Fever and parturition. An experimental study in rabbits. The hyperthermic effect of purified lipopolysaccharides (Pyrexal, Wander) was tested and analyzed in pregnant rabbits. The fever produced premature deliveries - probably caused by oxytocin, released from the posterior pituitary - in 50% of 40 tested rabbits on the 31st day of gestation. Injections of Syntocinon had a roughly equally strong effect. In control animals injection of saline did not accelerate delivery. The offspring of several animals, in which hyperthermia had been induced, were born dead. Fever during pregnancy thus can result in premature delivery and in injury to the fetus. Fever and febrile conditions occurring during pregnancy should therefore be treated as promptly and as effectively as possible.


Cervical cancer. Mass screening, incidence and mortality in Finland. Since mass screenings were started in Finland, the incidence of cervical cancer has dropped by about 50 per cent. In the age groups 25-60 the decrease has been two thirds. Moreover, there has been a similar decrease in mortality in the younger age groups, in particular. All risk groups are not covered by the screening program, however. Cervical carcinoma is still a socio-medical and clinical problem particularly among elderly women.


Mass screening in Sweden for cancer of the uterine cervix. Results and epidemiologic effect. The mass screening program in Sweden for cancer of the uterine cervix, which was started in 1964, is now almost nation-wide. Approximately a quarter of a million women are screened every year. The attendance varies between 55 and 90%. Approximately two per cent of the screened female population is invited to further examination or treatment. The yield through the mass screening program varies between 3.5 and 10 positive cases per 1000 examined women. The incidence of cancer of cervix is decreasing. This is most evident in those counties, which have been carrying out the screening program for about ten years. The stage distribution in cancer of the cervix has not been changed by the screening program. Mortality in cancer of the cervix is unchanged. There has been an enormous increase in the number of diagnosis of cancer in situ of the cervix, which is a difficult practical problem.


Direct analysis of volatile organic compounds produced by fungi. A gas chromatographic head-space technique has been developed for the analysis of volatile organic compounds produced by fungi. The method described is useful for establishing the pattern of volatile compounds emitted by an organism and for following the time course of production of volatile metabolites. Many of these volatile products are physiologically active and influence the growth and development of the same or other organisms.


Intake system using glass ampoules for gas chromatographic analysis of volatile compounds of biological origin. A gas chromatographic intake system using 1 ml glass ampoules is described. Examples of analyses of gases and volatile organic compounds produced by soil and soil organisms incubated in the ampoules are given. The gas chromatographic system was used to analyze permanent gases produced by germinating Fusarium conidia and by an agricultural soil as well as to study the respiration of Panagrellus nematodes. A comparison of the gas chromatograms of volatile organic compounds present in a beech forest soil and an agricultural soil indicates that the chromatograms represent "finger prints" of the two soils. Results obtained with the intake system described are compared to those obtained using a conventional head space technique.


Pyrolysis gas chromatography -- a potential technique for characterization of complex organic material. A pyrolysis gas chromatography (PGC) technique is described and various pyrolysers discussed. Results from analyses of synthetic polymers and organic salts are given. The influence of temperature rise time, pyrolysis temperature, pyrolysis time and sample size is considered. Pyrolysis studies on microorganisms are described various ways of improving the technique are considered.


Pyrolysis gas chromatography of microorganisms. Influence of various pyrolysis parameters on the yield of volatile organic products. Bacteroides fragilis was analysed by pyrolysis gas chromatography (PGC). The influence of temperature rise time, pyrolysis temperature and pyrolysis time on the yield of volatile organic pyrolysis products was studied. The use of short pyrolysis time (8 msec) and a high pyrolysis end temperature (1300 degrees C) was found to provide a high yield. In consecutive analyses of the test organism, under the pyrolysis conditions indicated, the standard deviation of the total yield of volatile organic products was +/- 7%. The pyrolysis technique described suggests that few secondary reactions of the pyrolysis fragments occur.


High-pressure liquid chromatography as a tool for determination of antibiotics in biological fluids. The toxicity of some antibiotics used today necessitates rapid, specific and accurate determinations of antibiotic concentrations in biological fluids. Microbiological assays do not fulfill these needs and new procedures have recently been developed, for instance, fluorimetric assays, radioimmunoassays and radioenzymatic assays. However, these techniques have not been generally applicable to various antimicrobial agents. - The technique for high-pressure liquid chromatography (HPLC) has recently been applied to determination of antibiotics in biological fluids. The methods involve extraction of drug from the biological samples, separation by HPLC and detection by ultraviolet spectrophotometry of fluorimetry. Results obtained with tetracycline, amphotericin B, and cephalothin show that this procedure meets the demands for rapid, specific and accurate monitoring of antibiotic concentrations in body fluids. Because of its versatility, the HPLC technique seems to be applicable to the determination of a variety of antibiotics and other drugs in clinical and experimental medicine.


3H-TDR labelling of osteoprogenitor cells after 226RA incorporation in mice. The time course of 3H-TDR labelling index of osteoprogenitor cells and the doses in endosteum of lumbar vertebra and distal femoral epiphysis were autoradiographically determined in young female mice after single injections of 19.7 and 55.9 micronCi/kg body weight of 226Ra. The selected bone areas were examined in animals killed 2 hours to 28 days after the injection of nuclide. It was ascertained that changes in the relative labelling index are depending on the absorbed doses of alpha radiation. The possible relevance of these experimental findings for the explanation of the osteosarcoma induction and localization is discussed.


Blast crisis of chronic granulocytic leukemia. Morphologic variants and therapeutic implications. Chronic granulocytic leukemia (CGL) terminates in a disease similar to acute leukemia. Except for a study indicating an increased response rate to the drugs, vincristine and prednisone, therapy of this terminal phase has been universally disappointing. We have studied the bone marrows and clinical courses of 67 patients in the terminal phase of CGL to discern if any parameters were associated with an increased response rate or survival. The results of this study indicate that patients who have a lymphoblastic morphology or hypodiploid cytogenetics in the terminal phase respond better to treatment with the combination of vincristine and prednisone than those with myeloblastic morphology or hyperdiploid cytogenetics. Response rate and survival are significantly increased in those with lymphoblastic morphology. Recognition of the heterogeneity of the terminal phase of CGL may dictate specific therapeutic modalities.


A photographic study of the soft-tissue profile of the Negro population. The present investigation was undertaken to compare the Ricketts, Steiner, and Holdaway soft-tissue values to the Negro individual. The study involved the photographs of more than 1,000 North American Negroes, (500 males and 500 females). One-hundred of the most attractive were selected by a group of judges of different social status levels. In this group fifty male and fifty female soft-tissue profile analyses were performed. The analyses considered were Ricketts' esthetic plane, Holdaway's H line, and Steiner's S line, because they are the most often used and widely accepted. The results of the investigation showed that the black individual was more protrusive in soft-tissue profile and that the standards for white persons established by Ricketts, Steiner, and Holdaway are not applicable to the black individual. Black males were reported to be more protrusive than black females. The study utilized a line drawn from soft-tissue nasion to soft-tissue pogonion. Measurements were made from this line to evaluate the soft-tissue profile. The use of this line suggests a method for measuring the profile in millimeters.


A vertical cephalometric analysis of the human craniofacial complex. A vertical analysis involving ten linear measurements was developed to localize skeletal and dentoalveolar dysplasias. The measurements are of biologic relevance, reflecting the amount of growth harmony or disharmony to the examination and record-taking time. The vertical dimensional analysis uses the age- and sex-related University of Michigan mean values for comparative data for each measurement. Ratios were computed for a five-unit proportional analysis. Both analyses were applied to assess the vertical problems of three female patients. The analyses detected specific areas of dysplasia for each patient.


[The closed system. A discredited conception of the past, by innovations the method of choice (author's transl)]. The closed circle system is a secure, modern, totally clean and economic anaesthetic system if there is an O2-control system like the O2-Biomarine, a CO2-control system like the ultrared absorption system at an O2-gas flow of about 250ml per minute and an intermittent N2O supply of 500 ml per minute applied in adult anaesthesia patients. The system has always to remain closed and can always remain closed and it has to be also leakfree. Overfilling of the bag has to be avoided, this can be achieved by totally stopping N2O-supply until the reservation bag or the Biomarine oxygen indicator do not make further N2O supply necessary. In the last four years we have used this closed circle system exclusively more than 17,000 patients. There are some advantages for the patient for example concerning the temperature and humidification of the narcotic gases, the body temperature and so on. Table 3 shows the equivalence and the superiority of the closed circle system in comparison to the semi-closed circle system and the semi open system. --Abbreviations of the description are: good=+, very good=++, excellent=+++, bad=-, very bad=--. From our experience we think that everyone who has learnt to use the closed circle system is no longer able to understand the use of the semi-closed circle system or even of the open and the semi-open system, as far as there are no special indications for them.


A simple method of diverting anaesthetic waste gases and vapours from the Engström ECS-2000 ventilator. A simple method of diverting anaesthetic waste gases from the Engström ECS-2000 ventilator is described. Unless special precautions are taken the digital volume measurement may be influenced; the simple solution of this problem is given.


Gilles de la Tourette's syndrome. Familial occurrence and precipitation by methylphenidate therapy. Gilles de la Tourette's syndrome was independently ascertained in two male cousins once removed. Previous studies have shown familial clustering of individuals with tics, but no consistent pattern of inheritance of Tourette's syndrome has been apparent. The onset and later exacerbation of symptoms in our younger patient were associated with the administration of CNS stimulants given for excessive motor activity. The adverse effects of methylphenidate and dextroamphetamine therapy on Tourette's syndrome supports the hypothesis that this condition results from a relative excess of CNS catecholaminergic activity. Physicians prescribing these agents should inquire about the presence of tics in patients and their families.


