- Email: [email protected]
Results of combined chemotherapy and retinotherapy for advanced intraocular retinoblastoma
782
CURRENT
This case highlights some potential causes of herpes virus reactivation in ARN. Analogous surgical trauma to the trigeminal nerve root (during decompression) has been shown to cause herpetic reactivation.-I. SHAMI Reprint requests to Dr Freeman: Shiley Eye Center, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093.0946.
Perception of Stimulus Size in Patients With Burning Mouth Syndrome. Lamey P-J, Hobson RS, Orchardson R. J Oral Path01 Med 25:420, 1996 Currently, several factors are implicated in contributing to burning mouth syndrome @MS). Vitamin deficiencies, allergies, denture problems, and endocrine disorders are among the factors that are considered to contribute to BMS. Despite the resources that link some factors to BMS, no single explanation has been offered as a single definitive reason for BMS occurrence. The authors here test their hypothesis that BMS patients may experience hypersensitivity to stimuli. In this report, the authors test patients perceptions regarding innocuous stimuli involving size perception of stimulus holes. Subjects included 20 BMS and 20 control patients. To be considered, the BMS patients had to present with a burning sensation of the tongue but clinically healthy appearing mucosa. Stimulus holes of four sizes were used along with a comparator series of holes. Comparative perceptions of the comparator and stimulus holes were made with fingers and the tongue. Results showed both the control patients and the BMS patients to have very similar size perceptions regarding the holes. Before this study, the authors felt that BMS patients could have exaggerated oral perception compared to the normal control subjects. However, there were no differences between the two groups in their ability to estimate the size of the holes presented to the tongue. The authors recognize the need for further investigation into BMS etiology.-K. BENSON Reprint requests to Dr P-J Lamey: The Queen’s University of Belfast, Grosvenor Road, Belfast BT12 6BP, United Kingdom.
Distraction Osteogenesisin the Mandible With a MotorDriven Plate: A Preliminary Animal Study. Schmelzeisen R, Neumann G, von der Fecht R. Br J Oral Maxillofac 34:357. 1996
Surg
Distraction osteogenesis has recently gained attention for the reconstruction of mandibular defects as well as an alternative to traditional mandible lengthening procedures. While early in its evolution, awkward external appliances and difficult activation mechanisms have slowed their acceptance. The purpose of the present investigation was to evaluate the viability of an internal motor-driven distraction device to lengthen the mandible. The device was mounted on a plastic or stainless steel 2.7 mm plate with the motor affixed to the posterior aspect of the plate. Within the anterior portion of the plate was a gliding extension unit. The device was placed on the medial aspect of the mandible of three Gottingen pigs via a submandibular incision. The osteotomy was performed and the power unit was inserted into a subcutaneous neck pocket of the animal. The power unit consisted of 2 X 3.6 V lithium batteries that provided impulses of 10 ms every 6 minutes. The motor could thus provide 10 N. The distraction period lasted 14 to 21 days after which the animals were sacrificed and histological examination was carried out. Two of the animals survived with lengthening of the mandible in the remaining animals of 11 and 13 mm. Histologic examina-
LITERATURE
tion showed early bone formation within the bone gap, with bone remodeling and lamellar bone formation. This preliminary investigation has served further the study of alternatives to the present prototypes for distraction osteogenesis. Currently smaller plates and motorized units are under biomechanical testing.-K.A. SILLOWAY Reprint requests to Dr Schmelzeisen: Department of Oral and Maxillofacial Surgery, Department of Mechanics, Central Research Department, Medical University of Hanover, Konstanty Gutschow Str 8, 30625 Hanover, Germany.
