Placing the maxilla in the most aesthetic sagittal position: validation of several reference lines in relation to the forehead shape.

The ideal sagittal position of the maxilla is highly subjective in orthognathic surgical treatment planning. There is no consensus on an analysis to predict the ideal sagittal position of the maxilla. The objective of this study was to determine the preferred maxillary position in relation to the forehead shape, in the Southern Chinese population. The maxilla position of eight patients was simulated based on Steiner's analysis (SA), glabella vertical (GV), Andrews' Element II (AE2), and the Barcelona reference (BR). The simulations were then used in an electronic survey, where respondents ranked the images for each patient from to 1-4 (most to least attractive). A total of 128 responses were collected from dental professionals and laypersons. The most preferred to the least preferred simulation was as follows (mean rank scores for the male and female patients in parenthesis): BR (males 2.06; females 1.98), GV (males 2.11; females 2.21), SA (males 2.59; females 2.40), and AE2 (males 3.24; females 3.41). There was no significant difference in the results according to the sex, age group, or profession of the respondents. The Barcelona reference and glabella vertical are useful in predicting the ideal maxillary position in patients with a flat forehead, and the Barcelona reference is the most preferred in patients with a rounded forehead.

Unusual metastatic presentations of a primary right parapharyngeal acinic cell adenocarcinoma.

Acinic cell adenocarcinoma (ACA) is a malignant epithelial neoplasm of the salivary glands. The patient reported herein presented with an unusual case of a metastatic ACA originating from the right parapharyngeal region, which eventually metastasized to the ipsilateral cavernous sinus and the contralateral mandibular ramus. The trigeminal nerve may have served as a channel for the spread of the cancer from the right parapharyngeal region to the cavernous sinus, and subsequently to the left mandibular ramus. The widening of the left inferior alveolar nerve canal was an early sign of metastasis in this case.

WICHE panel of expert consultants report: implications for nursing leaders.

A Panel of Expert Consultants, convened for WICHE's Analysis and Planning for Improved Distribution of Nursing Personnel and Services Project, projected nursing requirements for 1982 using an analytic model. Their projections and their recommendations for educational preparation, distribution of nursing services, practice, and planning to meet projected needs have important implications for nursing administrators and nursing educators.

Nursing care of oncology patients receiving chemotherapy.

As part of a research effort directed at identifying specific nursing activities related to the subsequent health status of the patient, this study explored relationships between selected nursing activities and patient outcomes for the oncology patient who was receiving chemotherapy. The study was correlational in design and descriptive in nature. Included in the study were 57 subjects from oncology and/or medical units in public and private nonprofit general hospitals. Human subjects' clearance was obtained for the study in each participating hospital. Data were collected primarily by means of patient and nurse responses to self-administered questionnaires. In the initial phase of data analysis, zero-order correlations were obtained for each pair of nursing activity and patient outcome variables. In addition, to identify relative contributions of different nursing activities to the health status of patients, regression analyses were performed in selected situations. The content and the quality of the explanation of the treatment and care regime were observed to be correlated positively with the patient's self-esteem. The quality of the explanation was observed to be positively related to the patient's knowledge base. Involving the patient in his care plan and giving him control over the activities of the day were positively correlated with importance of having things explained to him.