Oral cancer at a Tasmanian tertiary referral clinic, the Royal Hobart Hospital 1996-2002.

BACKGROUND: The Holman Clinic at the Royal Hobart Hospital includes a multi-disciplinary head and neck clinic which functions as a tertiary referral centre for Southern Tasmania and involves Ear Nose and Throat surgeons, Oral and Maxillofacial Surgeons, Plastic and Reconstructive Surgeons, Radiation Oncologists and Medical Oncologists. METHODS: The aim of this study was to examine retrospectively the number, gender distribution, age, site of lesion, histology, mortality and treatment modalities of the oral cancers referred to the Holman clinic at the Royal Hobart Hospital. The medical histories and a database of the Holman clinic were used as the sources of data for this study. A total of 101 patients were treated for oral cancer in the Holman clinic at the Royal Hobart Hospital from 1996 to 2002. There were 64 males and 37 females. RESULTS: The distribution of anatomical sites of the oral cancers in this study was as follows: 36 oral tongue lesions, 17 floor of mouth, 13 lip, five retromolar trigone, five mandibular alveolus, six buccal mucosa, nine palatal and 10 minor and major salivary gland cancers. The most common site of oral cancer was the tongue (35.6 per cent), followed by the floor of mouth (16.8 per cent) and lip (12.9 per cent). CONCLUSIONS: The majority of oral cancers were squamous cell carcinoma, except for the salivary gland cancers. The incidence of squamous cell carcinoma was between 67 and 100 per cent, depending upon the site involved. The trends found in this study are similar to those previously documented over the past 20 years.

The microtensile strength of bonding resins.

BACKGROUND: The purpose of this study was to determine the effect of water on the tensile strength of three bonding resins (All Bond 2, Scotchbond Multi-Purpose Adhesive, Clearfil LB Bond) and a low viscosity resin composite (Protect Liner F) after 1, 7, 28, 84 and 168 days of storage. METHODS: Cylinders of bonding resin 2.4 +/- 0.2 mm diameter and 9.5 mm long were made and stored at 37 degrees C for 24 hours. The specimens were milled into dumb-bell shapes and stored in either air or water at 37 degrees C. Five specimens of each material were stressed in tension after the specified storage times at a crosshead speed of 1 mm/min in a testing jig attached to a universal testing machine. The mean tensile strengths of bonding resins were calculated and analysed statistically using one-way analysis of variance, lower standard deviation and student t-tests. RESULTS: Comparison of the air and water samples at all test periods showed the tensile strengths of specimens stored in water were significantly less than those stored in air (P < 0.001). CONCLUSION: The effect of water on the tensile strength of bonding resins indicated a slight decrease in strength of each material over the 168 day test period, whereas the air samples showed little change over the test period.

Evaluation of three methods for detecting bacterial contamination in intravenous solutions.

Membrane filtration, small-aliquot inoculation, and double-strength broth methods of sterility testing were evaluated for detection of small numbers of bacteria in 5% dextrose injection (D5W). Each of 240 bags of D5W 50 ml were inoculated with approximately 10 2 Staphylococcus epidermidis and subjected to one of the three test methods at 1, 3, 6, 9, 12, 18, 24, or 48 hours after inoculation. After incubating at 25 degrees C for seven days, the test units were examined for turbidity, indicating growth of bacterial contaminants. Double-strength broth was shown to be more reliable than the other two test methods, detecting the bacterial contaminants in 30 of 30 samples through six hours. Successful recovery of low-level Staph. epidermidis in D5W decreased significantly after a nine-hour delay in processing. Membrane filtration and aliquot-sampling methods were comparable, each detecting contamination in 3-4 of 10 bags at one hour after inoculation. The number of false negatives increased with time, with no contaminants detected in any of the bags tested with these two methods nine hours after inoculation. It is concluded that the testing method selected to monitor for sterility and the amount of time elapsed before processing the sample are critical to the accuracy of results.

Evaluation of three methods for detecting low-level bacterial contamination in intravenous solutions.

The accuracy of three sterility-testing methods in detecting low-level contamination in deliberately contaminated intravenous solutions was studied. One-liter bags of 5% dextrose (D5W) and 0.9% sodium chloride (saline injections were contaminated with Staphylococcus epidermidis and Pseudomonas aeruginosa; approximately 10(1) viable bacteria were injected into each bag. Two membrane-filtration methods (Ivex-2 and Addi-Chek) and one aliquot method [twice concentrated trypic soy broth (2X-TSB)] were used to test each of 10 diliberately contaminated solutions for both D5W and saline; 500 ml of each liter bag was filtered or added to 2X-TSB. Incubation containers were stored at 37 degrees C and inspected at 24, 48, and 72 hours for turbidity. There was no significant difference among the three methods in the detection of contaminated saline solutions. The Addi-Chek system was significantly less effective in detecting contamination in D5W than either of the other methods. It is concluded that the Ivex-2 system is accurate and the easiest-to-use system of the three tested.

Hypertensive crisis resulting from avocados and a MAO inhibitor.

A hypertensive episode precipitated by avocados in a patient on tranylcypromine is described. The patient complained of severe throbbing headache, chest pain, and diaphoresis upon visiting the emergency room. Intravenous phentolamine was administered repeatedly to treat elevated blood pressure. Approximately 4 1/2 hours later, the patient's blood pressure stabilized, and he was released after a short period of observation. This is the first documented case of avocado induced hypertensive crisis.