Increased areas of anesthesia in the oral cavity have been shown to significantly impair oral function in normal individuals. In patients who undergo oral cavity reconstruction, loss of sensation plays a major role in producing disturbances in postoperative oral function. Free tissue transfer techniques have permitted the problem of sensory loss to be addressed through the use of sensate cutaneous free flaps, in which microneural anastomoses are performed between a sensory nerve supplying the flap and a recipient nerve in the head and neck. To critically assess the results of such reconstructions, the effect of sensory restoration on oral cavity rehabilitation must be studied. As a first step toward this goal, normal values for sensory discrimination of the floor of mouth and tongue are needed. Previous studies of oral sensation failed to examine the ventral tongue and floor of mouth. The purpose of this study is to determine the surface sensibility of these regions in healthy patients and in patients who received radiation therapy to the oral cavity. Sensation was evaluated using static and moving two-point discrimination in 90 healthy subjects divided equally into three age groups: 20 to 40 years, 41 to 60 years, and 61 to 80 years. In addition, 20 patients who received radiation therapy were studied. The mucosa of the dorsal and ventral aspects of the lateral tongue, tongue tip, and floor of mouth was examined. The tongue tip is the most sensitive area, followed by the dorsal lateral tongue, ventral lateral tongue, and floor of mouth. The effects of age and radiation therapy on sensory discrimination are discussed.(ABSTRACT TRUNCATED AT 250 WORDS)

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Palliation and survival compare favorably with other series, including many surgical series. The response findings encourage studies of both unresectable and (as neoadjuvant therapy) resectable tumors.

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Six patients with intraocular (vitreous) lymphomas were treated with high-dose intravenous cytosine arabinoside (Ara-C). Four patients were previously untreated, one patient had previously received ocular and central nervous system radiation therapy and relapsed, and one patient had previously received chemotherapy for systemic lymphoma. Five responses were observed: one complete and four partial. High-dose Ara-C is active in intraocular (vitreous) lymphoma, but complete response is uncommon. Adjunctive use of Ara-C in combination with ocular irradiation may be a useful form of therapy in this uncommon lymphoma.

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Twenty patients with inoperable locally advanced Stage II and III pancreatic cancer were treated with combined modality therapy. Radiotherapy consisted of split courses of 2000 cGy each and, as needed, an additional 1400 cGy, separated by 2-week intervals. Simultaneous multidrug regimen chemotherapy consisted of 5-fluorouracil, continuous infusion, 1 g/m2 days 1-5; streptozotocin, 300-500 mg/m2 days 1, 2, 3; and cisplatin, 100 mg/m2 day 3 of every 4-week radiotherapy course (RT-FSP). Primary tumors decreased more than 50% in volume in 11 of 20 patients. Computed tomography scans demonstrated apparent complete disappearance of the primary tumor in 7 patients. Only 3 patients had tumor regrowth within the radiotherapy field, all after the end of radiotherapy. Local control improved as measured by increased frequency of tumor shrinkage and decreased frequency of primary tumor growth, recognizing the limitations of a pilot study and comparisons to best historical results achieved with standard short 5-fluorouracil schedules and radiotherapy. Successful local control largely eliminates the most common cause of refractory pain and may decrease the need for some forms of early palliative surgical intervention. Tumor shrinkage sometimes downstages tumors, creating frequent investigational opportunities for either elective extirpative surgery or intraoperative radiotherapy. This pilot experience also supports testing of expanded eligibility staging criteria for combined modality treatment and testing of new drugs as part of 5-fluorouracil-radiotherapy-based regimens.

As organizations continue to respond to the existential challenge that is climate change, the extent to which employees engage in environmental sustainability is critical to that response. This study introduces new measures of pro-environmental employee engagement, pro-environmental job resources and pro-environmental meaningful work. Based on engagement theory, a model is tested that shows how perceived corporate environmental responsibility, pro-environmental job resources (supervisor support, involvement, information) and pro-environmental meaningful work (a personal resource) influence pro-environmental employee engagement. Online self-report survey data were collected through convenience sampling from 285 full-time and part-time employees (aged 18–89 years) working across a range of occupations and organizations in Australia. Data were analyzed using a confirmatory factor analysis (CFA) and structural equation modelling (SEM). In support of the proposed model, CFA and SEM results generally yielded a good fit to the data. Eight of nine proposed direct effects involving corporate environmental responsibility, pro-environmental job resources (modelled as a higher-order construct), pro-environmental meaningful work, and pro-environmental engagement, were significant. All proposed indirect effects within a re-specified model were significant. The final model explained 51% of the variance in pro-environmental job resources; 20% in pro-environmental meaningful work; and 71% in pro-environmental employee engagement. Overall, the results indicate that perceived organizational, job and personal resources play a motivational role in enhancing pro-environmental employee engagement. The study contributes a theory-based model and new measures of employee pro-environmental resources and engagement. The model can be applied to help organizations assess and develop interventions to address the critically important issue of environmental sustainability. Future research directions and study limitations are discussed.