Treatment of chronic gastric ulcer a study of the treatment recived by 135 gastric ulcer patients in a western community. A study was made of the treatment received by 135 gastric ulcer patients within one month and within six months of diagnosis. The treatment was divided into three types. Effective measures included surgery and those measures that have been shown favourably to influence the initial healing rate of chronic gastric ulcer (i.e. hospital admission and carbenoxolone sodium). Ineffective measures included those that have been shown convincingly not to accelerate ulcer healing--diet, antacids, sedatives and no treatmen at all. Anticholinergic drugs were included in the third group where the evidence is conflicting. The patient's therapeutic status was assessed one month and six months after diagnosis. Within six months of diagnosis only 32% of patients received treatment that clinical trials have shown favourably to influence the course of gastric ulcer and approximately half received treatment that has never been shown favourably to influence the course of gastric ulcer. The social class of the patients and whether they were seen by a consultant physicians or family doctor made no difference to the form of therapy received.


A cheap oral therapy for Paget's disease of bone. Nine patients with painful Paget's disease of bone were treated for 200 days with a drug combination designed to elevated plasma calcium, hence stimulating the production of endogenous calcitoning and suppressing that of parathyroid hormone. This combination was oral calcium, a thiazide diuretic, a low phosphorus diet and aluminium hydroxide. Eight of the nine patients experienced sustained pain relief after 20--70 days. The mean plasma alkaline phosphatase (expressed as a percentage of the pre-treatment level) commenced to fall after 30 days of treatment and at 120 days was 58% of the pre-treatment level; this fall was sustained at 200 days. There was a mean rise of 0-08 mmol/l in plasma calcium; there was no significant change in plasma inorganic phosphorus or plasma creatinine. In view of the extremely low cost of this drug combination and its lack of side-effects, it is suggested it be considered as a treatment for Paget's disease of bone.


A comparison of oral theophylline and oral salbutamol in exercise-induced asthma. Ten patients with exercise-induced asthma were premedicated with oral salbutamol and oral theophylline on separate occasions before performing a standardised exercise test. Although both agents produced bronchodilatation, reflected by increases in peak expiratory flow rates (PEFR) at rest, they were generally ineffective in preventing an abnormal post-exercise fall in PEFR. Only one patient was afforded protection by salbutamol and another two patients by theophylline.


Myocardial ouabain content and susceptibility to ouabain cardiotoxicity associated with circulatory volume overload in the dog. The influence of circulatory volume overload on the myocardial uptake of ouabain and on cardiotoxicity was studied in the unanaesthetised dog with aorto-caval fistula. One hour after tritiated ouabain (0-02 mg/kg IV) both ventricles and atria contained more ouabain than did those of normal dogs (left ventricle (LV), 166+/-23 (SD) ng/g vs. 97+/-19 ng/g, P less than 0-001) while concentrations in skeletal muscle, liver, kidney and plasma were not different in the two groups. In other experiments ouabain was infused to cardiotoxicity (7-5 microgram/kg followed by 3 microgram/kg/min). Cardiotoxicity occurred earlier in dogs with fistula than in normals (16-5+/-2-7 min vs. 24-1+/-2-4 min, P less than 0-001). Ouabain concentrations in myocardium were not different (LV, 434+/-58 ng/g, vs. 442+/-42 ng/g) while concentrations in liver and kidney were less in those with fistula (181+/-35 ng/g vs. 278+/-69 ng/g, P less than 0-001; 1422+/-189 ng/g vs. 2747+/-479 ng/g, P less than 0-001). Average content of skeletal muscle was also less, in proportion to administered dose. The increment in myicardial ouabain content associated with aorto-caval fistula appears to be physiologically active and hence is presumably specifically bound to the digitalis receptor. The observations in this model suggest the possibility of augmented cardiac glycoside uptake in some clinical cardiac diseases.


The use of non-activated prothrombin concentrate in the management of haemophilia A with factor VIII antibodies. Three children with haemophilia and antibodies to factor VIII were treated with a non-activated prothrombin concentrate (Prothrombinex) for 12 bleeding episodes. There was clear clinical response and joint aspirations were performed after infusions of phothrombinex in a dose of 30--50 factor IX units/kg body weight and there was no clinical evidence of thrombosis or febrile reactions. There was a significant shortening of the activated partial thromboplastin time (PTT) at one and four hours after the initial infusion with a return to pre-infusion levels 9--24 hours after infusion. The shortening in the PTT was less marked in subsequent infusions. There were no changes in the level of factor VIII procoagulant activity, factor VIII related antigen or factor VIII antibodies after the infusion. In two patients platelet function studies were unaltered by the infusion and in one patient procoagulant levels of factor II, IX and X were no greater than expected from the infusion. We conclude that infusions of non-activated prothrombin concentrates are clinically effective in the treatment of children with haemophilia and factor VIII antibodies but the mechanism of action is unknown.


Erythromycin jaundice: diagnosis by an in vitro challenge test. A 53-year-old housewife who had developed severe cholestatic hepatitis following the administration of erythromycin estolate therapy two-and-a-half years previously, was studied by an in vitro "challenge" test in which peripheral venous lymphocytes were cultured in the presence of erythromycin estolate, erythromycin stearate and erythromycin base. Evidence of blastogenesis was observed in response to erythromycin estolate, but not to erythromycin stearate of erythromycin base. This test thus provided evidence that the patient was "sensitized" to erythromycin estolate without exposing her to the risk of in vivo challenge. Furthermore, in contrast to previous studies, the findings provide evidence that erythromycin estolate jaundice is mediated by immunological mechanisms.


The pyloric septum: acquired or congenital? Pyloric septa are occacionally found on radiographic or endoscopic examination of the upper gastrointestinal tract. Their frequent association with peptic ulcer disease has supported an acquired etiology. The exact pathogenesis of this unusual anomaly, however, remains unclear and its natural history is unknown.


The Laurence-Moon-Biedl syndrome in a Singhalese family. The first published occurrence of the Laurence-Moon-Biedl Syndrome in a Singhalese family is reported. Three members of a family of six with first cousin non-affected parents are described along with studies to indicate that the hypogonadism in this family can be ascribed to hypogonadotrophism. The high incidence of congenital heart disease and genito-urinary abnormalities noted by other is confirmed.


Landry-Guillain-Barré-Strohl syndrome in typhoid fever. A case is described of a 15-year-old girl who developed Landry-Guillain-Barré-Strohl Syndrome (LGBSS) on the ninth day of typhoid fever. In the absence of other known cause or association of LGBSS Salmonella typhi is believed to be aetiologically related. The patient recovered uneventfully from her neurological illness in about ten weeks from onset of symptoms.


Werner syndrome.

Werner syndrome. A case of Werner syndrome is reported. The patient was prematurely old, had skin atrophy, characteristic posterior subcapsular cataracts and prepubertal primary hypogonadism. Additional ocular features compatible with premature ageing included presbyopia, arcus seniles and diminished tear flow. Diabetes mellitus, poliosis, baldness and beak-like nose were not present.


Fertility and the physician.

Fertility and the physician. Gonadal function in both sexes is under the synergistic control of the pituitary gonadotrophins, follicle stimulating hormone (FSH) and luteinising hormone (LH) which are in turn influenced both by the hypothalamus (via the gonadotrophin releasing hormone) and by feedback signals from the gonads. There is good evidence that such feedback is mediated by steroid hormones and by a product of the germinal epithelium, termed inhibin. A logical approach to reproductive disorders involves the localization of the primary disturbance either to the hypothalamo-pituitary unit or to the gonad, on the basis of history, physical findings and the results of hormone assays. In men, the majority of disorders leading to infertility are of unknown aetiology and cannot, therefore, be treated specifically. In women, anovulation is usually readily treatable and recent studies have emphasised the usefulness of prolactin assays and of specific treatment for hyperprolactinaemia in restoring ferility. Increased understanding of the mechanisms leading to infertility may provide valuable new approaches to fertility control.


The vascular complications of digital replantation. A report on a series of 18 digital replantations is presented. The overall survival of digits was 13 (72%). All but one of the crush and avulsion amputations developed vascular complications. Venous insufficiency was much more commonly seen than arterial. Substantial blood loss was the rule in all digits which developed further vascular problems. A conservative approach is advocated for the majority of these complications.


Microsurgical vasovasostomy: a reliable vasectomy reversal. Optimal results of repair of a severed tube can be expected when a meticulous atraumatic microsurgical technique is based on a detailed knowledge of the anatomy and function of the tube. A reliable vas repair after vasectomy involves the avoidance of leakage or scarring in a tube of which the ends differ in internal diameter from 1 mm to 0-2 mm and in which the inner mucosal layer is difficult of access because of its solid muscular core surround. In addition, the healing will only occur without massive scarring and the nerve supply will only return if the blood supply can be retained as close as possible to the anastomosis. The technique described was first researched in the Macaque monkey and requires considerable microsurgical expertise. It has proved reliable in that 98% of the first 50 patients showed sperms in their ejaculates three months after operation, with a 62% pregnancy rate after an operation on one side only. The vasectomies had been performed up to 13 years before, and one can only conclude that a routine scrotal vasectomy should not be considered irreversible.


Vascular compression of lower cranial nerves: observations using microsurgery, with particular reference to trigeminal neuralgia. A new finding made possible by the use of the operating microscope in neurosurgery is discussed. Nineteen patients with trigeminal neuralgia have been explored, and in 14 of these vascular compression of the fifth nerve at its entry zone to the pons has been found. Relief of this vascular compression has caused cessation of pain in all these patients. In addition, one patient with hemifacial spasm, and one patient with glosso pharyngeal neuralgia, are reported; each of these also had vascular compression of the appropriate nerve causing the symptoms.


Ergonomics applied to the practice of microsurgery. Microsurgery presents special problems of visual information and fine manipulation, including tremor control. These problems can be studied usefully through ergonomics, the science of man at work, already used widely in industry. This paper presents factors affecting visual feedback, normal hand tremor, and instrument design, and refers to the process of skill acquisition and the care of surgical instruments.