Resultsof Combined Chemotherapy and Retinotherapy for Advanced Intraocular Retinoblastoma. Kingston J, Hungerford J, Madreperla 114:1339, 1996
S, et al. Arch
Ophthalmol
Until recently, the standard management of Reese-Ellsworth group V (R-E group V) retinoblastoma has been treatment with either primary enucleation or whole eye irradiation. This prospective study was designed to determine the visual and anatomical results and survival after combined chemotherapy and whole eye radiotherapy for patients with bilateral Reese-Ellsworth group V retinoblastoma. Fourteen children in whom bilateral R-E group V tumors diagnosed were followed-up. No child had clinical or radiographical evidence of extraocular extension when the tumor was diagnosed. The patients were treated with chemotherapy and whole eye radiotherapy (40 to 44 Gy in 20 to 22 equivalent fractions). Ultrasonographic measurement of the tumors in each eye was performed before treatment and after each of the first two courses of chemotherapy. The median followup time was 60 months. After two courses of chemotherapy alone, all tumors decreased in height, usually by more than 50%. Of the 20 eyes of surviving children (excluding eyes enucleated primarily and the two children who died during follow-up), 14 (70%) were preserved at the last follow-up. The use of chemotherapy to debulk tumor, facilitating either further surgery or the effect of radiotherapy, thereby improving local control rates is standard practice in the management of tumor such as Ewing sarcoma, rhabdomyosarcoma, and neuroblastoma. Three studies of radiotherapy for eyes with group V retinoblastoma report eye salvage rates of lo%, 29%, and 66%. In the current study, 14 (70%) of 20 eyes in surviving patients were preserved. Therefore, it would seem that there was some achievement in eye preservation by adding chemotherapy to the same radiotherapy protocol. This study shows that chemotherapy plus radiotherapy regimen was successful in salvaging most eyes with R-E group V retinoblastoma, and ocular complications occurred frequently.-I. SHAM1 Reprints requests to Dr Madreperla: Department of Ophthalmology, Center for Vision Research, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106 (e-mail: sam [email protected]).
The Role of DDAVP (Desmopressin)in Orthognathic Surgery. Guyuron B, Vaughan C, Schlecter B. Ann Plast Surg 37:516, 1996 Desmopressin (DDAVP) has been used as a nontransfusional treatment for mild to moderate hemophilia and Von Willebrand’s disease. DDAVP has recently been shown to increase the plasma concentration of factor VIII, thereby increasing coagulant activity. Controlled clinical trials indicate that DDAVP can reduce blood loss and transfusion requirements for patients with normal coagulation profiles
CURRENT
This case highlights some potential causes of herpes virus reactivation in ARN. Analogous surgical trauma to the trigeminal nerve root (during decompression) has been shown to cause herpetic reactivation.-I. SHAMI Reprint requests to Dr Freeman: Shiley Eye Center, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093.0946.
Perception of Stimulus Size in Patients With Burning Mouth Syndrome. Lamey P-J, Hobson RS, Orchardson R. J Oral Path01 Med 25:420, 1996 Currently, several factors are implicated in contributing to burning mouth syndrome @MS). Vitamin deficiencies, allergies, denture problems, and endocrine disorders are among the factors that are considered to contribute to BMS. Despite the resources that link some factors to BMS, no single explanation has been offered as a single definitive reason for BMS occurrence. The authors here test their hypothesis that BMS patients may experience hypersensitivity to stimuli. In this report, the authors test patients perceptions regarding innocuous stimuli involving size perception of stimulus holes. Subjects included 20 BMS and 20 control patients. To be considered, the BMS patients had to present with a burning sensation of the tongue but clinically healthy appearing mucosa. Stimulus holes of four sizes were used along with a comparator series of holes. Comparative perceptions of the comparator and stimulus holes were made with fingers and the tongue. Results showed both the control patients and the BMS patients to have very similar size perceptions regarding the holes. Before this study, the authors felt that BMS patients could have exaggerated oral perception compared to the normal control subjects. However, there were no differences between the two groups in their ability to estimate the size of the holes presented to the tongue. The authors recognize the need for further investigation into BMS etiology.-K. BENSON Reprint requests to Dr P-J Lamey: The Queen’s University of Belfast, Grosvenor Road, Belfast BT12 6BP, United Kingdom.
