Effects of 4% Hypertonic Saline Solution Mouthwash on Oral Health of Elders in Long Term Care Facilities

PURPOSE: This study was done to examine the effects of 4% hypertonic saline solution mouthwash and tooth brushing education on the oral health of elders living in long term care facilities. METHODS: In this quasi-experimental study, the participants were assigned to a 2% experimental group (n=20), a 4% experimental group (n=20), and a control group (n=20). Data were analyzed using ANOVA, repeated measures ANOVA, Fisher exact test, Chi-square test, Kruskal-Wallis test and multiple response analysis with the SAS program. RESULTS: Regular tooth brushing and use of 4% hypertonic saline solution mouthwash by elders provided better oral health by decreasing xerostomia, oral tongue plaque, halitosis, and the number of oral bacteria. CONCLUSION: The results indicate that regular tooth brushing with continuous 4% hypertonic saline solution mouth washing education promotes oral health for elders in long term care facilities, thus the dental care described in this study is recommended for elders in long term facilities.

Radiographic Findings of Primary Lung Cancer with Delayed Detection on Chest Radiographs

PURPOSE: To analyze the causes of delayed detection of lung cancer on chest radiographs. MATERIALS AND METHODS: We retrospectively reviewed 105 cases in which an initial diagnosis of lung cancer, based on anexamination of plain radiographs, had been missed or misinterpreted. All occurred between October 1993 and April1997. We reviewed the initial chest radiographs and compared the features noted with those seen on later chestradiographs and computed tomographic (CT) images. RESULTS: Undetected lung cancer was identified in 56 patients(56/105, 53.3%) It had been hidden by superim-posed structures (41, 73.2%), overlapped by combined benign diseases(12, 21.4%), or the nodules were subtle(3, 5.4%). Of the 41 lung cancers hidden by a superimposed structure, thecentral type accounted for 29 (70.7%) and the peripheral type for 12 (29.3%). The 29 central type had been hiddenby the left hilum (n=15), the right hilum (n=10), the heart (n=3), or a rib (n=1). The twelve peripheral type werehidden by a rib (n=7), the heart (n=2), the diaphragm (n=2), or the left hilum (n=1). Of the 12 lung cancersoverlapped by combined benign diseases, pulmonary tuberculosis (n=6), pleural effusion (n=4), congestive heartfailure (n=1), and dif-fuse interstitial lung disease (n=1) were present at the time of interpretation. Themisinterpreted lung cancers were identified in 49 patients (49/105, 46.7%) and were seen to be combined withbenign disease (16, 32.6%), or as obstructive pneumonia without a central mass (15, 30.6%), air-spaceconsolidation (7, 14.3%), cavity (7, 14.3%), double lesion (2, 4.1%), or young age below 26 years (2, 4.1%). Ofthe 16 lung cancers misinterpreted as combined disease, pulmonary tuberculosis (n=14) and pleural disease (n=2)had been initially diagnosed. CONCLUSION: Most commonly, lung cancer was missed or misinterpreted because it washidden by a normal structure or combined with a benign disease. Perceptual errors can be reduced by appropriatetechniques and the scrutiny of trouble spots such as the parahilar, retrocardiac, retrodiaphragmatic and costalregions. Errors in the analysis of lung cancer can be reduced by increased awareness of growth patterns anduncommon man-ifestations of the disease.

A comparative study on aberrations of chromosome 17 and proliferating cell fraction in lung cancer

To better understand the relationship between specific chromosome changes found in human lung tumors and their phenotypic consequences a the tissue level, an in situ hybridization (ISH) procedure of chromosome 17 and immunohistochemistry of proliferating cell nuclear antigen (PCNA) were done. The deparaffinized sections were stained with pericentromeric probes for chromosome 17 and an immunohistochemical study of a monoclonal antibody against PCNA were performed. The numbers of chromosome signals were than compared with the positivity of PCNA expression. The mean numbers of chromosome were 1.62 in normal lymphocytes and 2.48 in lung cancer cells. Tumors showed a high mean positivity of PCNA of 43.4%. Mean PCNA expression was higher in squamous carcinomas than in adenocarcinomas (p<0.05). A linear correlation between numbers of ISH signals and PCNA expression was not demonstrated, but there was a tendency of increasing PCNA positivity according to increasing numbers of ISH signals in adenocarcinomas of the lung and the tumor tissues which were over 50% positive PCNA expression. There was no linear correlation between numbers of ISH signals, PCNA positivity and tumor stages, and keratinization of squamous cell lung cancer. These results suggest that ISH will prove to bo an important tool for determining the underlying genetic basis for tissue phenotypic heterogeneity by allowing genetic determinations to be made on paraffin-embedded tissue sections where histologic architecture is preserved, and immunohistochemical nuclear staining with anti-PCNA on routinely processed tissue is a simple technique for the assessment of proliferation in non-small cell lung carcinoma.