Perineural spread (PNS) of mucosal squamous cell carcinoma of the head and neck region occurs with a reported frequency of 2% to more than 27%. Patients previously diagnosed with and treated for head and neck cancer should be closely followed by both their physician and their dentist in order to facilitate the coordination of care. This case history demonstrates the results that can occur when a team approach to head and neck cancer is not followed, especially in a patient who is an infrequent and somewhat reluctant health care utilizer. Despite mandibular pain, the patient, who had a history of a carcinoma of the lower lip and had developed PNS, was not referred to a dentist. In patients with a previous history of squamous cell carcinoma, sensory and/or motor changes must be closely monitored when there is a suspicion of PNS. The outcome of this case supports improved collaborations between physicians and dentists in following head and neck cancer patients.

Aged↗

PubMedDate not supplied

Dry beriberi: unusual complication of prolonged parenteral nutrition.

An adult with Crohn's disease on home total parenteral nutrition (TPN) for 8 months presented with peripheral neuropathy and ataxia. The patient was found to be deficient of thiamine. A prompt symptomatic response to intravenous thiamine suggests that the patient had the chronic form of dry beriberi. To our knowledge, this variety of beriberi in a patient on TPN has not previously been reported.

Adult↗

PubMedDate not supplied

[Use of oxygen therapy during labour and acid-base status in the newborn].

The effect of supplemental maternal oxygen therapy on acid-base status has for years been a subject of controversies. There is still no general agreement about oxygen administration in pregnancy or in labour. Many clinicians believe that in normal pregnancy maternal oxygen treatment has merely negligible, if any, influence on the foetus. Maternal oxygen therapy has frequently been suggested when oxygen supply to the foetus was insufficient, viz. in antepartum or intrapartum hypoxia. The aim of this study was to determine whether a brief maternal hyperoxygenation during caesarean section or during the second stage of normal delivery affects cord blood acid-base status measured at birth. Patients with uneventful term pregnancy admitted to the delivery room in spontaneous labour or indicated for elective caesarean section were matched and prospectively ascribed to the control or treatment group. The latter received 60% oxygen for ca. 10 min at 15 L/min by a face mask. We studied 41 normal term infants of healthy mothers (24 from caesarean sections, the remaining 17 delivered vaginally). The control group consisted of normal newborns chosen according to the same criteria except that their mothers had no oxygen supplementation. Immediately after delivery, umbilical cord paired blood samples were drawn. Arterial and venous specimens were analysed for blood gases and acid-base balance parameters. Statistical analysis assisted by computer software was performed using Mann-Whitney U test. A p value < 0.05 was considered significant. All tested parameters related to the acid-base status and blood gases were similar in the treatment and control groups. Concluding, a short period of maternal hyperoxygenation either in the second stage of vaginal spontaneous delivery or during caesarean section did not affect umbilical cord blood acid-base status measured at birth.

Acid-Base Equilibrium↗

PubMedDate not supplied

Activation of blood platelets in chronic hepatitis and liver cirrhosis P-selectin expression on blood platelets and secretory activity of beta-thromboglobulin and platelet factor-4.

BACKGROUND/AIMS: Blood platelets are cells that quite often undergo damage in chronic liver diseases. Endotoxemia and hyperkinetic circulation influence platelets in an active manner. The role of platelets in the development of hepatitis and liver fibrosis is speculative. The aim of the study was to determine the influence of chronic liver diseases on platelets morphologic parameters, their secretory activity and P-selectin expression. METHODOLOGY: The examination was completed in the group of 29 patients with chronic hepatitis and 27 with liver cirrhosis of postinflammatory etiology (HBV, HCV). Liver biopsies were carried out in all patients. Thirty-two healthy individuals were the control group. Platelets morphological parameters (number, volume, platelet crit, micro- and macrothrombocyte fraction) were estimated. beta-thromboglobulin concentration and platelet factor 4 in blood serum as well as P-selectin expression on resting platelets and after thrombin activation were also examined. RESULTS: Number, volume, and platelet crit decreased with the advancement of a liver disease. Megathrombocyte fraction increased inversely with the severity of liver damage. The concentration of beta-thromboglobulin and platelet factor 4 alpha-granule contents in blood serum was higher 2- and 7-times, respectively than in healthy controls. P-selectin expression on resting platelets was considerably higher. After stimulation with thrombin, P-selectin expression was equal (chronic hepatitis) or higher (liver cirrhosis) than in the control. CONCLUSIONS: There are changes of platelet morphological parameters, with accompanying megathrombocyte fraction increase that occur in chronic liver diseases. Thrombocytes in chronic liver diseases and liver cirrhosis are more activated. Platelet sensitivity to stimuli in these ailments is higher (liver cirrhosis) than in the healthy controls.

Adolescent↗

PubMedDate not supplied

Effect of antidepressant drugs and different receptor antagonists on the grooming induced by the dopamine D-1 agonist SKF 38393.

The effect of four antidepressant drugs: imipramine (IMI), amitriptyline (AMI), citalopram (CIT) and mianserin (MIA), as well as various receptor antagonists: prazosin (alpha 1), yohimbine (alpha 2), ritanserin (5-HT2), atropine (Ach), chlorpyramine (H1) and SCH 23,390 (D-1) on grooming potentiated by the selective D-1 receptor agonist SKF 38,393, as well as on spontaneous grooming was studied. Antidepressant drugs inhibited in a dose-dependent manner the SKF-38,393-induced grooming, as well as spontaneous grooming in rats and mice. A similar, dose-dependent inhibitory effect was shown by all the compounds mentioned above, which block various receptors. The results indicate that the inhibitory effect of antidepressants on the SKF 38,393-induced grooming is not specific.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