The catheter team: an essential service for rehabilitating neurogenic bladders. A carefully controlled programme of intermittent catheterization provides substantially better care of the bladder than indwelling catheters during the initial period after acute spinal cord injury. It is very difficult to maintain a programme of intermittent catheterization around the clock without a small team of nursing personnel highly skilled in the technique of aseptic catheterization. the practical details of setting up a catheter team are described. Some of the results that have been associated with the establishment of such a team at the Rehabilitation Branch of the Royal Perth Hospital are presented.


Orthopaedic surgery and rehabilitation in rheumatoid arthritis. Orthopaedic surgical procedures are episodes in the continuing management and rehabilitation of the patient with rheumatoid arthritis. Well-chosen procedures give excellent relief of symptoms and deformity, and successful management is a prime example of rehabilitation requiring considerable team work from physician, surgeon, therapists, social workers and nursing staff. Team work enables the rheumatologist to be in charge of the overall management of the patient through the clinic with responsibility for general medical care, while the surgeon can take charge during periods in hospital for surgery and the immediate postoperative outpatient care. Cooperation between physician and surgeon eases each of some of the clinical burden that is at present provided by this disease.


Complete remission of metastatic malignant melanoma following immunotherapy with Bacillus Calmette-Guerin (BCG): report of a case. A complete response to BCG is described in a case of recurrent melanoma. In a woman aged 38 years, intracutaneous metastatic deposits confined to the limb of origin had occurred after excision of a malignant melanoma from the ankle, and elective groin dissection had shown two lymph nodes infiltrated with melanoma. BCG vaccine was applied to the buttock, initially by scarification and later by a multiple puncture gun. All metastases slowly regressed, and biopsy of a metastatic site at six months showed no tumour cells. The patient remains free of detectable disease 36 months after the commencement of therapy. It is inferred that BCG may facilitate remission of melanoma, perhaps by reason of antigenic cross-reactivity between BCG and surface components of human melanoma cells.


Hepatic metastases from colorectal carcinoma: an analysis of survival rates and histopathology. Out of 338 patients undergoing laparotomy and resection of a primary colorectal carcinoma, 49 (14-5%) were folnd to have liver metastases. The average age was 70 years. The median period of survival was 11-4 months. The histological grade of malignancy of the primary tumour did not appear to influence the survival rate. Compared with similar tumours in patients without hepatic metastases, the primary growth showed a significantly increased incidence of venous invasion, a higher grade of malignancy, and a more frequent origin from the right colon. When the local spread of the primary tumours was investigated it was found that one-third of them had not progressed beyond Stage Dukes A or B.


A new microsurgical needleholder.

A new microsurgical needleholder. Microsurgery demands precise and rapid manipulation of needle and thread with maintenance of special respect for the fragility of the tissues. The design of the needleholder is of paramount importance in achieving these goals. The instrument described below is light, long enough to rest comfortably in the hand, and balanced in such a way that it can be manipulated into awkward corners with relative ease.


Amputation: surgical technique and postoperative management. The decision to amputate should be made with due consideration of the eventual rehabilitation of the patient. With this in mind, general principles of amputation surgery are outlined and specific levels of amputation are described. Early post-amputation management has advanced over the last two decades to make rehabilitation goals the more readily reached. These advances are discussed.


Current practice of peripheral arterial surgery. Current methods of assessing and treating common problems in peripheral arterial surgery are reviewed, Topics specifically excluded are extracranial arterial disease, renovascular reconstruction, the thoracic aorta, and the upper limb arteries.


Aspects of the microcirculation.

Aspects of the microcirculation. The microcirculation is an important but little understood part of the cardiovascular system. As new techniques have been developed, more accurate information has become available concerning the changes in the microcirculation in both health and disease. A review has been made of some of the more important facets of the microcirculation of particular interest to surgeons. Reference is made to basic physiology, especially the mechanisms controlling flow in the microcirculation. The significance of changes in small blood vessels in hypovolaemic, septic, and progressive shock is also discussed, and the role of platelet aggregation in shock states is explored.


The initial phase of gastric emptying before and after vagotomy and pyloroplasty. The initial phase of gastric emptying of solid food was monitored with the use of a gamma camera and on-line computer facilities. In normal subjects a consistent pattern was seen comprising an early delay in the onset of emptying ("plateau"), followed by an exponential decay curve. After vagotomy the plateau was lost, and the exponential pattern of emptying commenced once the stomach was full. There was no evidence of sudden "dumping" of contents from the stomach. The overall rates of emptying as measured by the half emptying time (T 1/2) were the same in normal and postvagotomy subjects.


Clinical experience with Samoans in Auckland, New Zealand. Samoans constitute the second largest ethnic Polynesian minority group in New Zealand. Generally, this is a socially and culturally deprived group from a European viewpoint. Causative factors of social and emotional stress and coping mechanisms are described. A number of culturally determined syndromes are encountered clinically. These are categorized. A practical, clinical approach to the Samoan patient is suggested.


Cognitive function and length of survival in elderly subjects living at home. 177 people aged 65 or over, chosen at random from larger representative samples of elderly people living at home in Newcastle upon Tyne, were given the Weschler Adult Intelligence Scale (WAIS) or a shortened form of it, and followed up for 7 years or till death. Discriminated function analysis showed that the power of the test score to predict death occurring within 2 years was not explained away by its correlations with age, sex, social class or physical disability. Exclusion of clinically diagnosed chronic brain syndromes reduced but did not abolish the relationship found to exist between test score and outcome. The ascertainment of impaired cognitive functioning has important applications in the assessment of prognosis and in the planning of care of elderly people.


Attitudes of young drug users towards significant life concepts as measured by the semantic differential. Thirty young drug users were matched for age and sex with thirty young orthopaedic outpatients. All completed an Osgood Semantic Differential. Results suggested that drug users see Drug Laws and Present Attitudes to Drug Use as bad. In the user group a poor perception of self is combined with concepts of ideal self which appear unattainable.


Crisis, life events and accidents.

Crisis, life events and accidents. Using two life event scales, we found that patients who had sustained accidental injuries had experienced more changes in their lives over the past six months than a matched control group drawn from students and persons undergoing minor surgery. The implications of this finding are discussed.


Early psycho-social assessment of overdose patients in a casualty department. In response to the very large number of patients presenting at the Casualty Department of the Alfred Hospital, Melbouren, following suicidal acts, a Psycho-Social Assessment Clinic employing a crisis intervention model was established in 1970. This communication outlines the structure and functions of the Clinic, describes 100 consecutive new patients seen over a four month period in 1974 and emphasises the benefits to both patients and hospital arising from the operation of such a Clinic.


A method of controlled ventilation with a circle-absorber breathing system. A simple method of adapting a pressure-cycled ventilator of the flow generator type to ventilate patients on a circle-absorber anaesthetic system is described. Standard lengths of corrugated black rubber tubing are placed between the ventilator and the circle-absorber is deadspace, replacing the reservoir bag. The performance of this modification was investigated and a functional volume for the tubing calculated. There was a simple relationship between the tidal volume, the length of tubing and the fresh gas flow required to avoid dilution of the anaesthetic gases by the driving gases.


Effect of methylprednisolone on the nucleoside metabolism of a human lymphoblastoid cell line. Concentrations of methylprednisolone which have lethal effects on human lymphoblastoid cell lines in vitro cause a reduction both in the uptake of uridine and thymidine into acid-soluble material and their incorporation into acid-insoluble material. These effects are virtually instantaneous, which indicates that they do not depend on alterations in gene activity. Normal uptake of nucleosides into cells is by both simple and facilitated diffusion, and methylprednisolone appears to act directly on the cell surface to inhibit only facilitated diffusion uptake.


[Extracorporeal treatment with L-asparaginase (author's transl)]. L-asparaginase therapy is often limited by allergy or toxicity and probably in some cases by antibody mediated inactivation of the enzyme. These problems can be avoided by extracorporeal application of l-asparaginase. As the enzyme is a stable tetramer with high molecular weight it cannot pass through the dialysis membrane in contrast to the amino acid l-asparagin which is destroyed. The resulting l-asparagin depletion of the plasma is  sufficient for therapeutic success. Effective extracorporeal l-asparaginase therapy is demonstrated in two patients with ALL who were resistant to other chemotherapy and could not be treated intravenously because of allergy and toxicity.


A test with dexamethasone in acute leukemia. A simple test with dexamethasone (DMS) in acute leukemia (AL) is described. In peripheral blood, blast cell count is determined before 8 mg DMS are given intravenously, and 2, 4 and 6 hours afterwards. The result is expressed as the lowest blast cell count after DMS in percentage of the initial value. This test was performed on 51 adult patients with AL. The results were correlated with the morphological and cytochemical classification. Only patients with clearly classified AL were evaluated. A statistically significant difference in blast cell response between acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML) was observed. In 12 out of 16 cases of ALL, but in only 1 out of 19 cases of AML, the blast cell count decreased to 50 percent or less of the initial value. The results of the test were further correlated with the results of treatment. In 11 out of 12 patients with ALL, who showed a response to DMS, glucocorticoids were included in the treatment regimen. A complete remission was obtained in 7 out of 10 patients who were treated for the first time. In the remaining 4 patients with a poor response to DMS, a complete remission after the first treatment was obtained in only one case. The number of patients examined is to small for final conclusions on the value of this test for a discrimination between glucocorticoid-responsive and non-responsive cases of AL. Nevertheless, these preliminary results indicate that further trials seem to be warranted.


