Intubation v. dilatation plus bleomycin in the treatment of advanced oesophageal cancer. The results of a prospective randomized trial.
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Biomedical subjects
Publications and source records attributed to P J Becker.
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Preliminary evidence is presented that plasma pyridoxal-5-phosphate levels are considerably and significantly reduced (P less than 0.0001) in patients suffering from myocardial infarction when compared to a healthy control group.
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Hepatocellular carcinoma has a lower prevalence and presents at a later age in urban Blacks than in rural Blacks. These differences have previously been shown not to be attributable to differences in serum hepatitis B virus markers. In the present study, the average age of patients with hepatocellular carcinoma in a developing urban Black population is shown to have risen from 38.9 to 56.5 years (p less than 0.0001) over a 20-year interval, while the prevalence of co-existing cirrhosis has declined from 66 to 44% (p less than 0.05) and tissue HBsAg positivity has fallen from 44 to 17.7% (p = 0.002). The lower prevalence of tissue HBsAg in the recent patients may be explained by their older age. Macronodular cirrhosis was present in 56% of cases in the earlier period but declined to 18.9% in the later period, with micronodular cirrhosis becoming the dominant nontumor pathology (p = 0.002). Liver damage attributable to the abuse of alcohol is now found in more than half of the cases (48/90) of hepatocellular carcinoma occurring in this population. The remainder show no changes (12 cases) or show macronodular or incomplete septal cirrhosis (30 cases), presumed to be of viral origin. The latter cases are more likely to have serum markers of current hepatitis B virus infection than those with evidence of alcohol abuse. We conclude that alcohol is increasing in importance as an etiologic association of hepatocellular carcinoma in urban South African Blacks. At the same time, the prevalence of macronodular cirrhosis (and of cirrhosis as a whole) in urban patients with this tumor has declined. The reason for this decline is not known.
Enzymes involved in vitamin B6 metabolism, i.e., pyridoxal kinase, pyridoxamine (pyridoxine) 5'-phosphate oxidase, and pyridoxal 5'-phosphate phosphatase, were assayed in hemolysates prepared from cord, maternal, and control blood samples. Mean cord and control pyridoxamine (pyridoxine) 5'-phosphate oxidase activities were significantly higher than maternal activities (p less than 0.001 and p less than 0.05, respectively). A significant correlation (p less than 0.001) was observed between maternal and cord vitamin B6-metabolizing enzymes. Cord pyridoxal 5'-phosphate levels correlated significantly with maternal pyridoxal 5'-phosphate levels (p less than 0.001) and with cord pyridoxal kinase activity (p less than 0.05). Maternal pyridoxal 5'-phosphate levels appear to be the most important factor determining fetal vitamin B6 status.
One hundred consecutive superficial mass lesions in various body sites were sampled by both conventional fine needle aspiration (FNA) and by a fine needle without the application of syringe suction. The latter technique is based on the principle of capillarity and may be termed "fine needle capillary" (FNC) sampling. The two sampling techniques were compared using five objective parameters: (1) the amount of diagnostic cellular material present, (2) the retention of appropriate architecture and cellular arrangement, (3) the degree of cellular degeneration, (4) the cellular trauma and (5) the volume of obscuring background blood and clots. There was no statistically significant difference between the efficacies of the two sampling techniques for any of the parameters studied. FNA sampling was diagnostic in a greater number of cases than was FNC sampling, but this difference was not statistically significant at a level of P = .05. When FNC sampling was diagnostic, it more frequently produced superior-quality material; conventional FNA, although diagnostic in a greater number of cases, mostly produced adequate, rather than superior-quality, material. This trend was not, however, statistically significant at a level of P = .05. These findings differ from those of previous studies (which have shown overall superiority of FNC sampling over conventional FNA sampling) and suggest that the technique of fine needle sampling employed for cytodiagnosis can be left to the personal preference of the operator.
This study tested whether information obtained from an inventory of denture-related variables can help a dentist recognise the potentially slowly adapting denture patient. Sixty-one patients completed an inventory of denture complaints prior to the fabrication of complete maxillary and mandibular dentures. Subjects were subsequently divided into groups of slowly adapting and rapidly adapting patients. A clinically derived classification was compared to a theoretic model. Seventy-four percent of the theoretically slowly adapting patients and 89% of the theoretically rapidly adapting patients corresponded with their clinical classifications.
PURPOSE: The purpose of this study was to facilitate the recognition of denture patients who are unable to adapt to conventional dentures and who are likely to benefit from treatment using implant-supported prostheses. MATERIALS AND METHODS: Sixty-nine patients who where referred for postgraduate prosthetic treatment at Wits Dental School completed a self-report inventory of items related to their dentures in current use. Conventional dentures were fabricated for all subjects. Those patients who could not adapt to conventional complete denture treatment were referred for treatment with implant-supported prostheses provided that they conformed with the recommended criteria for this treatment modality. RESULTS: Analysis of the inventory of pretreatment denture complaints yielded variables that differentiated between the group who remained with conventional dentures and the group that was referred for implants. Significant variables were the period that a mandibular denture was used before new dentures were requested (P = 0.025); the period that a maxillary denture was used before further treatment was sought (P = 0.03); the discarding of a mandibular denture (P = 0.035); and pain complaints related to maxillary dentures (P = 0.045). A logistic regression model was used to compare the clinical division of the sample with that determined by the mathematic model. Sixty-six percent of the subjects who accepted conventional treatment and 69% of implant patients corresponded for both classifications. CONCLUSION: The authors conclude that pretreatment denture complaints can be used diagnostic aids for evaluating patients who are likely to benefit from implant-supported prostheses.