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BACKGROUND: It has been suggested that patients with squamous cell carcinomas derived from oral leukoplakia have a better prognosis than patients with carcinomas that are not associated with oral leukoplakia. AIM: To study the mortality rate of 19 patients with a squamous cell carcinoma derived from pre-existing oral leukoplakia. METHOD: The mortality rate of 19 patients with a proven oral squamous cell carcinoma derived from a pre-existing oral leukoplakia was compared with that of a similar size group of patients with oral carcinoma without a pre-existing oral leukoplakia, being matched for gender, age, smoking habits, use of alcohol, oral subsite and histopathologic grade. Treatment in all patients was primarily by surgical excision. The mortality rates up to 5 years have been computed according to the Kaplan-Meier method. RESULT: No significant difference of the mortality rates up to 5 years of follow-up was observed between the two groups of patients. CONCLUSION: Patients with oral cancer developing from pre-existing oral leukoplakia do not do better than those with de novo oral cancer. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence and location of advanced neoplasia in patients undergoing colonoscopy, and to compare the yield per indication., Methods: In a multicenter colonoscopy survey (n = 18 hospitals) in the Amsterdam area (Northern Holland), data of all colonoscopies performed during a three month period in 2005 were analyzed. The location and the histological features of all colonic neoplasia were recorded. The prevalence and the distribution of advanced colorectal neoplasia and differences in yield between indication clusters were evaluated. Advanced neoplasm was defined as adenoma > 10 mm in size, with > 25% villous features or with high-grade dysplasia or cancer., Results: A total of 4623 eligible patients underwent a total colonoscopy. The prevalence of advanced neoplasia was 13%, with 281 (6%) adenocarcinomas and 342 (7%) advanced adenomas. Sixty-seven percent and 33% of advanced neoplasia were located in the distal and proximal colon, respectively. Of all patients with right-sided advanced neoplasia (n = 228), 51% had a normal distal colon, whereas 27% had a synchronous distal adenoma. Ten percent of all colonoscopies were performed in asymptomatic patients, 7% of whom had advanced neoplasia. In the respective procedure indication clusters, the prevalence of right-sided advanced neoplasia ranged from 11%-57%., Conclusion: One out of every 7-8 colonoscopies yielded an advanced colorectal neoplasm. Colonoscopy is warranted for the evaluation of both symptomatic and asymptomatic patients.

The objective of this study is to retrospectively assess the clinical relevance, i.c. the event of a local recurrence, in patients surgically treated for tongue and floor of mouth squamous cell carcinoma when tumour cell are observed histopathologically at a distance of less than 0.5 cm. Furthermore, the pattern of invasion and the presence or absence of perineural spread were recorded. A total of 68 patients, surgically treated because of a tongue or floor of mouth squamous cell carcinoma, were examined. Patients in whom any degree of epithelial dysplasia was observed in the mucosal surgical margins had been excluded beforehand. Local recurrence occurred in 2 out of 30 patients with a free surgical margins >0.5 cm and in 3 out of 38 patients with a free surgical margin <0.5 cm, the difference being not statistically significant. Apparently, the presence of tumour cells within a distance of less than 0.5 cm, but not into the deep surgical margin, does not necessarily seem to require additional treatment. The pattern of invasion and the presence or absence of perineural spread were not significantly related with local recurrence either.

To compare the effects of two free radical scavengers, dimethylsulfoxide 50% (DMSO) and N-acetylcysteine (NAC), for treatment of complex regional pain syndrome I (CRPS I), a randomized, double-dummy controlled, double-blind trial was conducted. Two outpatient clinics of two university hospitals in The Netherlands participated in the study and 146 patients, were included over a period of 24 months. Patients were randomized into two treatment groups, one was instructed to apply DMSO 50% five times daily to the affected extremity, the second was treated with NAC 600mg effervescent tablets three times daily, both combined with placebo. Interventions were accompanied by pain medication, occupational therapy for upper extremity CRPS I and physical therapy for lower extremity CRPS I in specific circumstances. Treatment was given for 17 weeks, with a possibility to continue or switch medication after this period, up to 1 year following the onset of treatment. An impairment level sum score was the primary outcome measure. Upper and lower extremity skills and functions, and general health status were also evaluated. Overall, no significant differences were found between NAC and DMSO after 17 and 52 weeks on impairment level and general health status. Significant differences were found for subscores of lower extremity function, in favor of DMSO-treatment. Subgroup analysis showed more favorable results for DMSO for warm CRPS I and significantly better performance of NAC for patients with a cold CRPS I. Results tended to be negatively influenced if the duration of the complaint was longer. Treatment with DMSO and NAC are generally equally effective in treatment of CRPS I. Strong indications exist for differences in effects for subgroups of patients with warm or cold CRPS I: for warm CRPS I, DMSO-treatment appears more favorable, while for cold CRPS I, NAC-treatment appears to be more effective.

This study assesses the reproducibility, construct validity, and responsiveness of a new self-report quality of life questionnaire, the "How Are You?" (HAY), for 8-12-year-old children with asthma, which contains both a generic and a disease-specific part. Two hundred twenty-eight children with asthma completed the HAY and the Child Attitude Toward Illness Scale (CATIS), while their parents monitored the actual asthma status; 80 children were measured three times in order to assess reproducibility and responsiveness; 296 healthy children completed the generic section of the HAY. Significant differences were found between children with asthma and healthy children, and among asthmatic children differing in actual asthma status. Reproducibility was adequate and supportive evidence was found for construct validity. Responsiveness was demonstrated by significant score changes for most dimensions in clinically changed children. The HAY seems useful for both discriminative and evaluative research in children with asthma.