[Isoenzymes of acid phosphatase in blood cells of normal subjects and patients with leukemia (author's transl)]. The activities of acid phosphatases (AP) were measured in leukocytes from patients with chronic myelocytic leukemia (CML), macrophages, granulocytes, in the fractionated mononuclear cells of patients with CML and with hairy-cell-leukemia (HCL) and in the cells from patients with acute leukemia (AL). The lowest activities were found in lymphocytes of normal subjects and of patients with chronic lymphatic leukemia (CLL) and in thrombocytes. Isoenzyme (IsE) 1 was characteristic for thymocytes, IsE 2 for granulocytes, IsE 3 for pathologic blast-cells, lymphocytes and thrombocytes, IsE 4 for macrophages, IsE 5 with components a and b for the mononuclear fraction of patients with HCL. In addition IsE 5 was detected in lymphocytes, macrophages and CLL-cells. In 4 patients with HCL the relative percentage of IsE-5-fraction was slightly greater than the percentage of tartrate resistant cells. In two patients with questionable HCL well marked IsE-5-fractions were recognized but no tartrate resistant cells. In one patient with HCL a relatively high percentage of tartrate resistant hairy-cells and in comparison an inadaquate low IsE-5-fraction was found. These different relations were explained with the more sensitive method of gelelectrophoresis and different affinity of substrates to AP.


Fanconi anemia leading to acute myelomonocytic leukemia: cytogenetic studies. A 6-year-old boy with Fanconi anemia, developed acute myelomonocytic leukemia with marker chromosomes from an interchange in the malignant clone in the bone marrow. The possible aetiological role of therapy, the morphological characteristics and chromosome aberrations of the bone marrow cell line are discussed in relation to previous reported cases of Fanconi anemia in which acute leukemia has supervened.


Conceptions of Finnish people about their periodontal situation. The conceptions of Finns regarding their own periodontal status were surveyed in 1972. The interviewed sample, drawn to cover the total Finnish population aged 15 years and over, comprised 965 persons. After exclusion of 233 edentulous subjects, a total of 732 dentulous persons were accepted for the present interview study. 10 percent of the interviewees were aware of their having gingivitis at that time. 57 percent were of the opinion that they had never had gingivitis. On the other hand, 20 percent of the interviewed persons had recently observed gum bleeding while 54 percent stated that they had never observed it. 21 percent of the interviewees were aware of their having dental calculus and 46 percent had the impression that they had never had calculus. 24 oercent of those interviewees who presently had calculus or had had calculus stated that they had never had it removed. Generally Finns failed to realize that gingival bleeding is a symptom of gingival inflammation. This point should be made clear in the dental health education of the future. The knowledge could help individuals to evaluate the state of their own periodontal tissues in order to obtain the best possible benefit from efficient home care.


Oral health status in relation to socioeconomic and ethnic characteristics of urban adults in the U.S.A. Nearly 1,300 adult members of a prepaid medical group plan in New York City were screened through automated multiphasic health testing in a series of test stations including a dental station, during 1971-1973. Oral status indicators were developed including a number of missing teeth, scores to measure levels of gingival and periodontal disease, Simplified Oral Hygiene Index scores, and ratios of decayed teeth. Ratios of filled teeth were calculated to measure levels of restorative care. The present paper examines the interrelationships of economic status, education and ethnic origin with each of the above oral status measures. It was found that variations in ratios of decayed and of filled teeth were primarily due to economic status while variations in a number of missing teeth, oral hygiene levels and levels of gingival and periodontal diseases were primarily due to screenees' educational level. Ethnic group differences could be explained in part by differences among these groups in economic and and educational levels. There were no consistent ethnic patterns, however, and while some differences could be explained by controlling for education and economic status, others persisted.


Relationship between sociomedical factors and TMJ-symptoms in Norwegians with myofascial pain-dysfunction syndrome. The relationship between background characteristics, stress, reported symptoms and clinical findings was studied in a group comprising 333 patients with Myofascial Pain Dysfunction Syndrome (MPD). Three-quarters of this clientele were women, most of them of young or middle age. The stressors most frequently reported were pressed working conditions, anxiety and frustration deriving from disease, and family problems. Of the symptoms, pain was reported by 78 percent of the patients, clicking by 53 percent, limitation of movement by 44 percent and feeling of stiffness and fatigue of masticatory muscles by 41 percent. Significant correlations were found between a number of variables, of which the close relationship between perceived pressors and muscle groups painful to palpation was considered to be a paramount importance. The data were combined into a hypothetic model postulating causal relations. The model was intended for testing and modification in coming studies.


Caries experience and oral cleanliness of 3- and 4-year-old children from deprived and non-deprived areas in Edinburgh, Scotland. Caries experience and oral cleanliness were measured in 1,453 3- and 4-year-old Edinburgh nursery schoolchildren living in areas of multiple urban deprivation and of non-deprivation in the city of Edinburgh. Children with poor oral cleanliness had a mean dmf value of 3.6 teeth compared with 1.6 teeth in those with good oral cleanliness. The greatest relative increases in caries experience were seen in the incisor and canine teeth and upon the occlusal and approximal surfaces. Children living in deprived city areas had a mean dmf value of 3.0 teeth compared with 2.0 teeth in those from non-deprived areas. This difference in caries experience was partially accounted for by the different standards of oral cleanliness found between the deprived and non-deprived areas. In the deprived areas there was a trend towards a high caries experience which was independent of the standard of oral cleanliness. The children were in considerable need of dental care. Only 23 percent of dmf teeth had been either extracted or restored.


Sympathetic cardiovascular reflex initiated by bradykinin-induced stimulation of cardiac pain receptors in the dog. 1. Bradykinin (0.02-5 microgram) applied to the epicardium of the left ventricle in the open-chest, anaesthetized dog, elicits dose-related reflex pressor effects and acceleration of the heart rate. 2. Bradykinin-induced reflex tachycardia was suppressed after the blockade of beta-adrenoceptors with propranolol, whereas reflex pressor responses were prevented by blocking the alpha-adrenoceptor sites with phenoxybenzamine. 3. Vagotomy and atropine treatment did not affect reflex hypertension and tachycardia to epicardial bradykinin. 4. After spinal section at C1, the pressor responses to epicardial bradykinin were significantly reduced, but still present in all but one experiment. A small acceleration of the heart occurred in two out of five spinal dogs with intact vagi and was absent in three vagotomized spinal dogs. 5. The results indicate the reflex activation of the sympathetic outflow to the heart and blood vessels, mediated mainly at a supraspinal level as a predominant mechanism for the cardiovascular response initiated by bradykinin-induced stimulation of cardiac pain receptors.


Study of a fissure sealant in mentally retarded Canadian children. The occlusal fissure of 812 permanent and primary posterior teeth of 160 retarded children were sealed with a fluid resin which was polymerized with an ultra-voilet lamp. A half mouth technique was used to evaluate the effectiveness of the sealant in the prevention of fissure caries. The 1st year, the sealant was retained intact on 73 percent of the permanent teeth and on 64 percent of the primary teeth. After 2 years, the sealant was retained intact on 61% of the permanent teeth and on 40% of the primary teeth. The retention of the fissure sealant was better on premolars than molars both in the 1stand in the 2nd year. A single application of the fissure sealant was effective in reducing fissure caries up to 2 years.


A correlation study of diet, oral hygiene and dental caries in 457 Canadian children. The interrelationship of diet, oral hygiene and caries was evaluated. Of the sample size of 457 children, 234 were in grade 1 and 223 grade 7. Five-day diet surveys were obtained, followed by clinical examinations for oral hygiene and caries. One examiner, using mouth mirror, explorer and extraoral light, conducted the caries examination. From the diet surveys, refined and total carbohydrate consumption was calculated per day; between meals, at meals, and totaled for the day. Five-day totals, which included one weekend, were recorded along with frequency of eating per day and for the 5-day periods. Computer analysis revealed no significant correlation between the diet variables and caries or oral hygiene indices and caries. The children with high caries indices did not have the poorest oral hygiene nor consume the most carbohydrates. Similarly, the children with low caries indices did not have the cleanest teeth nor consume lesser amounts of carbohydrates.


Oral hygiene and gingival health in Danish dental students and faculty. This survey attempted to determine the status of oral cleanliness and gingival health in 150 dental students and 101 faculty members in a dental school. Without advance notice, plaque deposits were scored, using the Plaque Index System, and gingival health was determined using the criteria of the Gingival Index System. The 1st-year students had the poorest hygiene and gingival health. An improvement (P less than 0.01) was noted in the 2nd-year students who were still not in clinical training but had completed a course in preventive dentistry including oral hygiene techniques. Further improvement (P less than 0.05) was found in students participating in the clinical courses (3rd and 4th years). However, some deterioration of both hygiene and gingival status occurred in the senior 5th year. Among the faculty, the best oral hygiene and gingival state were found in members of departments in which clinical work centered around patient motivation toward prevention and tooth conservation. The scores for plaque and gingivitis were worse in the departments of oral surgery, dental materials, orthodontics and the basic science departments. Almost all departments and every class showed a few individuals with very poor oral hygiene. It is suggested that regular patient contact influences the personal attitude toward oral hygiene, and that professional activity and emphasis on different aspects of the curriculum may be reflected in the attitude of health professionals toward oral health.


Enamel mottling in a high strontium area of the U.S.A. As part of an epidemiologic study conducted in seven towns in Wisconsin, U.S.A., enamel mottling, opacities, and pigmentations were assessed in 1, 313 12- to 14-year-old schoolchildren. Enamel mottling was found to increase in prevalence and severity as strontium concentrations in communal drinking water increased. This trend held for lifelong residents only, and could not be demonstrated among children who immigrated to the towns after 1 year of life. No relationship of enamel mottling and water fluoride concentrations was found.


Pilot study on dental erosion in a Norwegian electrolytic zinc factory. In 12 workers in a Norwegian factory using electrolytic methods to extract zinc, a relationship was found to exist between degree of erosion, number of teeth affected and the length of service. The prevalence of caries, abrasion and attrition was not higher than in comparable population groups. The correlation between diagnosis of erosion based on clinical examination, and diagnosis based on evaluation of color slides was good.


