RESUMO
Myocutaneous flaps are used widely in the surgical treatment of advanced cancers, which in the past had been thought to be inoperable. Tumor recurrences are expected more frequently in these patients. Recurrent tumors may spread locally and to the regional areas via lymphatics and vessels. However, the lymphatic spread may differ in cases where myocutaneous flaps are used for reconstruction. This study is based on five patients with head and neck cancer who underwent reconstruction with myocutaneous flaps. Technetium Tc99m-labeled dextran was used to demonstrate the lymphatic flow, and technetium Tc99m rhenium sulfur colloid was used to show the lymph nodes of the neck and pectoralis major myocutaneous flap. Our findings show that the newly formed lymphatics do not pierce the fibrotic border of the donor and recipient sides. Lymphatic metastasis may occur to the internal mammary nodes through the myocutaneous flap only after recurrent tumors have invaded the myocutaneous flap directly.
Assuntos
Linfonodos/diagnóstico por imagem , Metástase Linfática/patologia , Músculos Peitorais/diagnóstico por imagem , Músculos Peitorais/transplante , Retalhos Cirúrgicos/métodos , Retalhos Cirúrgicos/patologia , Axila , Transplante Ósseo , Mama , Coloides , Dextranos , Humanos , Linfonodos/patologia , Metástase Linfática/diagnóstico por imagem , Neoplasias Bucais/patologia , Neoplasias Bucais/cirurgia , Pescoço , Esvaziamento Cervical , Invasividade Neoplásica/patologia , Recidiva Local de Neoplasia/patologia , Compostos de Organotecnécio , Músculos Peitorais/patologia , Cintilografia , Rênio , Transplante de Pele , Coloide de Enxofre Marcado com Tecnécio Tc 99mRESUMO
Nine maxillary sinuses of 8 patients who had undergone Caldwell-Luc surgery (CWL) were injected with 100-125 microCi 99mTc-DTPA in 0.2 ml from the gingivo-buccal sulcus, passing through the canine fossa window. Sinus half-emptying times and percent contribution of the natural ostium (NO) and the naso-antral window (NA) to the clearance from the sinus were calculated, using time-activity curves as well as the activity of cotton wool plugs placed into the middle and lower conchae. Mean half-emptying times in patients in whom the mucosa had been removed were shorter than those in patients in whom it had been left in place. In the former group percent drainage through the NO was higher than that through the NA whereas in the latter group the opposite was the case. These findings are consistent with the thesis that if the mucosa is retained, the cilia continue their sweeping action towards the NO but if it is removed the NA gains importance in the drainage. This method is promising for the evaluation of maxillary sinus drainage following CWL.
Assuntos
Sinusite Maxilar/cirurgia , Depuração Mucociliar/fisiologia , Pentetato de Tecnécio Tc 99m , Humanos , Sinusite Maxilar/diagnóstico por imagem , Sinusite Maxilar/fisiopatologia , CintilografiaRESUMO
The frequency of sister chromatid exchange (SCE) was studied in cultured peripheral lymphocytes from 15 untreated patients with carcinoma of the larynx and 10 healthy control subjects. Bromodeoxyuridine-incorporated chromosomes were treated with Hoechst 33258 and stained according to conventional methods. To measure SCE frequency, at least 15 mitoses per donor were evaluated. The SCE values were found to be higher in cancer cases than in control cases.