The accuracy of preoperative assessment in determining invasion of the mandible by intraoral squamous cell carcinoma was analyzed in 48 patients who underwent mandibulectomy, and the results correlated with the histopathological reports of the resected specimens. Only 50% of the patients underwent the "ideal" surgery based primarily on clinical judgement, whereas 10 patients in the series were significantly undertreated. Clinical judgement and routine preoperative x-rays are accurate in cases where there is gross involvement of the mandible (17 of 19) but are significantly less successful in determining early bone invasion, invasion of the periosteum, or periosteal new bone formation. In such cases (26 of 48), a technetium-99m bone scan provides additional information. A grading system for reporting orthopantomographics (OPTs) and bone scans has been developed and utilized to form a reference grid to determine the optimum extent of mandibular surgery. The results show that using this protocol, unnecessary mandibular surgery may be reduced and inadequate surgical excision avoided.

Carcinoma, Squamous Cell↗

PubMedDate not supplied

Effect of oral zinc sulphate and penicillamine on zinc metabolism in patients with rheumatoid arthritis.

Whole body zinc and zinc absorption were measured in 14 patients with classical rheumatoid arthritis (RA). Half of these patients were treated with penicillamine for a period of 8 wk and the other half received zinc sulphate orally for a similar period of time. Whole body zinc and zinc absorption were not significantly affected by either therapy. These observations suggest that any pharmacological effect of oral zinc sulphate or penicillamine on patients with RA is not mediated by their effect on zinc metabolism in such patients.

Administration, Oral↗