[Glycogen storage disease (Pompe's disease) presenting as myopathy in the adult (author's transl)]. In a 46-year-old woman with progressive atypical limb-girdle dystrophy for eight years the electromyogram revealed a myopathic pattern with signs of denervation activity. Enzymehistochemical and biochemical investigations of muscle and liver biopsies indicated type II glycogen storage disease (Pompe's disease). This type, with its prolonged course and the almost exclusive clinical involvement of proximal muscles mimics a "degenerative" neuromuscular disease, particularly muscle dystrophy, in the adult. Caused by acid maltase deficiency it is not a rare disease.


[Frequency and differentiation of odontogenic tumors]. The odontogenic tumors stand for a group of lesions of a most interesting and fascinating kind. They represent mirror images of an uncontrolled odontogenesis. The insurmountable problems of insufficient knowledge of etiology, its exceptional rarity and diversity, as well as the lack of a generally accepted nomenclature and classification, defeat almost every attempt to gather and estimate clinical data of the various tumor forms. Considering these problems, various diagnostical criteria to deliminate each single tumor form have been valued and tabulated by means of statistical data, taken from world literature. Easily comprehensible clinical diagnosis, such as sex, age, location, and "characteristic" x-ray results have been valued and tabulated. From the variety of these most different classifications, being mentioned in a short historical survey, the "Histological Typing of Odontogenic Tumours, Jaw Cysts, and Allied Lesions", published by the WHO in 1971, has been chosen and taken as a basis. In addition to this rarely publicised data concerning the absolute and the relative frequency of these tumors have been compiled.


[Multiple odontomas in Gardner's syndrome]. A case of Gardners syndrome is described. This illness, inherited by autosomal dominance clinically shows multiple soft tumours, osteotomatosis, occasionally also odeontomata and polyposis intestinalis. The almost invariably occuring malignant degeneration of single intestinal polyps has led to the inclusion of Gardner's syndrome into the group of precancerous conditions.


[Odontomas with special reference to Gardner's syndrome]. Analysis of world literature appears to show that large hard odontomata of the jaw are relatively rare. 43 such odontogenous tumours are reported which were treated during 30 years in the maxillo-facial clinic in Heidelberg and in which the feasibility of mandibular reconstruction following partial resection was considered. The attention of dentists and maxillo-facial surgeons is drawn to odontomata, which are part of the symptom complex of Gardner's syndrome; a case is described where this rare disease presented.


[Clinical aspects, evaluation and treatment of odontogenic myxomas (fibromyxomas)]. Myxomata are benign, locally invasive, growing tumours which presumably arise from the connective tissue of dental papillae. They grow slowly and do not give rise to any symptoms. They are therefore of considerable diagnostic importance. They arise in the dentigerous part of the jaws and extend into the ramus of the mandible and from the maxilla into the maxillary sinus. X-ray shows them as mono- or polycystic spaces. The benign nature of myxomata leads to the temptation to operate conservatively. Excochleation and curettage have a recurrence rate of about 25%. Further excision is therefore required which, depending on the extent of the tumours, consists of partial resection of upper or lower jaw. Personal experience of 10 patients is given and discussed.


[Studies on maxillary growth in patients with cleft palate]. Breadth, length and height of the maxilla and palate measured on models of children with cleft palate decrease at first in the years after operation. The original measurements of the breadth of the dental arch are exceeded at the age of 8,5 but not the length of the dental arch.


[Metal plate osteosynthesis and wire osteosynthesis for the treatment of periorbital fractures in an experimental study]. With consideration of the special situation in periorbital fractures, the fundamental differences between wire and metal plast osteosynthesis was demonstrated on the basis of mathematical calculations, mechanical considerations and tension optical experiments. We further report on the different behaviour of both methods of osteosynthesis in tension experiments which demonstrate the distinct superiority of the metal plate.


[Comparative studies on the adhesiveness to the bone of various implantation materials]. After earlier experiments showed that bone became adherent to glass ceramic, the maximum mechanical stress on the bone-ceramic interface, as compared with polymethylmethacrylate (PMMA) and aluminium oxide ceramic, was investigated for shearing force and tension. Whereas the PMMA and aluminium oxide ceramic test objects which had been inclosed in the connective tissue were very easily pushed out without measurable pressure, the average fracture load for 15 smooth glass ceramic objects was 466 p/mm2 in the pushed out test and 167 p/mm2 in the tension test.


[The femoral region of the rat for the training in microsurgical vascular and neural anastomosis technics]. Regular practice in the operative technique is prerequisite for good functioning of micro surgical vessel and nerve anastomoses. The femoral region of the rat provides in one site an artery, a vein and several nerve branches. In one operation surgical anastomosis can be performed on all three structures.


[Compression osteosynthesis with percutaneous bone screws--clinical aspects and radiographic findings]. In a previous paper (Jacobs 1976) the development of an apparatus was described which achieved a compression osteosynthesis through the use of percutaneous bone screws without encroaching on the area of the fracture. As indication for this procedure we consider the condition which is described under the synonyms "post-traumatic osteomyelitis", "osteitis" and "fracture infection". Clinical experience is described with consideration of technical measurements - for the first time in vivo measurements of interfragmental compression in the patient and X-ray findings.


Effect of leupeptin on induction of lymphoblastic leukemia in mice by N-nitrosobutylurea. The effect of leupeptin on the induction of lymphoblastic leukemia in ICR/JCL female mice by N-nitrosobutylurea (NBU) was investigated. NBU was given as a 0.02% solution in drinking water for 10 weeks. A 0.1% concentration of leupeptin was given in the diet. Group A was fed on the leupeptin diet from the beginning, Group B received it after the end of NBU treatment, and Group C was fed on a leupeptin-free control diet throughout. The average periods in the appearance of leukemia in groups A, B, and C were 115+/-50, 112+/-43, and 100+/-17 days (mean+/-SD), respectively, and there was a significant difference between groups A and B and Group C at P less than 0.001. In regard to this point, leupeptin might have the effect of retarding the rpocess of leukemogenesis. However, leupeptin showed no effect on the incidence and histopathological finding of leukemia.


Infection by the distribution of biotypes of enterobacteriacease species in leukaemic patients treated under ward conditions and in units for protective isolation in seven hospitals in Europe. In a cooperative study on the efficiency of isolation and decontamination in patients with acute leukaemia performed in seven hospitals in Europe, faecal samples and oral washings were collected twice weekly and shipped for culturing to a Central Bacteriological Laboratory. In this laboratory the Enterobacteriaceae species isolated from these samples were biotyped as well as those isolated from infections that occurred in these patients during treatment. Enterobacteriaceae biotypes isolated for the first time during the isolation phase of the patient indicated a leak in the isolation system. The "colonizing" (newly resident) biotypes of Enterobacteriaceae species were found to be more often involved in infections and to be more commonly distributed among the patients in the participating hospitals than the "contaminating" (transient) Enterobacteriaceae biotypes. Furthermore, a linear correlation was found between the incidence of gram-negative infections and the number of cases in which these Enterobacteriaceae biotypes colonized the gastro-intestinal tract of patients. The majority of the infections was caused by Enterobacteriaceae biotypes that had settled in the gastro-intestinal tract during treatment and consequently were of nosocomial origin.


Panoramic radiography in dentistry.

Panoramic radiography in dentistry. Examples of panoramic radiography equipment in use are briefly reviewed and the differences pointed out between those operating on the principle of tomography and other "panoramic" instruments. The various uses to which panoramic radiography is put are described and the problems involved in using them explained. The advantages and disadvantages of panoramic radiography are listed and comparisons drawn between the degree of clarity and precision for diagnosis obtained with it as against that obtained using normal periapical radiographs.


Acute maxillary sinusitis caused by a guttapercha point. A case of acute sinusitis caused by a gutta-percha point is presented. The foreign body was introduced into the sinus during root therapy. Antibiotic therapy was ineffective. Surgical treatment consisted of radical antrostomy and removal of the foreign body.


[Anaesthesia for diagnostic and therapeutic endoscopy procedures (author's transl)]. The experienced anaesthetist in endoscopic anaesthesia in otolaryngology appreciates the need for adequate alveolar ventilation and that the risks are considerable. Certain principles, which have been found useful are presented. From five anaesthetic techniques for laryngeal microsurgery the injector method is described in detail. This method has proved very advantageous especially for surgical procedures on the posterior laryngeal commissure and for the treatment in special instances of tracheal stenosis. The technique mentioned were used without serious complications in about 1000 endoscopies in the last five years.


Human thymidylate synthetase derived from blast cells of patients with acture myelocytic leukemia. Purification and chracterization. Thymidylate synthetase (EC 2.1.1.B.) from blast cells of patients with acute myelocytic leukemia has been purified more than 1470-fold by affinity column chromatography. Methotrexate was the affinity ligand. dUMP was found to be a necessary additive for retention of the enzyme by the affinity column. Disc electrophoresis and sucrose density gradient centrifugation revealed a single enzyme species with a molecular weight of 76,000. The enzyme exhibits a temperature-dependent conformational change with activation energies of 5.3 +/- 0.4 and 17.3 +/- 1.9 kcal/mol, respectively, above and below a transitional temperature of 35 degrees. This conformational change is reflected in the binding affinity of dUMP but not of 5,10-methylenetetrahydrofolate. The enzyme displays a broad pH maximum in the range of pH 7.4 to 8.8. The Michaelis constants for dUMP and (+/--L-5,10-methylenetetrahydrofolate are 1.8 +/- 0.2 and 31 +/- 8.3 micrometer, respectively. Initial velocity and product inhibition studies reveal the enzymic mechanism to be ordered sequential. dUMP binds before 5,10-methylenetetrahydrofolate and dihydrofolate is released before TMP. 5-Fluoro-2'-deoxy-5'-uridylate (FdUMP) behaves as in irreversible inhibitor with a Ki of 1.68 +/- 0.45 nM. The enzyme has a turnover number of 6 min-1 per FdUMP binding site. Methotrexate inhibits noncompetitively with respect to dUMP and binds tighter to the enzyme in the presence of dUMP. Methotrexate antagonizes inactivation of the enzyme by FdUMP.


