Frank L. Thorne

Wound botulism: a life-threatening complication of hand injuries.

Botulism is usually associated with the ingestion of food contaminated with Clostridium botulinum, and these organisms occasionally contaminate traumatic injuries. It is unusual for them to result in clinical infection, but when this occurs, it is a catastrophe completely out of proportion to the degree of wound injury. A case is presented in which typical manifestations of descending cranial nerve and generalized motor paralysis were noted. Prolonged respiratory and general supportive assistance was required, as is usually the case. Although mortality rates in this disease are high, recovery is usually complete in survivors and was true in this instance.

Immediate reconstruction of the pharynx after combined therapy for advanced tonsillar carcinoma

Abstract A combined approach of radiation therapy and surgery has been used in ten patients with advanced tonsillar carcinoma. Moderate doses of preoperative irradiation were promptly followed by a composite resection and immediate cervical or forehead flap reconstruction. The technic is discussed. The results have demonstrated excellent healing and impressive oral function. A longer follow-up period will be necessary to determine the value of this approach as a curative procedure.

FAMILIAL CHRONIC PEMPHIGUS-Reply

To the Editor.— Thank you for your recent letter containing the reprint and note from Drs. Biro and Maday of Budapest. I have been unable to obtain a translation of this reprint as yet, but the photographs do show excellent results from the surgical treatment of familial chronic pemphigus. Needless to say, my co-authors and I were not aware that an article dealing with the surgical treatment of this disease had been published in 1966 in The Dermatological Journal of Budapest . This is approximately the same time that our patient was undergoing treatment and our research was being done into the historical background of this problem, and this article may well have not been listed in Index Medicus at that time. There are few times when one can truly claim a surgical first, and I am sure that if the truth were known there would be other cases antedating both