The adenomatoid odontogenic tumor: an analysis of 57 cases in a black African population

PURPOSE: This study analyzed the findings in a large series of adenomatoid odontogenic tumors (AOT) in Nigerians. PATIENTS AND METHODS: Hospital records of all cases of AOT diagnosed at three teaching hospitals were reviewed and analyzed. RESULTS: Most of the tumors were intraosseous (central) (98.3%) and of the follicular type (75%). Females were more frequently affected than males (1.4:1), and patients in their second decade of life were most frequently affected (75%). Patients with follicular AOT were relatively younger (15.2 +/- 5.6 years) than those with extrafollicular tumors (20.9 +/- 13.8 years). However, males who presented with extrafollicular tumors (14.6 +/- 3.9 years) were relatively younger than their female counterparts (24.9 +/- 16 years). The maxilla was affected nearly twice as often as the mandible (1.8:1), and the canine tooth was frequently embedded in the tumor (76.9%). Although follicular tumors were most frequently located in the maxilla (76.3%), extrafollicular tumors were more commonly found in the mandible (69.2%). CONCLUSION: The distribution of this tumor in black Africans does not appear to be substantially different from that reported in caucasians.     

A new silver sulfadiazine water soluble gel

Silver sulfadiazine is the most commonly used topical antibacterial agent for the treatment of burn wounds. It has many clinical advantages, including a broad spectrum of antimicrobial activity, low toxicity, and minimal pain on application. The current formulation of silver sulfadiazine contains a lipid soluble carrier, polypropylene glycol, that has certain disadvantages, including pseudo-eschar formation and the need for twice daily application. The purpose of this investigation was to describe a new formulation of silver sulfadiazine in a water soluble gel, poloxamer 188. The antibacterial activity of this new gel has been compared to that of the commercially available silver sulfadiazine cream by in vitro and in vivo testing. The results of the in vitro antibacterial testing of these two different agents demonstrated the superiority of the new gel formulation. In experimental wounds, the antibacterial activity of the gel and the commercially available silver sulfadiazine cream were not significantly different when applied once a day. The antibacterial activity of the gel when applied once a day was comparable to that encountered by twice daily applications of the silver sulfadiazine cream by experimental wounds. The major advantage of this gel was its ease of application and removal that is attributed to its water solubility.     

Effects of the 65 mph speed limit on injury morbidity and mortality

Effective December 1987 and January 1988, the maximum speed limit on rural limited access highways in Michigan was raised from 55 mph to 65 mph. This study examined the effects of the raised limit on injury morbidity and mortality. A multiple time-series design was used, comparing roads where the speed limit was raised with roads where the limit remained unchanged. Data were collected on numbers and rates of automobile crashes, injuries, and deaths from January 1978 through December 1988. Time-series intervention analyses were conducted to estimate effects associated with the speed limit change while controlling for long-term trends, seasonal cycles, and other patterns. Statistical controls were also included for major factors known to influence crash and injury rates. Results revealed significant increases in casualties on roads where the speed limit was raised, including a 19.2% increase in fatalities, a 39.8% increase in serious injuries, and a 25.4% increase in moderate injuries. Fatalities also increased on 55 mph limited access freeways, suggesting that the 65 mph limit may have spillover effects on segments of freeways where the limit was not changed. No significant changes in fatalities or injuries were found on other types of roads. The increased convenience of reduced travel time with the higher speed limit is obtained at a significant cost in terms of injury morbidity and mortality.     

EHV transformer dielectric specification improvements

EHV transformers have higher failure rates than lower voltage transformers. Many of these failures have been attributed to dielectric mechanisms. Therefore, the dielectric specification for these transformers has been enhanced by upgrading ratings, conducting comprehensive design reviews, performing voltage sensitivity analyses and proving the integrity of the transformer with improved dielectric tests. Most elements of the new specification have been applied to eight transformer designs, and the results are discussed. It is recommended that the industry further investigate insulation coordination and failure analysis of EHV transformers, and that standards be expanded to incorporate special requirements for these ratings     

A patient with Graves' disease, thrombocytopenia and chronic hepatitis B

A 22-year-old Chinese man, a HBsAg carrier, presented with relapse of thyrotoxic Graves' disease complicated by thrombocytopenia and hepatitis. Platelet count and liver enzymes gradually improved following successful treatment of the thyrotoxicosis with radioactive iodine. Possible pathogenetic links and therapeutic implications are discussed.     

Patterns of clinical metastasis in breast cancer: an analysis of 100 patients

Many patients diagnosed with breast cancer will develop metastases and these have diverse presentations. We have reviewed 100 consecutive patients who have died with metastatic breast cancer, to determine the frequency, sites and mode of presentation of recurrent disease. The commonest site of failure was loco-regional (n = 61), this usually presented with a mass, but a minority of patients also complained of pain. Bone metastases developed in 60 patients and produced bone pain, pathological fracture (n = 6) or cord compression (n = 5). Pulmonary metastases producing shortness of breath were diagnosed in 34 patients and were asymptomatic in a further 10. Intra-abdominal metastases were found at some time in 23 patients, most commonly in the liver (n = 20) and the majority complained of epigastric pain (n = 17). Brain metastases occurred in 23 patients and produced a wide range of symptoms including those of a space-occupying lesion (n = 10), cranial nerve palsy (n = 7), diabetes insipidus (n = 3), focal limb weakness (n = 2) and meningitis (n = 1). Three patients had choroid metastases producing reduced visual acuity. Recurrent breast carcinoma can present in a variety of ways, therefore any new symptom or sign should be considered to represent recurrence until proved otherwise.     

Is apoptosis involved in mechanisms to eliminate Onchocerca ochengi during Simulium damnosum s.l. immune response?

Co-injection of the parasite Onchocerca ochengi and the caspase inhibitors z-VAD.fmk and boc-D.fmk into the natural vector Simulium damnosum s.l. led to significantly increased survival of the parasites. Subsequent in situ apoptosis detection assays demonstrated that in the case of boc-D.fmk the enhanced survival was due to a diminished apoptosis level of the microfilariae in vivo. Additional assays using O. ochengi microfilariae which were coinjected with serine protease inhibitors into S. damnosum s.l. revealed that certain serine protease inhibitors can reduce the level of apoptosis.