Distraction Osteogenesisin the Mandible With a MotorDriven Plate: A Preliminary Animal Study. Schmelzeisen R, Neumann G, von der Fecht R. Br J Oral Maxillofac 34:357. 1996
Surg
Distraction osteogenesis has recently gained attention for the reconstruction of mandibular defects as well as an alternative to traditional mandible lengthening procedures. While early in its evolution, awkward external appliances and difficult activation mechanisms have slowed their acceptance. The purpose of the present investigation was to evaluate the viability of an internal motor-driven distraction device to lengthen the mandible. The device was mounted on a plastic or stainless steel 2.7 mm plate with the motor affixed to the posterior aspect of the plate. Within the anterior portion of the plate was a gliding extension unit. The device was placed on the medial aspect of the mandible of three Gottingen pigs via a submandibular incision. The osteotomy was performed and the power unit was inserted into a subcutaneous neck pocket of the animal. The power unit consisted of 2 X 3.6 V lithium batteries that provided impulses of 10 ms every 6 minutes. The motor could thus provide 10 N. The distraction period lasted 14 to 21 days after which the animals were sacrificed and histological examination was carried out. Two of the animals survived with lengthening of the mandible in the remaining animals of 11 and 13 mm. Histologic examina-
LITERATURE
tion showed early bone formation within the bone gap, with bone remodeling and lamellar bone formation. This preliminary investigation has served further the study of alternatives to the present prototypes for distraction osteogenesis. Currently smaller plates and motorized units are under biomechanical testing.-K.A. SILLOWAY Reprint requests to Dr Schmelzeisen: Department of Oral and Maxillofacial Surgery, Department of Mechanics, Central Research Department, Medical University of Hanover, Konstanty Gutschow Str 8, 30625 Hanover, Germany.
Resultsof Combined Chemotherapy and Retinotherapy for Advanced Intraocular Retinoblastoma. Kingston J, Hungerford J, Madreperla 114:1339, 1996
S, et al. Arch
Ophthalmol
Until recently, the standard management of Reese-Ellsworth group V (R-E group V) retinoblastoma has been treatment with either primary enucleation or whole eye irradiation. This prospective study was designed to determine the visual and anatomical results and survival after combined chemotherapy and whole eye radiotherapy for patients with bilateral Reese-Ellsworth group V retinoblastoma. Fourteen children in whom bilateral R-E group V tumors diagnosed were followed-up. No child had clinical or radiographical evidence of extraocular extension when the tumor was diagnosed. The patients were treated with chemotherapy and whole eye radiotherapy (40 to 44 Gy in 20 to 22 equivalent fractions). Ultrasonographic measurement of the tumors in each eye was performed before treatment and after each of the first two courses of chemotherapy. The median followup time was 60 months. After two courses of chemotherapy alone, all tumors decreased in height, usually by more than 50%. Of the 20 eyes of surviving children (excluding eyes enucleated primarily and the two children who died during follow-up), 14 (70%) were preserved at the last follow-up. The use of chemotherapy to debulk tumor, facilitating either further surgery or the effect of radiotherapy, thereby improving local control rates is standard practice in the management of tumor such as Ewing sarcoma, rhabdomyosarcoma, and neuroblastoma. Three studies of radiotherapy for eyes with group V retinoblastoma report eye salvage rates of lo%, 29%, and 66%. In the current study, 14 (70%) of 20 eyes in surviving patients were preserved. Therefore, it would seem that there was some achievement in eye preservation by adding chemotherapy to the same radiotherapy protocol. This study shows that chemotherapy plus radiotherapy regimen was successful in salvaging most eyes with R-E group V retinoblastoma, and ocular complications occurred frequently.-I. SHAM1 Reprints requests to Dr Madreperla: Department of Ophthalmology, Center for Vision Research, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106 (e-mail: sam [email protected]).
The Role of DDAVP (Desmopressin)in Orthognathic Surgery. Guyuron B, Vaughan C, Schlecter B. Ann Plast Surg 37:516, 1996 Desmopressin (DDAVP) has been used as a nontransfusional treatment for mild to moderate hemophilia and Von Willebrand’s disease. DDAVP has recently been shown to increase the plasma concentration of factor VIII, thereby increasing coagulant activity. Controlled clinical trials indicate that DDAVP can reduce blood loss and transfusion requirements for patients with normal coagulation profiles