Postdoctoral research training in cariology: an opportunity initiated by the National Caries Program at the University of Minnesota School of Dentistry. In response to the need for development of measures to effectively control human dental caries, a postdocroral research training program in cariology has been established at the University of Minnesota School of Dentistry. This article discusses the concept of cariology, the background leading to the development of the program, and the goals and structure of the program. The recruiting and training of individuals to perform and direct multidisciplinary basic and applied research in cariology are explained. A didactic and clinical program is presented which gives a comprehensive introduction to cariology to trainees with a Ph.D degree and little previous knowledge of the multifactorial nature of dental caries.


Correlates of dentists' attitudes toward continuing education in TEAM. All dentists in active practice in Rhode Island were surveyed to determine their attitudes toward continuing education in TEAM. A total of 74.6 percent of those surveyed responded to the questionnaire. Only one variable, location in a building with other dental offices, was found to be associated with a perceived need for training in TEAM. Demographic background, practice busyness, practice efficiency, and knowledge and attitude profiles were found to be associated with an interest in attending such continuing education courses.


Course evaluation by committee.

Course evaluation by committee. An intradepartmental course evaluation committee has been established in the Department of Community Dentistry at the University of Louisville School of Dentistry. This committee's review of student evaluation mechanisms was a major focus in the assessment of all departmental courses. An evaluation technique, based on a comparison of existing student evaluation mechanisms against criteria established by the committee and approved by the departmental faculty, was designed and applied. The committee was viewed as successful by departmental course directors; however, its suggestions were not widely implemented by the departmental faculty. Several reasons are cited for this, as well as suggestions for future modifications of the committee's procedures.


Results of a workshop on the development of TEAM training programs. A two-week workshop was conducted to instruct current and potential directors of TEAM programs in planning and implementation of effective programs. A participant was sent by 36 of the 59 invited dental schools. Nineteen persons were selected as workshop faculty. The first week was spent in didactic sessions on educational methods, TEAM curriculum topics, and noncurricular issues. The second week was spent on development and review of original TEAM proposals. Significant overall gains in proficiency test scores were earned by both participants who came from schools with funded TEAM programs (n=16) and those from schools without funded programs (n=18). No test score differences were observed between these groups. The two areas of greatest perceived weakness at the end were evaluation and management training. Data on TEAM grant submissions during the two years following the workshop are discussed, along with several implications for planning of long-term workshops.


A comparison of glazing materials for composite restorations. Composite restorations containing quartz fillers have shown persistent roughness after finishing which contributes to marginal discoloration and staining. Resin finish coatings have been used to attempt to overcome this problem. This study was designed to compare the durability of two resin coating materials used on two brands of composite restorative materials. Results showed that composites glazed with resin coating finishes at placement maintained their luster, color match, and surface smoothness significantly better after one year than composites that were not coated. After a year it was concluded that composites on which the resin coating is intact maintain their color match, luster, and smoothness significantly better than uncoated composite restorations.


Surgical intervention to reestablish adequate intermaxillary space before fixed or removable prosthodontics. Supraeruption of the right maxillary molars and concomitant drop of the alveolar ridge resulted in loss of intermaxillary space. With the patient under local anesthesia and intravenous sedation, a posterior segmental osteotomy was performed, on an outpatient basis, to reposition this segment superiorly into the maxillary sinus. Stabilization was accomplished with a prefabricated acrylic splint. The patient quickly resumed her daily routine with normal postoperative healing and satisfactory intermaxillary space.


The medical consultation: its role in dentistry. Dental practice frequently requires close cooperation between the dentist and physician. The medical consultation request is extremely valuable in achieving this cooperation. The request must contain sufficient information to enable the physician to understand the dentist's findings, the patient's anticipated dental treatment needs, and the specific reasons for the consultation request. To ensure completeness, accuracy, and to provide a clear record from a medico-legal standpoint, the medical consultation request should be in writing.


Four-year clinical evaluation of a pit and fissure sealant. The clinical retention of a single application of a pit and fissure sealant was evaluated on the teeth of children to determine the influence that this protective coating, or its loss, would have on caries activity during a four-year period. The sealant was fully retained on 50% of all paired permanent teeth at 48 months. Of the 689 pit regions that retained the sealant, 95% were rated as having severe loss of substance, only 5% as slight loss, and none with no loss of substance. It also was found that 53% of all paired permanent control teeth judged cariesfree at the baseline examination were found to be carious, whereas only 30% of the treated teeth examined were carious. The corresponding relative reduction in caries rates was, therefore, 43%. The actual number of teeth estimated to be saved by the sealant treatment at 48 months, as measured by net gain per 100 teeth treated, was 23. The net gain per child was estimated as 2.7 teeth saved from caries (full mouth), with a positive treatment benefit in 69% of the children. When the sealant remained intact, there was a pronounced reduction in caries initiation--the percent effectiveness being 84%.


A new desensitizing dentifrice: preliminary report. Dentin sensitivity is one of the most painful, ubiquitous, and least satisfactorily treated chronic problems of the teeth. The purpose of this clinical trial was to test the sensitivity-reducing effectiveness of five dentifrices over a six-week period. For the study, 176 adults, ages 18 to 63, exhibiting a total of 486 hypersensitive surfaces, were randomly allocated to five experimental groups to use one of the following: a strontium chloride dentifrice, a 0.4% stannous fluoride gel, a pluronic F-127-sodium citrate gel, a pluronic F-127 gel, or a control dentifrice. No specific instructions were provided as to the frequency or method of toothbrushing; thus, the participants brushed their teeth in their usual manner. The analysis of the data was limited to 168 persons who complied with study procedures. Chi-square analysis examined the statistical differences between the four test agents and the control formulation. The desensitizing effect of the pluronic plus sodium citrate gel was highly significant, and the plain pluronic F-127 preparation was effective to a lesser degree. Patients using the strontium chloride or stannous-fluoride-containing dentifrices did not exhibit a significant improvement over the control group. This study demonstrated that a pluronic polyol gel containing sodium citrate is highly effective in controlling tooth hypersensitivity.


Hereditary angioedema: review of literature and dental treatment. Hereditary angioedema (HAE) is an autosomal dominant syndrome in which the pathogenesis differs from the more common nonhereditary (allergic) angioedema. Respiratory embarrassment precipitated by trauma (including dental manipulation) accounts for the high morbidity of the patients. The purpose of this paper is to establish a successful procedure for dental-medical treatment of patients with HAE.


Comparison of multiple assays for detecting human antibodies directed against surface antigens on normal and malignant human tissue culture cells. Four separate assays of human antibody reactivity to four separate normal and malignant human tissue culture cell lines from two patients have been evaluated using a single highly-reactive allogeneic serum. The visual and end-point cytolysis assay and the 51Chromium release assay were equally sensitive in measuring complement mediated antibody cytoxicity and both were far more sensitive than a trypan blue dye exclusion assay. The assay of antibody reactivity by hemadsorption technique was about 10 times more sensitive than any of the cytotoxicity assays. This latter assay measures only IgG antibody however. These assays showed that cell lines from different patients may differ greatly in 'reactivity' to an allogeneic serum and emphasized the importance of utilizing tumor and normal cells from the same patient when using tissue culture cells to search for tumor specific reactivity. These observations emphasize the importance of utilizing multiple assays against paired normal and malignant cells from the same patient to be certain of the specificity and magnitude of the measured antibody.


Irregular cervical dissemination of tumours of the maxillo-facial region. In nearly 90% of lymphatic disseminations, metastasis of carcinomata of the oral cavity follows the normal regional anatomy of the efferent lymphatic system, and usually manifests itself in three homolateral filtering groups. More than 90% of lymphatic metastases occur in the first year following diagnosis of the primary tumour. Such a sequence may be regarded as "regular" metastasis. Anatomical variations and metastasis-induced or therapy-induced blockage of the efferent lymphatic system can change the pattern of metastasis to "irregular". The present studies are specially directed towards recurrence of metastasis, lymphangiosis blastomatosa, the so-called late metastasis as well as the problem of branchiogenic carcinoma. The explanation of clinical aspects has been substantiated with topographic-anatomical and histological findings as well as experience gained in lymphography and lymphoscintigraphy of the cervical lymphatic system.


Haemangiosarcoma following irradiation of a haemangioma of the face. (Case report). The malignant complications of irradiating benign conditions are well known and fortunately less frequent than in a previous era of widespread use of superficial roentgen therapy. However, because of the long latent period from exposure to irradiation until the development of the tumour, the clinician must continue to be alert. The behaviour and treatment of a haemangiosarcoma occurring 18 years after irradiation of a haemangioma is described.


Titanium implants as a temporary replacement of mandible. A report of 30 cases. In a 5-year period, 30 titanium implants (Bowerman and Conroy 1969) were utilised for the reconstruction of mandibular defects following tumour operations. Of these, 20 implants were removed prematurely. Reasons for early removal were: 1. postoperative dehiscence of wound (5), 2. perforation through the skin or mucosa (5), 3. infection of graft bed (7), 4. breakage of the implant (1), 5. tumour recurrence (2). A total of 9 implants were retained for one or more years. The results are compared with those of Bowerman (1974). Reasons for the early loss as well as the clinical implications are discussed.


The importance of retrograde phlebography in the diagnosis of orbital lesions. The authors describe a technique for retrograde phlebography of the orbit. A selection of the typical findings in 51 cases of orbital phlebography is presented. The diagnostic importance of the examination in cases of similar clinical symptoms has been stressed. This method is best suited to the investigation of cases of venous malformation, especially of the intra-orbital, peri-orbital and retro-orbital area. Side-effects and complications have been described. A comparative assessment against other competetive methods of investigation, like the computer tomography has been attempted.


