Tumors of the major salivary glands.

Tumors of the major salivary glands are reviewed according to classification, location, surgical procedure and end results. Our data of the incidence of benign and malignant tumors show that the most commonly involved area is the parotid gland and the most frequent is of the mixed variety. In the parotid region 80 percent are benign and 20 percent are malignant; whereas, in the submandibular gland, the malignant and benign tumors are equally distributed. The need for an extensive surgical attack and inclusion of contiguous structure is dictated by the nature of the malignant disease. The role of postoperative irradiation is discussed as is the indication for neck dissection. Management of the facial nerve, relative to malignant tumors of the parotid gland, is considered in detail.     

Diagnostic value of a psychological test in cases of suspected child abuse

The use of the Bene-Anthony Family Relations Test is described and illustrated by three examples of child abuse. This test should be considered in the investigation of definite or suspected cases of abuse and as part of the preparation of court evidence.     

The horse that was a zebra: primary lymphoma of bone mimicking shoulder strain in an elderly male

Primary malignant tumours of the extremities are rarely seen in chiropractic clinics. A case is presented of an eighty year old male who had complained of pain in the right shoulder of several days duration. History and clinical examination were consistent with mechanical joint pain. Following an appropriate course of conservative care the patient continued to improve until a re-injury occurred 3 months later. At that time, radiographs revealed an ill-defined moth-eaten lesion in the proximal humeral head. Subsequent evaluation demonstrated it to be a rare histologic sub-type of lymphoma. This case highlights several important issues ranging from clinical presentation to case management.     

The physics of FeldenkraisPart 3: stability

In the last article in this series, we briefly examined the Principle of Least Effort and the five forms of strain. Strain, you may recall, in physics, describes a change in the volume of a material when a force is applied. Our treatments are a blend of rotation and translation movements of our hands with a changing mix of strains being applied onto the client's tissues. Harnessing and interweaving the various forms of strain with dexterity may aid us in improving our treatment efficacy.In this tissue, we will consider the importance of anchorage and stability in treatment, We will consider a set of ‘House Rules' for improving treatment. In addition, we will explore Bernstein's concept of degrees of freedom.     

The role of MR imaging in evaluating metastatic spinal disease

Fifty-eight patients with suspected epidural metastases were evaluated with MR imaging. Six patients were examined on two separate occasions. MR was judged to be diagnostic in 60 of the 64 examinations. Twenty-two patients also underwent myelography. MR was as diagnostic as myelography in all cases of epidural metastases. In addition, MR offered several advantages over myelography in the evaluation of metastatic spinal disease, including demonstration of paravertebral tumor extension, identification of additional osseous metastatic lesions, and visualization of areas of spinal cord compression occurring between areas of myelographic blocks. We conclude that MR imaging is the examination of choice for evaluating suspected metastatic spinal disease.