Novel application of high-dose rate brachytherapy for severe, recalcitrant palmoplantar pustulosis.

Palmoplantar pustulosis (PPP) is a chronic pustular dermatitis of the palms and soles, which is frequently associated with significant pruritus and pain, often limiting daily activities. We present the case of a 36-year-old man with severe PPP who had treatment failure with multiple medical therapies but showed marked improvement with high-dose rate brachytherapy. Brachytherapy has the advantage of providing a conformal dose distribution over complex curved surfaces, such as the foot and ankle. Our observations suggest that brachytherapy may be a well-tolerated treatment option for patients with severe, refractory PPP.

Partial breast irradiation: a review of techniques and indications.

The addition of whole-breast external beam radiotherapy (EBRT) to breast-conserving surgery results in a significant reduction in the risk of death due to breast cancer, but this may be offset by an increase in deaths from other causes and toxicity to surrounding organs. Because of this, and with a view to patterns of local recurrence, irradiation of the tumour bed has been explored in selected patients with early breast cancer using a variety of radiotherapeutic modalities. This review article explores the treatment options for partial breast irradiation and examines their role within the field of breast cancer treatment.

The salivary microbiota as a diagnostic indicator of oral cancer: a descriptive, non-randomized study of cancer-free and oral squamous cell carcinoma subjects.

BACKGROUND: The purpose of the present investigation was to determine if the salivary counts of 40 common oral bacteria in subjects with an oral squamous cell carcinoma (OSCC) lesion would differ from those found in cancer-free (OSCC-free) controls. METHODS: Unstimulated saliva samples were collected from 229 OSCC-free and 45 OSCC subjects and evaluated for their content of 40 common oral bacteria using checkerboard DNA-DNA hybridization. DNA counts per ml saliva were determined for each species, averaged across subjects in the 2 subject groups, and significance of differences between groups determined using the Mann-Whitney test and adjusted for multiple comparisons. Diagnostic sensitivity and specificity in detection of OSCC by levels of salivary organisms were computed and comparisons made separately between a non-matched group of 45 OSCC subjects and 229 controls and a group of 45 OSCC subjects and 45 controls matched by age, gender and smoking history. RESULTS: Counts of 3 of the 40 species tested, Capnocytophaga gingivalis, Prevotella melaninogenica and Streptococcus mitis, were elevated in the saliva of individuals with OSCC (p < 0.001). When tested as diagnostic markers the 3 species were found to predict 80% of cancer cases (sensitivity) while excluding 83% of controls (specificity) in the non-matched group. Diagnostic sensitivity and specificity in the matched group were 80% and 82% respectively. CONCLUSION: High salivary counts of C. gingivalis, P. melaninogenica and S. mitis may be diagnostic indicators of OSCC.

A new compound curved needle for skin and skin-graft closure.

A new compound curved needle has been developed for skin and skin-graft closure from a unique stainless steel alloy, American Society for Testing Materials (ASTM) 45500. This needle has a short, straight, sharpened point with a reverse cutting edge and a curved distal section. In spite of its geometry, it exhibits sharpness and resistance to bending and breakage similar to that of a needle with a single radius of curvature that is manufactured from the same alloy. The design of this new needle enables the surgeon to pass it through the skin with greater accuracy to a controlled depth and length of bite.

Concurrence of multiple sclerosis and Hodgkin's disease.

Although multiple sclerosis and Hodgkin's disease are reported to have similar epidemiologic features, this is only the first case report in which there was concurrence of these diseases. Fourteen years after successful treatment of Hodgkin's disease, this 31-year-old white male developed multiple sclerosis. The diagnosis of multiple sclerosis was made on the basis of clinical and paraclinical findings that were characteristic of multiple sclerosis. In addition, specific tests were performed to rule out a variety of infectious, metabolic, and neoplastic diseases that simulate multiple sclerosis.

Adaptive communication systems for patients with mobility disorders.

An adaptive communication system has been developed for individuals with mobility disorders. It uses specialized computer software and hardware that compensate for this disability. For an individual with a motor-control impairment who is not able to use a keyboard effectively, a computer voice-recognition technology now removes this communication barrier. Speech-recognition systems consist of three basic components: speech processing, speech recognition, and speech understanding. The new Dragon Dictate (Dragon Systems, Inc., Newton, Mass.) is the first large-vocabulary speech recognition system in the personal computer industry that interactively learns a user's vocabulary and mode of speaking and responds to natural language rather than to limited sets of words. This speech-recognition system requires a microprocessor, a display monitor, a printer, and specific software packages, including word-processing and enhanced memory-management software. Important considerations in the use of this speech-recognition system include microphone positioning and training of the system. With the advent of this new voice-recognition computer system, another communication barrier between the disabled and society has been overcome.

Injury due to uncontrolled acceleration of an electric wheelchair.

Approximately 750,000 disabled individuals use electrical platform mobility aids (wheelchairs) for adaptive transportation. Because there are no mandatory standards for platform mobility aids and wheelchairs, these adaptive transportation aids are prone to potential design and maintenance problems. An injury caused by uncontrolled acceleration of a platform mobility aid is reported. Examination of the platform mobility aid identified a defect in its speed control regulator that has been subsequently corrected by the manufacturer.

Automated hydrotherapy pool water treatment system.

An automated hydrotherapy water treatment system was described that controls chemical pumps that maintain the pool's water pH and chlorine levels at the designated set points, regardless of the bather load. This system consists of sensing electrodes, a controller, and positive displacement pumps. Because outbreaks of waterborne infections have never been reported in facilities in which the pool water has been continuously maintained at pH 7.2 to 7.8 with a free available chlorine level of at least 1.0 ppm, we recommend that this type of water treatment system be installed in all public pools.

A new hydrofitness device for strengthening muscles of the upper extremity.

A new hydrofitness device has been devised for strengthening upper extremity muscles during aquatic exercise. It consists of a molded plastic fenestrated outer shell with an inner rotating disc that can be easily adjusted to alter the surface area of its frontal presentation. By changing the surface area of its frontal presentation a graded, individualized exercise program can be prescribed. A buoyant foam disc has been incorporated into the device to prevent it from sinking to the bottom of the pool. On the basis of this evaluation, performance of this device was judged to be superior to that of other devices for strengthening upper extremity muscles during aquatic exercise.