Sinuscopy for the diagnosis of blow-out fractures. Between 1973 and 1976 thirty-one patients with the symptoms of a blow-out fracture underwent sinuscopy. In all these cases a precise diagnosis was not possible from the clinical and x-ray findings alone without exploratory surgery. In 28 cases an exact diagnosis could be made using sinuscopy; 21 patients with blow-out fractures underwent reconstructive surgery to the orbital floor. In the remaining 7 cases fracture of the orbital floor was ruled out and the patients were spared more extensive diagnostic procedures. In 3 cases the diagnosis of a fracture could not be definitely established. Exploratory surgery of the orbital floor showed blow-out fractures which needed treatment. These findings were photographed; 5 typical photographs of fractures are presented. Sinuscopy provides a simple and sure method in the diagnosis of blow-out fractures. Its early application is recommended in cases of suspected fractures of the orbital floor, since reconstructive surgery of blow-out fractures yields the best functional results when performed within 2 weeks after the accident.


Nerve injury in fractures of the condylar neck. Although fractures of the condylar neck belong to the most frequent injuries of the jaws, and various nerves are found in close proximity to the temporomandibular joints, only little mention is made in the literature of neurological complications arising from accidents. We have therefore carried out a prospective study on nerve injuries in 237 fractures of the articular process in the period 1971-1975. We found two cases of post-traumatic Frey's syndrome, whereby the syndrome developed from a post-traumatic auriculotemporal neuralgia. We also found loss of function of auriculotemporal buccal and facial nerves, and loss of taste sensation of the tongue in another case, caused by damage to the chorda tympani. This paper discusses the formal and causal origin of the individual damages, and suggests possibilities for their management.


Secondary reconstruction of cranial defects. The increase in the number of cranial defects following injury requires more extensive use of plastic reconstructive measures on account of the exposed site of the defects or for cosmetic reasons. In 30 cases of secondary cranial defects, we have used various means of reconstruction. Alloplastic materials are used in our patients only to a limited degree, autologous bone transplants are preferentially employed. Of the autoplastics, secondary calvarium reimplantation has been the most successful, with respect both to function and cosmetic results. Our experience shows that split-rib grafts are also very suitable for the closure of defects, while sliding bone grafts with a periosteal pedicle are rarely indicated. The selection of the transplant material in the individual case and our experience with various methods are discussed.


Clinical and experimental results of a sandwich-technique for mandibular alveolar ridge augmentation. During the past two and a half years, thirteen patients have been operated upon using a "sandwich-technique" for mandibular alveolar ridge augmentation. This new technique was advocated by Schettler in 1974. In 3 cases, autologous rib cartilage was used, in 6 cases an autologous transplant from the iliac crest, and on four occasions, autologous "cialit"-conserved bone chips were inserted. All transplants healed without complications and no resorption was found in either the autologous or homologous transplants at the late follow-up examinations. These findings are supported by animal experiments in rabbits with the aid of the polychrome sequence marking technique using fluorochromes.


Experimental reimplantation utilizing microvascular anastomosis in animals. The use of the operating microscope and special microsurgical instruments make it possible to achieve successful anastomosis of blood vessels of less than 1 mm in diameter. Microvascular surgery offers newer possibilities in the transplantation of dermisfat grafts, and has led to an unusually high degree of success in the reimplantation of tissues. This paper describes a technique for microvascular anastomosis in animal experiment, using as a model the reimplantation of a completely amputated rabbit ear. In 10 amputated rabbit ears, the central auricular artery with a diameter of 0.5 mm and the two marginal auricular veins with diameter of 0.5-1.0 mm were microsurgically anastomosed. Of the 10 reimplanted ears, 8 survived. The postoperative angiogram showed an unrestricted patency of all the vessels.


Dermoid cyst of the floor of the mouth in an infant. (Case report). Dermoid cysts of the floor of the mouth in the infant are rarely encountered although the aetiology is mainly embryological. Meyer proposes the classification of the cysts based on the histological differentiation of the elements of the cyst wall. A case is reported which shows differences in the epithelial lining of the cysts found followed by the differential diagnosis and treatment.


Effect of bevelling on the occurrence of fractures in the enamel surrounding composite resin fillings. Three different types of cavities: (1) with a 90 degree cavo-surface angle, (2) with a bevel at the cavity margin 0-25-0-50 mm wide, and (3) with a bevel at the cavity margin 0-5-1-0 mm wide, were prepared in extracted human teeth. Fifteen cavities of all three types were filled with Adaptic. Fifteen cavities of Type 2 and of Type 3 were filled with cosmic and the same number and types of cavities with prestige. The fillings were polished 10 min after starting the mix of the composite resins. Fractures in the enamel at the cavity margins were visualized by discoloration with methylene blue. Fractures were observed around all types of cavities, but, for all types of materials, an increased bevel at the margin gave an increased number of fillings without fractures in the enamel. However, great variations in the frequency of fractures were also observed; i.e. Adaptic showing a small frequency, Cosmic a medium and Prestige a great frequency of fillings connected with fractures at the enamel margin.


A colorimetric study of coffee and tea staining of four composite resins. Colorimetric measurements were made on four composite resins before and after controlled immersion treatments. The four composite resins were: Adaptic (Johnson and Johnson), Prestige (Lee Pharmaceuticals), Addent XV (3M Mfg. Co.) and Smile (Kerr Mfg. Co.). Specimens of each material were prepared with mylar surfaces and with abraded finished surfaces. Separate groups of specimens of the four materials were immersed in three separate solutions for 12 days at 55c. The three solutions used were: a control solution of distilled water and coffee and a solution of distilled water and tea. For all materials and surface finishes, immersion in coffee and tea produced significantly greater colour changes than distilled water. Coffee produced significantly greater colour changes than tea with the exception of 'Prestige' and 'Addent XV' with finished surfaces. When immersed in a tea solution, specimens of the same material with differing surface finishes showed greater differences in colour change than when immersed in control and coffee solutions. The relative colour changes of the four materials due to the immersion procedures were as follows: 'Adaptic' showed the least colour changes and "Smile' showed the most. 'Addent XV' and 'Prestige' tended to vary between the former two. Comparison and correlation of colorimetry results with visual assessment scores allowed for the expression of the objective measures in subjective terms suitable for clinical purposes.


Influence of different endodontic methods of treatment upon the process of apical closure of immature pulpless human teeth and the structure of the newly formed calcified tissue in apical opening. A description is given of the pathohistological structure of the calcified tissue in the apical opening of four extracted immature pulpless human teeth treated by various endodontic methods. It is concluded that in the tooth treated by mortal extirpation there was neither histological healing nor any tendency for further apex formation. In both the tooth where vital extirpation was performed and in one of the teeth treated as apical periodontitis, the apices were formed from conglomerates of different calcified tissues, identical to the tissue which was formed under comparable conditions in experimental dogs. In the fourth human tooth also treated as apical periodontitis after treatment the apical opening closed with irregular dentine tissue. In this study consideration was given to the problem of the origin of the odontoblasts which co-exist with the hard destructive process present in some pulpless teeth. It is concluded that in the case presented in this study the irregular dentine was formed by the same odontoblasts which took part in the process of normal odontogenesis. This fact, should be respected in the course of endodontic treatment of immature pulpless teeth.


In vitro polarization of dental amalgam in human saliva. Potentiostatic anodic polarization techniques in Ringer's solution are commonly used for the evaluation of the corrosion resistance of dental amalgam. This in vitro method strives to simulate the in vivo electrochemical behaviour of amalgam in an electrolyte of natural saliva. Several types of dental amalgam were anodically polarized in natural saliva solutions and supernatant saliva solutions. The anodic polarization profiles are presented, as well as scanning electron micrographs and x-ray analysis of the corroded amalgam surfaces. These reveal corrosion products consistent with results found with previous artificial salivas as well as deposits possibly related to the organic component of natural saliva.


Tissue reactions to implanted vitreous carbon and high purity sintered alumina. Vitreous carbon and high purity sintered alumina implants were inserted into the iliac crests and mandibles of rabbits. The reactions of the tissues were assessed after periods up to 2 years using resin embedded histological sections. Both types of material were well tolerated, although the alumina excited a slightly greater tissue response than did the vitreous carbon. Electron microprobe analysis of the bone around the implants failed to show the movement of known contaminants from the alumina and vitreous carbon into the surrounding tissue. Observations are made on the reactions of the tissues to the implants and the effect of cortical penetration and implant movement.


The surface structure of the human mandibular condyle in health and disease. A scanning electron microscopic study. Surface features of the human mandibular condyle have been studied by scanning and electron microscopy. Normal condyles possessed features similar to those in other diarthrodial joints but with certain differences. Two types of erosion and an exostosis were seen in diseased joints and the surface structure is described.


Reliability of preparation method for initial strength measurement of amalgam according to the ADA specification. The ADA specification method for preparation of amalgam samples for tensile strength studies has been investigated. It was determined as being of acceptable reliability for comparison against normal clinical use of the material.


Linear dimensional changes of three luting agents. The linear dimensional changes during setting of a reinforced zinc oxide eugenol cement (Alumina EBA Crown and Bridge Cement), a composite resin cement (Epoxylite 9080 Crown and Bridge Adhesive) and a zinc silico phosphate cement (Fluoro-Thin cement), have been studied. The measurements were were performed on specimens placed on a mercury bath. The cements were allowed to set under various environmental humidity. The measurements of specimen length started 3 or 5 min after commencing the mix. The EBA-cement showed a maximum contraction of 0-4 percent after 7 days when setting under dry conditions. Under wet conditions the cement had an initial contraction the first day of setting, and thereafter an expansion. After 21 days specimens setting under 100 percent relative humidity showed 0-3 percent expansion, whereas specimens immersed in water attained the initial length. The composite resin cement showed a contraction of 1-0 percent after 1 day when setting under dry conditions. Under wet conditions the specimens had an initial contraction of 0-8 percent the first day of setting being reduced to 0-4 percent during the next 20 days. The zinc silico phosphate cement showed a maximum contraction of 3-0 percent after 7 days under dry conditions and 0-5 percent after 1 day under wet conditions.


