Blood pressure and age in cross-cultural perspective.

Studies in traditional, nonindustrialized countries have shown that blood pressure need not increase with age in adulthood, although incremental age-related increases in blood pressure throughout adulthood are common in industrialized countries. This observation has influenced a statement by the 1997 Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure that a major future challenge is to "prevent the rise of blood pressure with age." The methods of preventing age-related blood pressure increases are not specified in the report. Anthropological surveys of populations with little or no change in blood pressure with age are difficult to replicate and verify, leaving future researchers the task of developing prevention strategies primarily based on studies of populations in which blood pressure increases with age. Here, I review blood pressure surveys used from 1954 to 1998 that have been used in the literature as examples of blood pressure and age research. This review reveals some of the difficulties in clearly defining the exact relationship between blood pressure and age and some of the problems in the development of methods to prevent age-related blood pressure increases.

Dental health and dental care requirements for young handicapped adults in Wessex.

The dental health status and treatment requirements of 195 young handicapped adults living in the Wessex Health Region are reported. These young adults, aged 25-34 years, attended adult training centres on a daily basis in each of the districts in Wessex Region. The amount of untreated caries was higher and the periodontal status worse for this group than would normally be expected in young adults in this age range. The dental care received was related to the ability of the subject to comprehend and co-operate with the operator. Nearly half the subjects could receive routine treatment in a normal surgery and about a quarter were likely to require hospitalisation and general anaesthesia to achieve any treatment. The community dental service should play an important role in organising and supervising preventive strategies, with the aim of improving oral hygiene for these young handicapped adults, which should materially improve their periodontal health.

Primary teratocarcinoma of the lung.

Presented is the ninth reported case of teratocarcinoma arising from the parenchyma of the lung. Treatment should include wide surgical resection and adjuvant chemotherapy. Postoperative radiation therapy should be utilized if there is residual disease or nodal metastasis. Preoperative radiation therapy should be considered if there is evidence of chest wall involvement.

Fifteen years surgical experience with carcinoma of the lung.

This review has emphasized the need to manage carcinoma of the lung with a systematic approach. Diagnostic and staging procedures should be performed to prevent unnecessary thoracotomy. In patients with limited pulmonary reserve, segmentectomy or wedge resection is an acceptable procedure. A staging mediastinal node dissection should be included in every resection for lung cancer. Those patients with positive mediastinal nodes found in this manner should receive postoperative mediastinal irradiation.

Leiomyosarcoma of the rectum: report of three cases.

Leiomyosarcoma is a malignant tumor which rarely occurs in the rectum. Three patients with leiomyosarcoma of the rectum are presented. Treatment should include wide surgical excision followed by adjuvant chemotherapy. Emphasis is placed upon computerized tomography as the method of choice for the diagnosis of recurrent disease. Recurrent tumor should be resected whenever possible.

Primary leptomeningeal presentation of T-cell lymphoma. Report of a patient and review of the literature.

Although secondary leptomeningeal lymphoma is relatively common, primary leptomeningeal lymphoma is rare. We report a patient with the extremely unusual clinical and pathologic presentation of a primary T-cell lymphoma of the leptomeninges. Diagnosis was established by morphologic and immunologic studies of cerebrospinal fluid (CSF) and brain biopsy. The leptomeningeal lymphoma responded well to intrathecal chemotherapy and irradiation but the patient has severe residual motor paralysis. The clinical and pathological features of primary and secondary central nervous system (CNS) lymphoma are reviewed in reference to this most unusual patient.

Primary malignant retroperitoneal tumors. Current management.

Our experience with 16 retroperitoneal tumors seen over a 13 year period has been reported. Patients presented with either an abdominal mass or abdominal pain associated with a large retroperitoneal tumor. Delineation of the tumor is best accomplished with computerized tomography and venacavography. Exploration and resection is possible in most patients. Postoperative radiotherapy and chemotherapy are recommended in most patients. Local recurrence frequently occurs and should be diagnosed early and resected aggressively if found.

Breast masses in young women.

Based on our review we conclude the following concerning breast masses in young women under 30 years of age: (1) Breast masses are nearly always benign. (2) Mammograms are not helpful in most patients. (3) Needle aspiration or needle biopsy is rarely indicated. (4) Excisional biopsy should be performed through a circumareolar or other cosmetic incision. (5) Preparation for frozen section and mastectomy is not indicated. (6) the breast should be reconstructed in layers without drains. (7) Further manifestations of benign disease can be expected in 15 percent of the cases.