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The “Tadpole Flap”—It's role in closure of palatal fistulae
545
CURRENT LITERATURE
level of the pacemaker unit and also by using the cautery in very short, repetitive bursts. Unipolar pacemakers have been reported to be more susceptible to ventricular fibrillation than bipolar pacemakers. The authors conclude that in this study life-threatening situations from electrocautery were avoided by attention to three basic considerations: the type of pacemaker, the proper grounding of all medical equipment in use during the procedure, and direction of the complete electrical flow of the electrocautery circuits below the level of the pacemaker.-S.J. MCKENNA Reprint requests to Dr Erdman: Department of Cardiovascular Surgery, Beilinson Medical Center, Petah Tiqva 49 100, Israel.
Study of AIDS-Related Lymphadenopathy in the Intraparotid and Perisubmaxillary Gland Lymph Nodes. Poletti A, Manconi R, Volpe R, et al. J Oral Path01 17:164, 1988 AIDS-related lymphadenopathy presenting in the salivary gland lymph nodes is an unusual event, with 20 cases having been previously reported. The authors performed studies on salivary gland and peripheral lymph nodes from two HIV-seropositive patients to determine their immunohistologic characteristics. The study revealed hypervascular reactive lymphoid hyperplasia with follicular centers containing a prevalence of suppressor T-cells. Within the nodes were numerous cysts lined by metaplastic squamous epithelium containing lymphocytes. Immunohistologic findings from salivary gland lymph nodes were similar to findings from peripheral lymph nodes. The authors suggest this may represent an exuberant reaction to the HIV infection.-W.K. MURPHY Reprint requests to Dr A. Carbone: Division of Pathology, Centro di Riferimento Oncologico, Aviano, l-33081 Italy.
Prevention of Rheumatic Fever. Dajani S, Bisno A, Chung K, et al. Circulation 77:1082, 1988 Group A g-hemolytic streptococcal upper respiratory tract infections are responsible for both initial and recurrent attacks of acute rheumatic fever. Throat cultures have traditionally been used to diagnose pharyngitis caused by group A streptococci. Prevention of rheumatic fever requires definitive diagnosis followed by appropriate antibiotic therapy to abolish these organisms. Penicillin is the antibiotic of choice for treatment of streptococcal infections. Erythromycin is used for those patients who experience allergic reactions to the penicillins. A ten-day regimen of oral antibiotic therapy is appropriate to prevent initial attacks of acute rheumatic fever. For patients with a history of rheumatic fever, continuous antimicrobial medication is recommended because an infection does not have to be symptomatic to initiate a recurrence. In this situation the duration of therapy is determined by the patient’s age and elapsed time since the last rheumatic attack. This may require antibiotic therapy into adulthood or longer for those patients who suffer from rheumatic carditis.-A.P. HEISE Reprint requests to the Office of Scientific Affairs: American Heart Association, 7320 Greenville Ave, Dallas, TX 7523 1.
Quantifications and Analysis of the Glycosaminogiycans in Human Gdontogenic Cyst Linings. Smith G, Smith AJ, Browne RM. Arch Oral Biol 33:623. 1988 Previous studies have demonstrated appreciable amounts of glycosaminoglycans (GAG) and proteoglycans in fluid aspirates from nonkeratinizing and keratinizing human odontogenic cysts. Connective-tissue ground substance is rich in GAG, and the presence of GAG in this connective tissue has been demonstrated histochemically; on the basis of enzymic and chemical digestion of tissue sections, hyaluronic acid and chondroitin sulphate were observed, with lesser amounts of other sulphated GAG. This study was undertaken to separate the GAG and quantitate their relative proportions. GAG were extracted from the connective tissue of 15 dental cysts, two dentigerous cysts, and seven keratocysts, and separated electrophoretically and chromatographically. Hyaluronic acid (dental, 2.38; dentigerous, 3.98; keratocysts, 3.19 kg uranic acid per milligram of lyophilized tissue) was the major GAG detected, with lesser amounts of heparin (dental 1.70; dentigerous, 2.85; keratocyst, 1.80 pg uranic acid per milligram of lyophilized tissue) and chrondrotin4-sulphate (dental 1.33; dentigerous, 2.85; keratocyst, 1.37 t_tguranic acid per milligram of lyophilized tissue). These molecules may play an important role in expansile cyst growth by enzymic release of these substances into the luminal fluid of these cysts.-T. CROWLEY Reprint requests to Dr Smith: Department of Oral Pathology, University of Birmingham, Dental School, St Chad’s Queensway, Birmingham B4 6NN, England.
