BACKGROUND: Minor salivary gland cancer occurs infrequently and presents a diagnostic and therapeutic challenge. The purpose of this study was to determine prognostic factors for this disease. METHODS: The medical records of 95 patients diagnosed and treated at the University of Alabama at Birmingham over a 35-year period were reviewed. Information concerning patient, disease, and treatment characteristics was compiled for each case. Multivariate analysis was conducted using a rank regression procedure. RESULTS: State I or II cancer (p = .022), the absence of cervical lymph node metastases (p = .001), and surgical margins which were free of cancer (p < .001) were predictive of increased 4-year disease-free survival by multivariate analysis. CONCLUSION: Our findings emphasize the need for detection of early-stage disease combined with complete surgical extirpation of the cancer, which provide the patient with the best chance for locoregional control and long-term survival.

Adenocarcinoma↗

PubMedDate not supplied

[Pathogenesis of staphylococcal infections of implanted plastics and intravascular catheters].

Coagulase-negative staphylococci are the predominant organisms causing infection of intravasal catheters and implanted plastic material. They are able to adhere to and grow on polymer surfaces. During the course of colonization they produce large amounts of an extracellular slime substance by which they are finally covered completely. It is supposed that this matrix of slime protects the embedded staphylococci against antibacterial substances and natural host defenses. The slime substance is not a true capsule but is loosely bound to the staphylococcal cells. It seems to have interesting biological properties such as an adhesin-like function and the ability to inhibit the lymphoproliferative response of mononuclear cells.

Animals↗

PubMedDate not supplied

[Urinary excretion of fluorides in inhabitants of the Canton Vaud who consume fluoridated salt as compared with that of the inhabitants of neighboring cantons who consume nonfluoridated salt].

In the Swiss canton of Vaud (512000 inhabitants) the salt available for human consumption has been fluoridated since 1969 by adding 250 mg F- per kg of salt. The urinary excretion of fluoride has been investigated in large samples of the population in 1970 and in 1974. The present study reports the results of the 1974 study, in which the urinary fluoride excretion of persons living in the canton of Vaud was compared to that of a smaller sample of people living in small townships across the border of the canton, in which neither edible salt nor water are fluoridated. The concentration of fluoride in 444 single samples of urine from adult persons living in the canton of Vaud was 1.06 +/- 0.03 mg/l, in 40 subjects living two townships across the border 0.62 +/- 0.06 mg/l. The excretion of fluoride per 24 hrs has been evaluated by measuring simultaneously the creatinine concentration in the urine samples under the assumption of constant creatinine and fluoride excretion within 24 hour periods. The calculated fluoride excretion in 366 subjects living in the canton of Vaud was 1.14 +/- 0.03 mg/24 hrs, that of 40 subjects living outside of the canton 0.60 +/- 0.05 mg/24 hrs when the figure inserted for the excretion of creatinine within 24 hours was taken from a study of Rowe [9]. A few data reported suggest that the mean excretion of creatinine in the urine of normal subjects living in Switzerland was only 67% of that measured in the U.S. by Rowe. Total fluoride excretions calculated under this assumption were 0.76 +/- 0.02 mg/24 hrs for persons living in Vaud vs. 0.40 +/- 0.04 mg/24 hrs in the subjects living outside of Vaud. The concentrations of fluoride found in the urine of the adult subjects of the present study did not differ significantly from those found in school children aged 7-15 living in the same communities. Concentrations of fluoride in urine appear to have increased since 1970 in subjects living in the canton of Vaud. This fact may indicate that a steady state equality between intake and urinary excretion of fluoride had not yet been reached in 1970. In 366 urine samples of subjects living in Vaud in 1974, the concentration of fluoride in urine could be represented as a linear regression on the concentration of creatinine. The slope of this regression was smaller than unity indicating an enhanced fluoride excretion at higher rates of urine flow and a depressed excretion at low rates of urine flow. The occurrence of diurnal variations in the urinary excretion of fluoride or of creatinine could not be excluded in the present study. The urinary excretion of fluoride exceeded 2.5 mg/24 hr in approximately 2% of the subjects living in the canton of Vaud but was smaller than 0.8 mg/24 hr in approximately 18%. It was concluded that fluoridation of salt at the level indicated should be an effective measure for the prevention of dental caries. It was, furthermore, concluded that salt fluoridation at the level indicated does not present any risk of toxicity.

Adult↗

PubMedDate not supplied

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Aged↗

PubMedDate not supplied

Extension osteotomy in malunited clavicular fractures.

The association of a malunited clavicular fracture with a pattern of disability that includes not only pain but also impairment of shoulder function is rare. But in cases where such an association exists, correction of the clavicular deformity should be considered. We report on 4 patients with a malunited fracture of the clavicle after nonoperative treatment. In all 4 patients fracture union had occurred with shortening associated with pain and ipsilateral glenohumeral dysfunction. The deformity was not associated with neurovascular dysfunction. On preoperative radiographs the shortening of the malunited clavicle was between 0.9 and 2.2 cm compared with the contralateral clavicle. all patients underwent an extension osteotomy of the clavicle with interposition of an autogenous iliac crestbone graft secured with a plate and screws. The length of follow-up was 1 to 4 years in 3 cases and 6 weeks in 1 case. The functional outcome was evaluated with the Constant-Murley and University of California-Los Angeles scales. All patients had immediate pain relief after osteotomy and correction of the deformity. Shoulder function rapidly improved and functional outcome was good in 3 of the 4 patients. In cases of shoulder function impairment associated with malunited clavicular fractures, extension osteotomy combined with autogenous bone grafting is likely to produce good results.

Adult↗