The influence of the spring activator on the mobility of the lower jaw in traumatically injured patients

For functional rehabilitation and improvement of mandibular mobility, 14 patients with dislocated collum or collum fracture dislocations were treated with a spring activator after surgical-conservative treatment. With an interincisal distance of<12 mm, therapy was started with a loop spring. The average age of the patients was 26.6 years. Eight patients showed additional traumatic injuries, 2 patients were seriously polytraumatically injured. The clinical investigations referring to the maximum mouth opening and maximal interincisal distance resulted in a good to very good functional rehabilitation in all cases. The average maximal interincisal distance of 31.7 mm at the beginning of the spring activator therapy could be increased to 47.3 mm. The largest increase of the maximal interincisal distance was observed after 4 weeks of therapy. The type of reaction, however, differed interindividually. Three patients showed a spontaneous improvement of the interincisal distance within the first 2 to 3 weeks of removal of intermaxillary fixation, whereas 7 patients whowed no improvement or only slightly improved values until insertion of the spring activator. An enlargement of the interincisal distance could be achieved in almost every patient within a relatively short period of time despite a drastically reduced mouth opening. Consequently, because of its mode of action in the form of a neuromuscular influence, the spring activator is especially suitable for the functional rehabilitation of patients with fractures of the condylar process.     

The orthopan tomoscintigram — a new application of emission computed tomography for facial bone scanning

The exact regional correlation of findings of facial bone scans, planar or SPECT, to dental orthopan X-ray films (OPT) is difficult because of the very different projection techniques. To improve correlative imaging in this regard a projection algorithm was developed that uses SPECT data of the skull for reconstructing an orthopan tomoscintigraphic projection. Fourteen conventional SPECT slices of the upper and lower jaws were obtained during bone scanning. All mandibular slices were superimposed resulting in a horseshoe shaped structure, which was marked by an ROI which was divided into segments. All 14 SPECT slices were then masked by this segmental ROI, thereby marking the teeth-carrying bone in all slices. The information from this horseshoe like ROI is then transformed into lines. Line by line arrangement results in an orthopan projection, the orthopan tomoscintigram. This new display allows 1:1 true scale superimposition with the X-ray OPT and markedly facilitates correlative imaging.     

Comparison of flow cytometric DNA content in the primary tumor and in the corresponding lymph-node metastasis of patients with squamous cells carcinomas of the head and neck

The clonal DNA content of the cell populations of primary tumors and corresponding lymph node metastases was analysed by DNA flow cytometry in 48 patients with squamous cell carcinoma of the oral cavity. Three primary tumors were diploid, two associated with diploid metastases, one showing an aneuploid cell line in the secondary lesion. Fourty-five cases were aneuploid in both the primary tumors and in the synchronous metastases, all characterized by nearly identical DNA indices of the corresponding primary and secondary lesions. With few exceptions, aneuploidy formation appears to take place prior to dissemination of metastatic cells.     

The significance of DNA flow cytometry in predicting survival and delayed clinical manifestation of occult lymph node metastasis to the untreated neck in patients with oral squamous cell carcinoma

A total number of 116 clinically neck-negative patients with squamous cell carcinoma of the oral cavity who underwent radical primary tumour surgery without simultaneous neck treatment were entered into this prospective study. The 5 year overall survival rate was 87% for patients with flow cytometrically diploid tumours and 58% for the aneuploid group (P < 0.05). By multivariate survival analysis, tumour stage (P < 0.05) and DNA ploidy (P < 0.05) were significantly associated with the outcome. The cumulative 3 year rate of delayed clinical manifestation of lymph node metastasis to the previously untreated neck was 12.6% for patients with flow cytometrically diploid tumours and 41.3% for the aneuploid group (P < 0.01). By multivariate analysis, the DNA ploidy status of the primary tumour was the only factor among tumour stage, localization and degree of histological differentiation predictive of occult metastasis development (P < 0.05). Also, patients with T1 tumours who frequently are not considered to benefit from elective neck dissection were at high risk of subclinical lymph node involvement if the primary tumours were aneuploid (47%), whereas only 10% of the diploid T1 sample showed occult neck disease. Particularly in patients with less extensive oral carcinomas, DNA aneuploidy is therefore an important decisive factor in elective neck dissection.     

Sinuscopy for the diagnosis of blow-out fractures.

Between 1973 and 1976 thirty-one patients with the symptoms of a blow-out fracture underwent sinuscopy. In all these cases a precise diagnosis was not possible from the clinical and x-ray findings alone without exploratory surgery. In 28 cases an exact diagnosis could be made using sinuscopy; 21 patients with blow-out fractures underwent reconstructive surgery to the orbital floor. In the remaining 7 cases fracture of the orbital floor was ruled out and the patients were spared more extensive diagnostic procedures. In 3 cases the diagnosis of a fracture could not be definitely established. Exploratory surgery of the orbital floor showed blow-out fractures which needed treatment. These findings were photographed; 5 typical photographs of fractures are presented. Sinuscopy provides a simple and sure method in the diagnosis of blow-out fractures. Its early application is recommended in cases of suspected fractures of the orbital floor, since reconstructive surgery of blow-out fractures yields the best functional results when performed within 2 weeks after the accident.     

Wie arbeitet eine Jung'sche Kinderpsychotherapeutin? Behandlungsberichte geben neue Einblicke

This article is concerned with the question what it is that is typical for children and adolescent psychotherapy as performed by Jungian psychotherapists. The aim is to develop an independent position in the continuous discussion concerning the proof of efficacy and quality control of psychotherapy. The first part of this article introduces basic concepts used by Jungian therapists specialized in psychotherapy for children and adolescents. In the second part, two case studies are discussed that were developed under the control of the Swiss Association for Children and Adolescent Psychotherapy (VKJP) entitled "Retrospective Documentation of the Treatment Process". Drawn from these case studies, the so-called productive developments will be demonstrated in the third part. The retrospective documentation of the treatment process contributes to the understanding of outsiders and insiders of the therapeutic method as it is outlined in the concepts described in the first part of this article.     

Giant ossifying fibroma: a clinicopathologic study of 8 tumors

Clinical, radiographic and microscopic features of 8 ossifying fibromas diagnosed in 7 patients and measuring more than 8 cm in greatest diameter, were reviewed. The tumors occurred in both juvenile and middle aged patients and all lesions in women involved the maxilla. The abundance of fibrous connective tissue and resorption of mineralized deposits are indicative of altered cellular differentiation and proliferative activities in large ossifying fibromas. Focal areas of aneurysmal bone cyst formation were identified in the majority of lesions.     

Intra-arterial chemotherapy]

BACKGROUND: The development of arterial chemotherapy in the course of the twentieth century is recapitulated, emphasizing the implications of advancements which have been made in anatomic examination and cell biology. CHEMOTHERAPY: The literature is reviewed to determine the current position of arterial chemotherapy among other treatment strategies. As a single modality treatment, it is exclusively employed as palliative treatment. Combined with surgery, radiation or immune therapy, arterial chemotherapy is of further significance as part of multimodality treatment. The best chance for cure is achieved if applied as induction therapy.