Longitudinal analysis of growth of the soft palate and nasopharynx from six months to six years. Between the ages of six months and six years, longitudinal lateral headfilms were taken on 54 patients with palatal clefts or with unilateral and bilateral clefts of the lip and palate. They were measured and were compared to data on both normals and subjects with clefts of the lip only. The objectives of the study were: 1. To sutdy the effects of palatal surgery on the growth of the soft palate. 2. To compare the growth of the soft palate and nasopharynx among the patients with various types of clefts and normals. 3. To study the growth acceleration or so-called catch-up growth after palatal surgery at various ages. (Anterior palatal surgery at 14 months +/- 2 months. Posterior palatal surgery at 16 months +/- 2 months.) 4. To evaluate the relationship between velopharyngeal growth in cleft groups and voice quality.


The effect of changes in velopharyngeal orifice area on vowel intensity. This investigation studied the influence of changes in velopharyngeal orifice size on vowel intensity in normal speakers when subglottal air pressure was controlled. Controlled variations in velopharyngeal orifice area were achieved by two different methods. The effective velopharyngeal orifice areas introduced into the subjects were verified aerodynamically. A reduction in vowel intensity (SPL) was recorded during the large experimental velopharyngela orifice condition (50 mm2) when compared to a control condition. The clinical implications of these findings are discussed.


The morphology of musculus uvulae.

The morphology of musculus uvulae. The morphology of the musculus uvulae was studied utilizing detailed gross anatomical dissection and histological sectioning of the soft palate in seven adult human cadavers. The results indicated that the musculus uvulae is paired as previously described in most anatomy texts. Each bundle takes origin lateral to the midline from the tendinous palatal aponeurosis posterior to the hard palate and just anterior to the insertion of the levator veli palatini muscle. The two bundles converge in an area overlying the sling of the levator muscle and course along the dorsum of the soft palate terminating as two separate bundles which subdivide and insert between the mucous glands of the uvula proper into the connective tissue and basement membrane of the mucosa. Becuase of its location and size, it appears that contraction of the musculus uvulae would add bulk to the dorsal surface of the elvated soft palate thus aiding in occlusion of the velophryngeal portal during speech and deglutition.


The influence of primary unilateral cleft lip repair on facila growth. The lip pressure exerted by the repaired cleft lip was studied in 35 rabbits during a 20-week period. Animals were divided into four groups. Two of them were controls, and in the other two, two different surgical procedures were used for the lip repair. The results of this study indicate that there was reduction in lip pressure resulting from the surgically induced cleft lip, alveolus, and palate. Substantial increases in lip pressure were shown in both groups in which lip repair was completed. The influence of primary unilateral cleft lip repair on the facial growth of rabbits in this study will be presented in Part II of this report.


Effects of maxillary advancement on the speech of a sub-mucosal cleft palate patient. A nineteen-year-old patient with a surgically repiared sub-mucosal cleft palate was evaluted following a LeFort I osteotomy to determine the effects of the surgery of his speech. Tape recordings were made of his speech pre- and postoperatively during the administration of an articulation test, during casual conversation, and while repeating standard sentences. Spectrographic analysis of pre- and postoperative segments of a standard sentence were made. Results of the tests indicated that maxillary advancement had no adverse effect on articulation ability or voice in this case. Unexpected findings are discussed, and suggestions are given for clinical assessment and evaluation.


["Prophylactic" intrathecal radiogold (198au) in leukaemia in children (author's transl)]. 198Au radiogold-colloid (Behring) was injected as "prophylactic" therapy against central nervous system leukaemia in 26 children with acute leukaemia (22 acute lymphatic and 4 myeloid). During the period of observation (1.3. 1972 to 1.9.1975), 23 children remained free of central nervous system recurrences: 16 children are alive 3 to 39 1/2 months later, seven died after 4 1/2 to 29 1/2 months from the underlying disease. In one child CNS leukaemia developed after about five months, in another one during a second haematological recurrence, while the third one developed retrobulbar infiltration in the optic nerve. In general, 2 mCi 198Au gold-colloid was injected intrathecally via a lumbar puncture. The method was well tolerated.


