Squamous carcinoma of the head and neck: the untreated patient

One thousand, nine hundred and seventy-seven patients with squamous carcinoma of the head and neck are reviewed with particular reference to the patients not treated. The commonest reason for not treating the patients was that the tumour was too extensive (55%). A further 36% were too old or infirm to be considered fit for radical treatment, and 9% of patients refused treatment. Treated and untreated patients were compared for age, sex, site of the primary and TNM stage. The proportion of patients untreated varied according to site of the primary tumour, with 25% of pharangeal tumours being the highest proportional representation. Median survival for untreated patients was 88 days; survival time was significantly related to sex, T stage of primary tumour and patient's general condition.     

Factor structure of the Motivation Assessment Scale

The Motivation Assessment Scale (MAS) was developed to provide clinical information on four hypothesized functions that may control problem behaviour in persons with developmental disabilities. The original four-factor structure of the MAS was based on face validity, with the items being grouped in terms of each of the hypothesized functions. Validation of the scale was provided in terms of correlations between teacher ratings of eight children on the MAS and ranking of the controlling variables from functional analogue tests. In this study, staff in residential facilities rated 60 residents and teachers in schools rated 96 students on the MAS. The target behaviour rated for both samples was self-injury, with the institutional sample engaging in the behaviour more than 15 times an hour and the school sample, less than 15 times an hour. The results of factor analyses, with varimax rotation, provided a conceptually meaningful factor structure with the institutional sample, but not with the school sample. The 16 MAS items resolved into four factors that were conceptually related to four conditions that may maintain problem behaviour (i.e. sensory, escape, attention and tangible). The results suggested that the original MAS has a robust factor structure and may be clinically useful in predicting the controlling functions of problem behaviours, if the target behaviours occur at a rate no less than 15 responses per hour.     

High resolution protein mapping in fibroblast cell lines and hair roots from patients with genetic disease*

Protein patterns of cultured fibroblasts and hair root lysates from healthy controls and patients with genetic diseases (Duchenne muscular dystrophy, Friedreich's ataxia, Marie's ataxia, Lesch-Nyhan syndrome, maple syrup urine disease, and trisomy 13, 18 and 21) were obtained with two-dimensional electrophoresis. The analysis of these patterns in 39 gels by visual comparison revealed differences in the presence and absence of 20 specific protein spots. However, this variability, which has been observed in healthy controls as well as in patients, could not provide a diagnosis for a specific genetic disease. Only in one case - trisomy 18 - was an additional spot observed, which was not present in any of the other gels.