ABSTRACT
Patients with carcinoma involving chronic fistulizing Crohn's disease may have developed the malignancy due to chronic epithelial irritation at either end of the fistula tract. Alternatively, the carcinoma may be the cause of the fistula. Examples of each type of relationship are presented in the reports of four patients from our institution and supported by a review of the literature. The diagnoses of such carcinomas are often delayed due to lack of specificity of symptoms and signs. A high index of suspicion and regular surveillance of high-risk patients are recommended.
Subject(s)
Abdominal Muscles , Carcinoma, Squamous Cell/complications , Crohn Disease/complications , Gastric Fistula/etiology , Ileal Diseases/etiology , Intestinal Fistula/etiology , Stomach Neoplasms/complications , Adult , Aged , Carcinoma, Squamous Cell/pathology , Colitis/complications , Crohn Disease/pathology , Female , Humans , Lymphatic Metastasis , Male , Middle Aged , Stomach Neoplasms/pathologyABSTRACT
This study investigated variations in occlusal prematurities and condylar positions using different methods of determining centric relation. Thirty patients were randomly placed into three groups of 10. In Group I a clinical analysis of occlusal patterns using bilateral mandibular manipulation (BMM) was compared to results with a chin point (CPM) method. Group II compared CPM to an anterior guidance jig (CPJ) method. Group III compared BMM to CPJ. Standardized transcranial oblique radiographs were taken of each temporomandibular joint using CPM and BMM on 10 patients. Condylar position was determined with tracing evaluations and direct measurements of the radiographs. Clinical results indicated that the initial point of contact was located most accurately with CPJ. Both initial contact points and secondary points were disclosed with CPM. The BMM disclosed the most tooth contacts. Contacts were most prevalent on the premolars. Radiographic analyses of condylar positions were inconclusive.