[Combination chemotherapy of acute lymphoid leukaemia in children combined with prophylactic cranial irradiation (author's transl)]. From June 1971 to May 1974, 41 children, aged four months to eleven years, with acute lymphoid leukaemia were treated by a schedule which included prophylactic cranial irradiation and intrathecal methotrexate injection after remission (phase II) and combination cytostatic treatment for 2 1/2 years (phase III). Induction of remission (phase I) was usually achieved with vincristine and a corticosteroid. Complete remission, now lasting 18 to 54 months, was obtained in 18 patients (44%), in nine of them without treatment for up to 24 months. Twelve patients (29%) had bone-marrow recurrence, five (12%) CNS and three (7%) testicular recurrence. One child died of liver failure in complete remission. Another nine patients, who had been pretreated according to a different schedule and were in their first remission for six to twelve months, were added to the programme from phase II onwards. Three of them now are in complete remission for 60 to 88 months, seven to 30 months after treatment had been stopped. The results indicate a significantly improved prognosis of acute lymphoid leukaemia in children.


Effects of 5-hydroxytryptamine on the lower esophageal sphincter in vivo: evidence for multiple sites of action. Intravenous administration of 5-hydroxytryptamine (5-HT) caused a dose-dependent contraction in the lower esophageal sphincter in the opossum. The smallest dose of 5-HT which caused a detectable contraction of the sphincter was 0.5 mug/kg, and a maximal sphincter contraction was produced by a dose of 40 mug/kg. Methysergide converted the contractile effect of 5-HT to a dose-dependent fall in the sphincter pressure; maximal inhibition of 77.2 +/- 7.2% of the resting pressure occurred with a dose of 40 mug/kg. The inhibitory effect of 5-HT was antagonized by tetrodotoxin, 5 MeO-DMT, and 5-HT tachyphylaxis. 5 MeO-DMT enhanced 5-HT-induced contraction of the sphincter. In the presence of 5 MeO-DMT and methysergide, 5-HT still caused a brief contraction of the sphincter; this contraction appeared to be due to stimulation of postganglionic cholinergic neurons as it was antagonized by tetrodotoxin or atropine. Reserpinization caused enhancement of the sphincter contraction by 5-HT. In the reserpinized animals in the presence of methysergide, 5-HT caused a small initial contraction followed by prolonged inhibition; atropine antagonized the initial contraction, while inhibition was antagonized by 5 MeO-DMT. These studies are consistent with the view that 5-HT exerts several different effects on the sphincter. 5-HT causes contraction of the sphincter by its direct action on the muscle and also by stimulation of cholinergic excitatory neurons. In addition, 5-HT inhibits the sphincter by stimulation of nonadrenergic inhibitory neurons.


A comparative analysis of the attitudes of dentists toward the advertising of their fees and services. Restrictions on advertising about services performed by professional groups have recently been questioned by the government and consumers. The purpose of this study was to determine dentists' attitudes about the use of advertising in their profession and to compare the results with responses from physicians, attorneys, and accountants. While a survey of these groups in three metropolitan areas indicates mild support for advertising in general, there was a definite negative reaction to advertising in the respective professions. Participants also reported their attitudes about the effects of advertising on prices and fees, quality of services, and public expectations and governmental regulations.


Beliefs of dental faculty and students about effective clinical teaching behaviors. Both faculty and students in the College of Dentistry at The Ohio State University participated in a study to identify their beliefs about what clinical instructors should do to be effective and efficient teachers. In the first stage of a two-stage study, dental faculty members were asked to write out in as much detail as possible what things they believed clinical instructors should do when teaching. Similarly, junior and senior dental students were asked to describe what clinical instructor behaviors they believed enhanced their learning. All the descriptions were read and summarized, and a checklist of the behaviors was constructed. In the second stage both faculty and students were asked to respond to the importance of each behavior. The responses were factor analyzed, and the most important specific behaviors were identified. Five of the factors seem to describe dimensions of teaching of special importance for dental clinical faculty.


