Characterization of raft-forming alginate suspensions formed in HCl or model food systems at varying pH levels to better simulate gastric postprandial conditions.

OBJECTIVE: Elucidate properties of raft-forming alginates in vitro with varying composition, a system in which the raft was formed (HCl solution; tomato soup; protein-rich beverage), and pH levels for a more accurate representation of postprandial gastric conditions. SIGNIFICANCE: Knowledge of the impact of the food system and pH on properties of raft-forming alginates may aid in formulation optimization. Recommendations may be made on food that is consumed prior to their consumption to optimize efficacy as a therapeutic agent. METHODS: Dispersions of sodium alginate, calcium carbonate, and sodium bicarbonate were prepared with levels similar to commercial formulations. Rafts were formed in HCl solution, tomato soup, and a protein-rich beverage at pH 1-4 to assess raft properties. RESULTS: Significant differences (p < 0.05) in raft mass, strength, resilience, and ability to buffer acid were observed depending on the system in which the rafts were formed. The highest mass was obtained in tomato soup (48.5 ± 9.8 g) compared to the protein-rich beverage and HCl solution (32.5 ± 4.5 g and 23.4 ± 4.8 g, respectively) at pH 1. Rafts formed in the protein-rich beverage exhibited the highest strength. Rafts formed in both food systems had a greater ability to buffer added acid compared to rafts formed in HCl solution. CONCLUSIONS: In vitro testing of raft forming alginates in HCl solution at low pH may not be sufficient to describe in vivo events, as a strong matrix effect was observed when rafts were formed in model meal systems at representative postprandial pH levels.

Is extended selective supraomohyoid neck dissection indicated for treatment of oral cancer with clinically negative neck?

Oral cavity tumors may develop occult metastases to the cervical lymph nodes. Current imaging techniques and routine histopathologic methods may fail to detect lymph node micrometastases, but the surgeon has to electively dissect a neck at risk of developing clinical disease. Supraomohyoid neck dissection has been the elective surgery for treating a clinically negative neck in patients with oral cavity primaries. A literature review revealed that level IV nodes can be significantly affected by occult disease with and without metastases in level I-III lymph nodes. This means that level IV nodes have to be included in the supraomohyoid neck dissection, resulting in a more extensive surgical procedure to ensure a margin of oncological safety.

Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease) diagnosed by fine needle aspiration biopsy.

A case of histiocytic necrotizing lymphadenitis involving a right submandibular lymph node is described in a 14-year-old Caucasian boy. The diagnosis was established on initial assessment by fine needle aspiration biopsy. Excisional biopsy, performed because the lymph node enlargement failed to regress, confirmed the cytological findings.

A review of heterotopia and associated salivary gland neoplasms of the head and neck.

Salivary tissue neoplasms may involve normal, accessory and heterotopic salivary gland tissue. A case of Warthin's tumour originating from heterotopic salivary gland tissue of the upper neck is reported. The radioactive uptake of 131I, evidenced in the neck mass in its pre-diagnostic assessment, suggested a diagnosis of cervical node involvement from a primary malignant thyroid neoplasm. A critical review of the literature on heterotopic salivary gland tissue neoplasms of the head and neck is also presented.

Kimura's disease of the intraparotid lymph nodes: fine needle aspiration biopsy findings.

A case of Kimura's disease involving two intraparotid lymph nodes is described in a 16-year-old Caucasian boy presenting with a painless swelling of the right parotid gland. A preoperative diagnosis of Kimura's disease was made on the basis of fine-needle aspiration biopsy (FNAB) and was confirmed by histological evaluation of the surgical specimen. FNAB is a safe and accurate procedure that can be used in the outpatient setting to enable a prompt preliminary diagnosis.

Basaloid squamous cell carcinoma of oral cavity and oropharynx.

Basaloid squamous cell carcinoma is a variant of squamous cell carcinoma with distinctive histological and immunohistochemical characteristics and aggressive behaviour involving predominantly the upper aerodigestive tract. We describe the clinicopathological findings, along with immunohistochemical investigations, in 5 new cases with carcinoma localized in oral cavity and oropharynx.

Bilateral secondary syphilis of the tonsil.

A patient with bilateral tonsillar enlargement secondary to syphilis is presented. Clinical appearance, histological findings and serological tests permitted a correct diagnosis to be obtained, ruling out the suspicion of cancer.

Plexiform schwannoma of the cheek.

We present a case of subcutaneous plexiform schwannoma, a rare benign peripheral nerve sheath tumour characterized by a multinodular and plexiform growth pattern. A review of the literature was performed to identify the relationship between plexiform schwannoma and neurofibromatosis types 1 and 2, and schwannomatosis. It is also important to distinguish plexiform schwannoma from plexiform neurofibroma, a particular type 1 neurofibromatosis lesion, because of the propensity of the latter for malignant degeneration.

Is primary radiotherapy an appropriate option for the treatment of verrucous carcinoma of the head and neck?

The literature on verrucous carcinoma of the head and neck was reviewed to analyse the use of primary radiation therapy in the treatment of this lesion. The results emphasize an overall local control rate of 43.2 per cent, and 6.7 per cent of true anaplastic transformation following irradiation. Diagnosis remains the fundamental problem: without a correct diagnosis of verrucous carcinoma, no correct treatment can be applied.

Hamartoma of the larynx: a critical review of the literature.

Hamartoma of the larynx is an extremely rare lesion, and the number of well-documented and acceptable cases is limited. The world literature is critically reviewed in order to develop a more accurate clinicopathological profile of this tumorlike malformation, which has to be differentiated from choristoma, teratoma, and rhabdomyoma, among others. Management consists of local excision, and the prognosis is good.

Ethyl alcohol induced skin temperature changes evaluated by thermography. Preliminary results.

The authors have investigated the validity of thermography in the study of ethyl alcohol induced hand blood flow changes in normal subjects before and after a standard meal. The superficial temperature changes of the hand of ten healthy subjects, 7 males and 3 females, 25-40 years old, were recorded in 4 conditions: a) on an empty stomach, b) after ingestion of a standard dose of ethyl alcohol (25 cc of whisky at 40%, corresponding to 10 g of alcohol), c) after a standard meal (1200 Kcal), d) after a standard meal and a standard dose of alcohol. Three male subjects were not drinkers. Arterial blood pressure and ECG were monitored during the different phases of the experiment. Results show a typical time course of the hand temperature in response to intake of alcohol, stronger in fasting non drinkers subjects. Our results confirm the valuable role of thermography in the study of alcohol-induced calorigenic effects.