The use of chloramphenicol ointment as an adhesive for replacement of the nail plate after simple nail bed repairs.

Fingertip injuries are common and are often repaired. The nail plate is replaced to protect the repair and maintain the alignment of the nail bed edges after repair. Once replaced, this can be secured by any means and often a suture is used. We advocate that a small bleb of chloramphenicol provides a simple method of securing the nail plate. It is fast, easy and secure. In addition it provides an antibacterial effect, which may be of some benefit.

Malignant tumours of the minor salivary glands--a 20 year review.

The UK incidence of malignant disease of the minor salivary glands is only 0.6 per million per year. The tumours have a varied histology, can present in any age group and are frequently advanced if located in the sinonasal cavities. In a 20-year review of 21 patients treated for minor salivary gland malignancy in a single institution, it was found that mucoepidermoid tumours were more common in the oral cavity and adenoid cystic carcinomas in the sinonasal tract (p = 0.002). Outcome was variable with sinonasal and adenoid cystic carcinoma having a poorer outcome. Kaplan-Meier curves showed that oral tumours had a higher probability of long term survival. Radical surgery with reconstruction and post-operative adjuvant radiotherapy was effective in achieving loco-regional control. There were no local recurrences within 5 years and three after 5 years. Five patients developed metastatic disease within 10 years and a further two after 10 years. Late recurrences occurred and survival was mainly determined by the presence of systemic disease.

Antenna procedure for the correction of hook nail deformity.

A total of seven antenna procedures for hooknail deformity were performed between 1990 and 2000. At a mean follow-up of 3 years 4 months there were no major complications, all patients had an improvement in their deformity (subjectively and objectively) and were pleased with their results. Some residual deformity remained in all cases including shortening of the nail, contour defect of the pulp and flattening or residual curvature of the nail.

Basal cell carcinomas: do they need to be followed up?

Basal cell carcinoma (BCC) is the commonest of the malignant skin tumours. The follow-up of patients following excision of these lesions varies immensely. The aim of this study was to assess the need for outpatient follow-up of patients who had a primary BCC excised. A retrospective study was performed using the case notes of 206 patients who had a primary BCC excised in Bangour General Hospital in the years 1986 and 1987. Fourteen were excluded from the study, leaving 192 patients with 215 lesions. The overall recurrence rate was 5.1% with 39% of lesions recurring if the tumour was incompletely excised compared with 1% if it was excised completely. Complete excision is therefore the key to surgical control and we feel that there is no need to follow up patients routinely if the BCC has been completely excised.

Paleoclimatic setting for Homo sapiens neanderthalensis.

A paleoclimatic hypothesis is presented to account for the evolution and eventual replacement of Homo sapiens neanderthalensis. Neandertal populations in the European Late Pleistocene were largely isolated by geographic barriers. Populations of modern Homo sapiens replaced Neandertals at 34000 years ago, near the end of the relatively cold oxygen isotope stage 3. These population were pushed into Europe by conditions brought on by increasing aridity affecting North Africa and southwestern Asia, and their dispersal was facilitated by lowered sea level.