Zygomaticus implants for retention of nasal prostheses after rhinectomy.

Malignant tumours of the nose occasionally require rhinectomy. Implant retained prostheses can give good aesthetic results. Predictable biomechanical retention of nasal prostheses can be achieved using osseointegrated implants and Brånemark intra-oral and craniofacial implants have been used previously. Zygomaticus implants are traditionally used for dental rehabilitation of the partially edentulous maxilla with severe bone resorption. We describe two patients in whom zygomaticus implants have been used to aid salvage in prosthetic reconstruction of the nose.

DNA microarray technology: insights for oral and maxillofacial surgeons.

Since the discovery of DNA and the recent sequencing of the entire human genome, there have been great advances in our understanding of the genetic basis of many diseases, including cancer. An exciting recent development is DNA microarray technology. This technique allows many genes to be studied in the same experiment rather than one gene at a time. It can therefore provide large amounts of data much more quickly than was previously possible. This has great implications for diseases such as cancer, which often show genetic damage in many parts of the genome. DNA microarray technology has now been used in the investigation of many tumours including melanoma, breast cancer, and lymphoma, as well as in the understanding of the genetic basis of metabolic diseases. However, it seems that our specialty knows little about the technique and its possible clinical applications. We give here a simple introduction to the technology and its likely role in the future management of oral cancer.

Use of audiotaped patient consultations in a head and neck oncology clinic and survey of patient attitudes to this facility.

The overall quality and delivery of patient care is becoming increasingly important, especially in those diagnosed with cancer. Multidisciplinary clinics are a valuable adjunct to this, but patients may not fully understand or comprehend all that is said to them. The use of audiotaping consultations has been studied in some settings, but not in head and neck cancer clinics. We report on a series of 50 consecutive head and neck patients to determine their views on the value of this facility. Thirty-nine patients (78 per cent) utilized the opportunity, of which 36 patients (92 per cent) found it beneficial. Over three quarters of the patients who used the facility thought that medical staff could benefit and learn from the tape recording. We recommend that audiotaping becomes a standard part of the multidisciplinary head and neck oncology clinic, helping to improve the overall quality of patient care.

Expression of inducible nitric oxide synthase in bone metastases.

AIMS: The signalling molecule nitric oxide (NO), produced predominantly in cancer by the enzyme inducible NO synthase (iNOS), has been implicated in the pathophysiology of many human tumours. The increased NO concentrations found in many human cancers may facilitate both angiogenesis and tumour dissemination. NO also plays a concentration-dependent role in bone re-modelling by acting on osteoclasts. Although iNOS has been studied extensively in most primary tumours, there are no reports that have investigated its expression in metastatic bone disease. METHODS: An immunohistochemical study was performed using a monoclonal antibody to iNOS in 27 cases of breast, renal and lung bone metastases, biopsied at the time of treatment for pathological fracture. RESULTS: iNOS expression was found in 14 cases and was predominantly localised to tumour cells in the metastatic deposits. A significant difference was found between iNOS expression in metastases and adjacent bone (p<0.001), where immunostaining was rarely seen and confined to immune cells. No microscopic differences in bone architecture could be seen between iNOS positive and negative metastases, and no correlations were found between iNOS expression and clinico-pathological variables. CONCLUSIONS: iNOS expression is not a pathognomonic finding in bone metastasis. Its role in the behaviour of bone metastases requires further investigation.

Multiple myeloma and bullous lichenoid lesions: an unusual association.

Many associations of lichenoid reactions have been described but this case appears to be a previously unreported association--with multiple myeloma. This case also demonstrates the necessity of a mucosal biopsy with adequate hematologic and serologic investigations to obtain a definitive diagnosis.

Cross-infection control: attitudes of patients toward the wearing of gloves and masks by dentists in the United Kingdom in 1987.

Dental patients in the United Kingdom were surveyed in February 1987 with respect to their views on whether dentists should wear gloves and/or masks. Most patients believed that gloves should be worn and few saw no need for either. Patients receiving care in a dental hospital were more enthusiastic than those seen in general practice in the belief that dentists should wear gloves and/or a mask.