Mandibular advancement: skeletal and dental changes during fixation. Skeletal and dental changes that occurred during maxillomandibular fixation after surgical advancement of the mandible were examined in 21 patients. Serial cephalometric monitoring showed skeletal relapse with compensatory dental changes in every case; the pattern of relapse varied. Common hypotheses currently expressed and applied by clinicians for presurgical prediction of such treatment results were objectively assessed for validity on the basis of the patient sample studied. The findings indicate that single variables cannot be isolated as being solely responsible for specific postsurgical changes.


Chondrosarcoma of the jaws and facial skeleton: a review of the Japanese literature. From the 35 cases of chondrosarcoma, the maxilla was the most frequently affected site (35.5%) and the mandible was the next (29.4%). Painless swelling is the conspicuous symptom for chondrosarcoma of the lower jaw and nasal complications are often recorded with the lesions of the upper jaw. Several kinds of histologically malignant featurs coexisted which made diagnosis complicated. The three-year survival rate was about 50% for chondrosarcoma of the lower jaw and much lower for the upper jaw.


Comparative analgesic potency of aspirin and ibuprofen. The object of a study was to evaluate the analgesic efficacy of ibuprofen for dental pain. The subjects were outpatients who were undergoing surgical removal of impacted teeth. We compared aspirin, 325 mg; aspirin, 650 mg; ibuprofen, 200 mg; ibuprofen, 400 mg; and placebo. Each patient received a single dose of one of the test medications; there was a minimum of 37 patients in each treatment group. Patients recorded pain intensity before receiving medication; then hourly, for four hours after medication, they recorded pain intensity, amount of relief, and side effects. Time-effect and dose-response curves were generated from the relief and change in pain-intensity scores. First-hour scores, peak scores, and total scores were analyzed. All active medications were significantly better than placebo and the mean effect for ibuprofen was significantly more than for aspirin.


Acinous cell carcinoma: a histogenetic hypothesis. A proposed origin of acinous cell carcinoma of the parotid gland from serous cells of the acinar part of the salivary unit has been challenged. To date, the alternative histogenetic concept of origin from the reserve cell of the intercalated duct has been largely conjectural and based on light microscopic and only isolated electron microscopic evidence. Light and electron microscopic findings now support a terminal duct origin for at least some acinous cell carcinomas.


Arthroplasty of the temporomandibular joint with use of a vitallium condyle prosthesis: report of three cases. We have devised a Vitallium intramedullary prosthesis to replace the deformed arthritic condyle in cases that require bilateral condylectomy or in rare long-term failures of a single condylectomy. Experience has led to modification of this prosthesis. Recently a rectangular stem that prevents rotation of the prosthesis in the condylar stub has been added (Fig 11). In bilateral condylectomies, replacement of only one side by the Vitallium condylar prosthesis is adequate, because it stabilizes the mandible by maintaining its original fulcrum in the temporomandibular joint. Three cases of replacement with the Vitallium condyle prosthesis are reported, with follow-up studies of two to three years postoperatively. The results to date have been gratifying.


Primary hyperparathyroidism exacerbated by pregnancy. Primary hyperparathyroidism may remain subclinical as long as there is adequate calcium in the diet. If the demand for calcium increases, as in pregnancy, the symptoms become evident. Any giant cell growths should alert the oral surgeon to the possibility of hyperparathyroidism. Untreated, hyperparathyroidism ultimately leads to fractures, irreversible kidney damage, and death by renal failure. Tetany must be guarded against after parathyroid surgery. Finally, the brown tumors of hyperparathyroidism need not be removed surgically since bone will regenerate if the disease is correctly treated by removal of the parathyroid adenoma.


False aneurysm of the lingual artery.

False aneurysm of the lingual artery. A case of false aneurysm of the lingual artery is presented. Although the clinical findings and history suggested an abscess, either preoperative aspiration or arteriographic studies might have permitted more definitive care during the patient's third hospitalization.


Thrombotic thrombocytopenic purpura: report of case. TTP is an acute, usually fatal disease of unknown etiology. Diagnostic confirmation of the disease requires histologic demonstration of the deposition of hyaline thrombi within the lumens of arterioles and capillaries in the absence of vasculitis. The clinical, laboratory, and histological manifestations of TTP were reviewed and a case was reported in which a gingival biopsy specimen was used to confirm the diagnosis. Emphasis is placed on the rapidity and ease of gingival biopsy and the possibility of earlier institution of therapy.


Fibrous dysplasia of the mandible and sphenoid bones: report of case. A case of fibrous dysplasia of the mandible has been presented in which further diagnostic procedures showed the presence of a second and potentially more dangerous lesion. The literature was reviewed with the purpose of bringing attention to the still confused state of fibro-osseous lesions of the jaws and skeleton. The relationship of the ossifying fibroma and fibrous dysplasia was explored in relative depth. Fibrous dysplasia is a usually benign fibro-osseous abnormality of bone that may occur as monostotic, polyostotic, or craniofacial disease or as a part of a syndrome. Its nosology is confusing and its etiology is still unknown.


Osteochondromas associated with facial asymmetry and masticatory dysfunction: report of two cases. Two cases of solitary osteochondromas interfering with mandibular motion are presented along with a brief review of the literature. A single incidence of an osteochondroma developing from the mandibular condyle is added to the growing number of case reports. In addition, an osteochondroma developing from the zygomatic arch is reported. Our review of the literature has shown no previous report of occurrence at this site.


Blood supply of human gingiva following periodontal surgery. A fluorescein angiographic study. This study demonstrates changes in the gingival vascular supply of humans following various periodontal surgical procedures. A special system was used to photograph circulatory changes following an i.v. injection of sodium fluorescein to visualize blood supply. The results of this study suggest that the following concepts are important in the design of periodontal flaps. 1. Flaps should be broad enough at their base to include major gingival vessels. 2. A flap's length to width ratio should not exceed 2:1. 3. Minimal tension should be produced by suturing techniques and the tissue should be managed gently during the surgical procedure. 4. Partial thickness flap preparations to cover avascular areas should not be too thin so that more blood vessels are included in them. 5. The apical portion of periodontal flaps should be full thickness when possible.


Alveolar bone loss in thymectomized golden hamsters. Fifty-six neonatally thymectomized and 41 neonatally sham-operated female golden hamsters (Mesocricetus auratus) were divided into 2 groups, one inoculated with Actinomyces (N16) and the other not inoculated. All animals were raised and maintained on a high sucrose, soft diet (Diet 2000) and water, ad libitum. White blood cell counts, differentials and total lymphocyte counts were determined at 4 to 5 weeks of age. The rejection of albino hamster skin grafts and the hemagglutination response to sheep red blood cells (SRBC) were used to determine inhibition of T lymphocyte function. Evaluation of alveolar bone loss at the end of 160 days indicated that the thymectomized animals with a significant depression of the hemagglutination response to SRBC and a lack of skin graft rejections had a significantly higher bone loss than sham-operated animals. This suggests that the cellular immune response plays a role in the periodontal syndrome in hamsters. Further investigation is necessary to establish how significant this role is in relationship to the numerous other factors that are present. These data suggest that the role of the cellular immune response in the hamster periodontium may be protective rather than destructive. The role of Actinomyces (N16) in the development of bone loss was not significant.


Long junctional epithelium: epithelial reattachment in the rat. The mesial gingiva of mandibular first molars of Sprague-Dawley rats were subject to irritants for 1, 2 or 3 months. The irritants were then removed for periods of 2 to 4 weeks before sacrifice (healing phase). The keratinized sulcular epithelium tended to remain stable while the junctional epithelium became very reactive demonstrating three responses: (1) Proliferation occlusally, (2) Proliferation apically and (3) Proliferation into the inflamed connective tissue. In approximately half of the rats the depth of the cuff epithelium did not change during the experimental procedures demonstrating the resistence of the rat to local irritation. In approximately 25 % of the animals (Group A) deepened sulci occurred with subepithelial connective tissue inflammation. In the remaining 25 % of the rats (Group B), the cuff epithelium proliferated apically but an increase in epithelial reattachment occurred (38 %) reducing the sulci to normal depths with reduced subepithelial areas of inflammation. Within the limitations of these results, this model system can be used to study the dynamics of the long epithelial attachment.


Let /S/ be your guide.

Let /S/ be your guide. New guidelines for establishing the vertical dimension of occlusion have been reviewed. They are based upon the fact that the body of the mandible assumes an easily recordable, repetitive horizontal and vertical position when the patient is at the /S/ position during speech. This controlled method of developing vertical dimension correlates the posterior speaking space with the placement of the upper and lower anterior teeth when set to a phonetic standard. This permits the development of a dependable vertical dimension of occlusion for most patients and also serves as a guide for the more difficult to treat Class II and tongue-thrusting patients. A method of obtaining a protrusive registration is also presented; it coordinates the angle of the eminences with the actual incisal guide angle of the patient. In all techniques there should be a final try-in after the setup of the teeth is complete. The guidelines presented in this article for controlling speech and "verticentric" can also be used to verify and/or alter that which has been established by any technique.


Fluoride release and physical properties of a fluoride-containing amalgam. 1. The amount and percentage of fluoride released from amalgam were less for the 1:1.6 alloy/mercury ratio than for the 1:1 ratio. 2. Higher fluoride concentrations resulted in a greater quantity but lower percentage of fluoride released from the amalgam. 3. Longer immersion times resulted in a greater amounts and percentages of released fluoride. However, the fluoride released per hour decreased with immersion time. 4. Immersion of the amalgam in lactic acid caused a greater release of fluoride than immersion in distilled water. 5. Disintegration of the amalgam was greater in lactic acid than in distilled water. The contribution of calcium fluoride to weight loss was greater in water than in lactic acid, indicating a corrosive effect for lactic acid. 6. The higher calcium fluoride content (2 per cent) decreased the compressive strength of the amalgam but did not alter the dimensional change.