James T. Helsper

Initial manifestation of acquired immunodeficiency syndrome in the head and neck region.

Initial manifestation of AIDS in the head and neck region occurs frequently. The purpose of this report has been to alert the head and neck surgeon to the occurrence of AIDS-related lesions, their clinical characteristics, and disease outcome. Incomplete recognition of these disorders may delay appropriate diagnostic study and initiation of therapy. We have described 10 patients in whom the initial manifestation of AIDS-related malignancies occurred in the head and neck region. Six of these patients were found to have Kaposis sarcoma, whereas four had non-Hodgkins lymphomas. The specific clinical and pathologic aspects of the disease have been described, which represent common patterns of presentation. It is crucial to obtain an accurate social history, as well as a complete medical history from any patient suspected of having AIDS, and prompt biopsy of suspect lesions should be performed.

Use of skin grafts in the mouth in the management of oral cancer

Abstract 1. 1. Intra-oral skin grafting has been a great aid in the surgical management of cancer in this area. 2. 2. More extensive mucosal excisions are possible with the use of skin grafts, probably leading to better survival rates. 3. 3. Better functional results are obtained when skin grafting is utilized. 4. 4. Earlier and better dental prosthetic devices may be placed in the rehabilitation of these patients. 5. 5. At least three distinct successful methods of placement are available and are used according to the site to be grafted.

Carcinoma of the tongue

Abstract A study of carcinoma of the tongue, based on 156 patients treated in private practice in The Pasadena Tumor Institute over a twenty-seven year period, is presented by classification of our total experience with the disease and tabulation of a determinate group of 134 patients. Similarity of the five year survival rates of the two groups is evident when comparing the total groups rate of 44.2 per cent with the determinate groups figure of 51.5 per cent. (Table V.) Our policy of treating a patient as an individual problem, rather than as part of a systematized program, has proved to be the best course of action over the years. Our selection of the type of therapy to be used (either surgery or radiation) is based on the age of the patient, his general condition, and the exact involvement of disease on admission. For this reason, we find it impossible to support one method of treatment over another. The gradual increase in prognosis is definitely encouraging, and the optimistic conclusion can be drawn that if a patient presents himself in stage I or II, even with operable cervical nodes, he has a 50 per cent prognosis for remaining free of disease for five years. This is nearly twice the survival rate of the first three decades of this century.

THE MOUTHWASH TECHNIC. A METHOD OF SCREENING FOR INTRA-ORAL CARCINOMA.

Abstract The method presented is suggested as a valuable screening test in intra-oral carcinoma, and we believe it is simple, reproducible, accurate, and results in a cell population representative of the entire oral cavity.

Radiolucent spaces in the jaws: A new guide in diagnosis☆

Abstract Attention to the diagnostic guide presented herein will provide distinction not only among types of cysts but will separate them from benign and malignant tumors.

Oral manifestations of systemic disease. Regimen of treatment.

Abstract The sore mouth is the most common oral complaint, and it has a myriad of specific and idiopathic etiologic factors. In the majority of these conditions a preliminary diagnosis may be made on the basis of general history, oral examination findings, and the results of simple laboratory procedures, such as blood counts, urine tests, and the azure-A test. With the exception of those conditions with specific etiology, all are within the province of the dental profession for diagnosis and treatment. The diseases with specific etiology are readily detected, and the patients should be referred to an internist for a coordinated curative effort. The large group of patients with less specific symptoms and signs may be partially or completely relieved of their complaints when placed on an optimal high-protein diet with liver or acid supplementation.