Faculty Bibliography

Five salivary gland hemangiomas in adults are reported. The feasibility of preoperative diagnosis on clinical and radiologic grounds is emphasized. Adult hemangiomas are of the cavernous type and can be differentiated from infantile capillary hemangiomas clinically as well as histologically. Cavernous hemangiomas in the adult should be treated by surgical excision.

Radiography and manometry have been used to study oesophageal motor function in a group of 31 diabetics, 23 of whom had alimentary or genitourinary symptoms attributed to autonomic neuropathy. Peristalsis was of diminished amplitude and oesophageal emptying in the 15 degrees Trendelen-Peristalsis was of diminished amplitude and oesophageal emptying in the 15 degrees Trendelenburg position was delayed. The lower oesophageal sphincter pressure was reduced. The changes seldom caused symptoms and they were not confined to those diabetics with alimentary or genitourinary symptoms attributable to autonomic neuropathy. They suggest that autonomic neuropathy in diabetes is widespread and often subclinical. Degeneration of the ganglion cells of the oesophageal myenteric plexus is associated with hypersensitivity of the oesophageal smooth muscle to cholinergic agents. Bethanecol, a cholinergic drug with muscarinic actions, accelerated oesophageal emptying and increased the lower oesophageal sphincter pressure to normal levels in our diabetics but the hypersensitivity to this drug found in the presence of ganglion cell degeneration was not seen. This implies that in diabetic autonomic neuropathy the predominant lesion is in the preganglionic fibres of the vagus rather than in the myenteric plexus of the oesophageal wall.

Vocal shimmer during sustained phonation was measured in normal subjects and patients with laryngeal polyps, using the mean amplitude difference between consecutive cycles expressed in dB. A small laboratory computer was then used for measuring each discrete amplitude and for data processing. The results showed some overlap between the values for two groups studied, but nevertheless it appears that the measured value may be a useful index in screening for laryngeal disorders and for definitive diagnosis of such disorders.

Two cultures of acid-fast bacilli with characteristics most closely resembling those of Mycobacterium fortuitum were recovered as casual isolates from sputa of a patient with an apparent brochogenic tumor. One of the cultures was consistenly cream colored to rosy buff. The other, however, changed from buff to rust to dark brown and had the gross appearance of a fungus culture.

A case is presented of a patient who developed ocular symptoms and a skin rash after treatment with oxprenolol (Trasicor) for 2 months. The lesions improved on withdrawal of the drug and her eye symptoms became worse when she was again treated with oxprenolol. Patients who receive beta-adrenergic blocking drugs must be watched carefully for side-effects

Old World monkeys were exposed to octaveband noise from 0.5 to 8 kHz at 120 dB SPL, 8 hours daily for 20 days. Restricted permanent threshold shifts and localized loss of outer hair cells were produced, which were reasonably well correlated with the exposure frequencies. There was also a loss of both inner and outer hair cells at the extreme basal end of Corti's organ, regardless of the exposure frequency. Implications for human inner ear pathology are discussed.