The “Tadpole Flap”-It’s Role in Closure of Palatal Fistulae. Watson JD, Reid CD. Br J Plast Surg 41:485, 1988 The authors discuss closure of anterior palatal fistulae in 13 cleft palate patients. The fistulae ranged in size from 1 to 4 cm* and were symptomatic. The nasal side of each fistula was closed using a local flap, and the oral side was closed using an advancement island flap (Tadpole Flap) with the blood supply based on the greater palatine artery. Results showed successful closure of the fistulae in eight patients, reduction in the size of the defect in three patients, with the remaining two procedures being aborted at the time of surgery due to a poor vascular pedicle. The authors conclude that the “Tadpole Flap” is a viable means of closing persistent palatal fistulae in the majority of cases.-R.K. QUIGG Reprint requests to Mr Watson: Department of Plastic Surgery, Feuchay Hospital, Bristol BSlQLE.
Cervical Ranulas. Batsakis JG, McClatchey Otol Rhino1 Laryngol 97:561, 1988
KD. Ann
Ranulas are benign space-occupying pseudocysts of sublingual gland origin. Cervical, plunging, or burrowing ranulas are an outcome of mucus extravasation from the sublingual glands entering into soft tissues and dissecting between fascial planes. They lack an epithelial lining and vary histologically with time-from mucin collections
CURRENT LITERATURE
level of the pacemaker unit and also by using the cautery in very short, repetitive bursts. Unipolar pacemakers have been reported to be more susceptible to ventricular fibrillation than bipolar pacemakers. The authors conclude that in this study life-threatening situations from electrocautery were avoided by attention to three basic considerations: the type of pacemaker, the proper grounding of all medical equipment in use during the procedure, and direction of the complete electrical flow of the electrocautery circuits below the level of the pacemaker.-S.J. MCKENNA Reprint requests to Dr Erdman: Department of Cardiovascular Surgery, Beilinson Medical Center, Petah Tiqva 49 100, Israel.
Study of AIDS-Related Lymphadenopathy in the Intraparotid and Perisubmaxillary Gland Lymph Nodes. Poletti A, Manconi R, Volpe R, et al. J Oral Path01 17:164, 1988 AIDS-related lymphadenopathy presenting in the salivary gland lymph nodes is an unusual event, with 20 cases having been previously reported. The authors performed studies on salivary gland and peripheral lymph nodes from two HIV-seropositive patients to determine their immunohistologic characteristics. The study revealed hypervascular reactive lymphoid hyperplasia with follicular centers containing a prevalence of suppressor T-cells. Within the nodes were numerous cysts lined by metaplastic squamous epithelium containing lymphocytes. Immunohistologic findings from salivary gland lymph nodes were similar to findings from peripheral lymph nodes. The authors suggest this may represent an exuberant reaction to the HIV infection.-W.K. MURPHY Reprint requests to Dr A. Carbone: Division of Pathology, Centro di Riferimento Oncologico, Aviano, l-33081 Italy.
