients with different malignant tumors of head and neck after treatment.</p><p><b>METHODS</b>Eighteen hemorrhage patients which have been successfully rescued with different malignant head and neck neoplasias after operation and (or) radiotherapy were analyzed retrospectively. Emergency treatment was used in 1 patient with nasopharyngeal cancer (NPC) suffering from massive epistaxis and suffocation after radiotherapy. The digital subtraction angiography (DSA) was used in 6 patients suffering from rupture of internal maxillary artery after irradiation for NPC. Two cases suffering from ulcer bleeding from deep par of pars nasalis pharyngis underwent repair of galea aponeurotic after elotomy. Hemostasis by finger pressing and per-cutsem ligation of carotid were used in 9 patients who suffered from rupture of carotid artery, then underwent normal treatment in operating room.</p><p><b>RESULTS</b>Ligation of carotid artery was used in one patient with NPC after radiotherapy suffering from bleeding from arteria carotis interna of skull base. DSA was used in 6 patients with hemorrhage of nasopharynx who was confirmed rupture of internal maxillary artery by CT and DSA. Two cases suffering from ulcer bleeding from deep par of pars nasalis pharyngis underwent repair of galea aponeurotic; pectoralis major myocutaneous flap and infra-trapezius were used in 7 patients with laryngocarcinoma, carcinoma of infra-pharynx, thyroid carcinoma and lymphadenoma of cervical part, 6 cases of them were successful while 1 patient's pectoralis major myocutaneous flap partly necrosis. One patient with thyroid carcinoma who can not be repaired after many operations and radiotherapies. One patient with lymphoma of cervical part also can not be repaired because bad body condition. All cases have no hemiplegic paralysis after first aid. One cases with NPC suffering from massive epistaxis that after ligation of carotid artery suffered from partly cerebral infarction and died of pulmonary infection 6 months postoperatively; 2 cases of nasopharyngeal carcinoma died of recurrence 11 months postoperatively; other cases died of recurrence (7 cases), metastasis and/or multi organic failure of the whole body (8 cases) from 12 to 36 months.</p><p><b>CONCLUSION</b>Different treatments were used in different cases, The DSA and per cutsem Ligation of artery after hemostasis by finger pressing were the modus operandi for NPC patients with intractable epistaxis after radiotherapy and patient suffered from rupture of carotid artery respectively.</p>

Selective neck dissection for node-positive necks (N1, N2) in patients with head and neck squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate therapeutic effect in a consecutive series of patients with node-positive of N1 and N2 head and neck squamous cell carcinoma (HNSCC) who underwent selective neck dissection as part of their treatment in a single institution.</p><p><b>METHODS</b>Retrospectively analyzed 36 patients with node positive head and neck squamous cell carcinoma, which had undergone 40 selective neck dissection (SND) and 16 radical neck dissections (RND) and the therapeutic effects of the SND in HNSCC patients with node positive. Kaplan-Meier method was used to estimate the survival analysis among the different levels, and log-rank method for comparison of the different distribution of the several influential factors of the survival; the fisher's exact test was used to test the difference of the neck recurrence between the groups that with or without lymph node extracapsular spread. Cox proportional hazard model was applied to screen the potentially significant prognostic factors.</p><p><b>RESULTS</b>The 3 and 5 years survival rate of this group were 76.8% and 54.3% retrospectively. The 3 and 5 years' survival rate were both 100% in the N1 + N2a group, while 59.4% and 32.0% in the N2b + N2c group correspondingly. With log-rank test between the two groups above, significant statistical difference was revealed (P = 0.003) in the 5 years' survival rates. To the groups that with or without extracapsular spread (ECS), the recurrence rate were 36.4% and 3.4% respectively and significant statistical difference existed (P = 0.015). In the groups that with or without ECS, the 3 years' survival rate were 45.5% and 81.8% , and 5 years' survival rate were 39.7% and 65.5% respectively, also the significant statistical difference (P = 0.0148 and P = 0.0423 respectively) had presented.</p><p><b>CONCLUSIONS</b>SND is appropriate for treatment of N1 neck of the patient with HNSCC; However, SND should be taken very cautious to the N2 neck and node-positive neck with extracapsular spread, MRND or RND might be a better choice to prevent the recurrence in the neck.</p>

Effect of acute exposure to microwave from mobile phone on DNA damage and repair of cultured human lens epithelial cells in vitro / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the DNA damage of human lens epithelial cells (LECs) caused by acute exposure to low-power 217 Hz modulated 1.8 GHz microwave radiation and DNA repair.</p><p><b>METHODS</b>Cultured LECs were exposed to 217 Hz modulated 1.8 GHz microwave radiation at SAR (specific absorption rate) of 0, 1, 2, 3 and 4 W/kg for 2 hours in an sXc-1800 incubator and irradiate system. The DNA single strand breaks were detected with comet assay in sham-irradiated cells and irradiated cells incubated for varying periods: 0, 30, 60, 120 and 240 min after irradiation. Images of comets were digitized and analyzed using an Imagine-pro plus software, and the indexes used in this study were tail length (TL) and tail moment (TM).</p><p><b>RESULTS</b>The difference in DNA-breaks between the exposure and sham exposure groups induced by 1 and 2 W/kg irradiation was not significant at every detect time (P > 0.05). As for the dosage of 3 and 4 W/kg there was difference in both group immediately after irradiation (P < 0.01). At the time of 30 min after irradiation the difference went on at both group (P < 0.01). However, the difference disappeared after one hour's incubation in 3 W/kg group (P > 0.05), and existed in 4 W/kg group.</p><p><b>CONCLUSION</b>No or repairable DNA damage was observed after 2 hour irradiation of 1.8 GHz microwave on LECs when SAR < or = 3 W/kg. The DNA damages caused by 4 W/kg irradiation were irreversible.</p>