Prevention of Rheumatic Fever. Dajani S, Bisno A, Chung K, et al. Circulation 77:1082, 1988 Group A g-hemolytic streptococcal upper respiratory tract infections are responsible for both initial and recurrent attacks of acute rheumatic fever. Throat cultures have traditionally been used to diagnose pharyngitis caused by group A streptococci. Prevention of rheumatic fever requires definitive diagnosis followed by appropriate antibiotic therapy to abolish these organisms. Penicillin is the antibiotic of choice for treatment of streptococcal infections. Erythromycin is used for those patients who experience allergic reactions to the penicillins. A ten-day regimen of oral antibiotic therapy is appropriate to prevent initial attacks of acute rheumatic fever. For patients with a history of rheumatic fever, continuous antimicrobial medication is recommended because an infection does not have to be symptomatic to initiate a recurrence. In this situation the duration of therapy is determined by the patient’s age and elapsed time since the last rheumatic attack. This may require antibiotic therapy into adulthood or longer for those patients who suffer from rheumatic carditis.-A.P. HEISE Reprint requests to the Office of Scientific Affairs: American Heart Association, 7320 Greenville Ave, Dallas, TX 7523 1.
Quantifications and Analysis of the Glycosaminogiycans in Human Gdontogenic Cyst Linings. Smith G, Smith AJ, Browne RM. Arch Oral Biol 33:623. 1988 Previous studies have demonstrated appreciable amounts of glycosaminoglycans (GAG) and proteoglycans in fluid aspirates from nonkeratinizing and keratinizing human odontogenic cysts. Connective-tissue ground substance is rich in GAG, and the presence of GAG in this connective tissue has been demonstrated histochemically; on the basis of enzymic and chemical digestion of tissue sections, hyaluronic acid and chondroitin sulphate were observed, with lesser amounts of other sulphated GAG. This study was undertaken to separate the GAG and quantitate their relative proportions. GAG were extracted from the connective tissue of 15 dental cysts, two dentigerous cysts, and seven keratocysts, and separated electrophoretically and chromatographically. Hyaluronic acid (dental, 2.38; dentigerous, 3.98; keratocysts, 3.19 kg uranic acid per milligram of lyophilized tissue) was the major GAG detected, with lesser amounts of heparin (dental 1.70; dentigerous, 2.85; keratocyst, 1.80 pg uranic acid per milligram of lyophilized tissue) and chrondrotin4-sulphate (dental 1.33; dentigerous, 2.85; keratocyst, 1.37 t_tguranic acid per milligram of lyophilized tissue). These molecules may play an important role in expansile cyst growth by enzymic release of these substances into the luminal fluid of these cysts.-T. CROWLEY Reprint requests to Dr Smith: Department of Oral Pathology, University of Birmingham, Dental School, St Chad’s Queensway, Birmingham B4 6NN, England.
The “Tadpole Flap”-It’s Role in Closure of Palatal Fistulae. Watson JD, Reid CD. Br J Plast Surg 41:485, 1988 The authors discuss closure of anterior palatal fistulae in 13 cleft palate patients. The fistulae ranged in size from 1 to 4 cm* and were symptomatic. The nasal side of each fistula was closed using a local flap, and the oral side was closed using an advancement island flap (Tadpole Flap) with the blood supply based on the greater palatine artery. Results showed successful closure of the fistulae in eight patients, reduction in the size of the defect in three patients, with the remaining two procedures being aborted at the time of surgery due to a poor vascular pedicle. The authors conclude that the “Tadpole Flap” is a viable means of closing persistent palatal fistulae in the majority of cases.-R.K. QUIGG Reprint requests to Mr Watson: Department of Plastic Surgery, Feuchay Hospital, Bristol BSlQLE.
Cervical Ranulas. Batsakis JG, McClatchey Otol Rhino1 Laryngol 97:561, 1988
KD. Ann
Ranulas are benign space-occupying pseudocysts of sublingual gland origin. Cervical, plunging, or burrowing ranulas are an outcome of mucus extravasation from the sublingual glands entering into soft tissues and dissecting between fascial planes. They lack an epithelial lining and vary histologically with time-from mucin collections