Survey of the perceived educational needs of dental faculty. A nationally distributed questionnaire was used to collect data from dental educators regarding their experience with courses in teacher training and the value they place on teacher preparation. Most dental educators have little or no formal training in education either at the undergraduate or the graduate level. Less than 15 percent possess a degree in education. However, over 95 percent indicated a belief that increased knowledge in education is desirable. Most respondents thought that a concentrated course of three to five days would be the most desirable format for in-service training courses in teaching.


A mini-research program for dental students. A mini-research program to familiarize dental students with scientific research methods is described. Students who have not been exposed to laboratory or clinical research and who are not familiar with the use of the library and other research resources participate. The gross anatomy laboratory is the setting for the data-gathering stage, although most basic science departments could conduct a similar program. The assigned topics are of a morphologic, observational, and descriptive, rather than experimental, nature. The best reports are selected for presentation at a brief scientific session patterned after meetings of the International Association for Dental Research.


Teaching oral biology laboratories to large numbers of students by video tape. A two-laboratory video-taped package was developed and presented to 180 dental, dental hygiene, and dental assisting students. The tapes dealt with (1) the growth of plaque in vitro on nichrome wire and on bovine enamel blocks and with (2) the measurement of plaque pH changes in vivo after a sugar solution rinse. The taped presentation was interrupted at frequent intervals to allow the students to perform the procedures. A program describing the use of the phase microscope was also developed and presented. Results showed that all students were able to perform the procedures satisfactorily and complete the laboratory report in approximately 40 percent less time than was required for the conventional laboratory. Students reported that they felt the video tapes had enabled them to master the required material and understand plaque and the food-host-bacterial interaction. Preparation time was at least twice that for the traditional laboratory exercise, and cost-benefit justification will require use of the video tape packages for several years without major revision.


Prevalence of delayed emergence of permanent teeth as a result of local factors. Delayed emergence of permanent teeth as a result of local etiologic factors was found in 45 of 1,032(4.3%) persons ages 8 through 18 in a dentally indigent population. In 36 persons (3.4%) delayed emergence resulted from causes other than those associated with premature primary molar extraction. This statistic probably approximates the potential for this problem in a treated population group. Teeth most commonly involved were mandibular second premolars, maxillary canines, and maxillary central incisors. The most common causes, respectively, were space loss, palatal position, and mesiodens. Supernumerary, malformed, and congenitally missing teeth were more frequent in persons with delayed emergence than in the rest of the population sampled. The difference was statistically significant. No correlation was found between delayed emergence and sex of the patient. In this study, teeth delayed in emergence behaved as other teeth in that they exhibited normal root development and did not contribute to resorption of adjacent roots. Except for maxillary canines, enlarged follicular spaces did not develop after eruption


Large antral odontoma as the cause of acute maxillary sinusitis: report of case. A case of a large compound odontoma in the right maxillary sinus causing acute maxillary sinusitis is reported. Seven large antral odontomas have been previously reported, none with the typical findings of acute sinusitis. Radiographs should always be considered in cases of recurrent maxillary sinusitis or pain, and the general practitioner should familiarize himself with lesions of the maxillary sinus that might be revealed in radiographic examination. Surgical excision is the preferred treatment for all odontomas, with no expectancy of recurrence. The odontoma described here was associated with an unusual bonelike capsule or cyst covering its superior surface, which necessitated careful exploration and dissection.


Office emergencies: an outline of causes, symptoms, and treatment. Conscientious dental practitioners are aware of the increasing chances for medical emergencies to arise in the dental office. New treatment modalities and drugs have increased potential life spans, but have also presented greater responsibilities to the dentist for properly managing these patients. Additionally, widely diversified sources are available to the dentist for acquiring and assembling all necessary information to train his personnel and organize equipment and drugs so he is constantly ready to handle any emergency. We have attempted to give a simple, thorough outline that provides basic information on causes, symptoms, and treatment of major medical emergencies, but that in no way reflects the only means of treating the specific emergency. We feel the manner presented allows one to regiment his diagnosis and treatment rapidly and make modifications to the list as needed.


Clinical evaluation of two pinless incisal edge repairs: a 24-month study. Adhesive resin and composite resin were used to restore the central incisors in a 21-year-old woman at an emergency treatment. Two maxillary fractured incisors were restored (one after endodontic treatment) and reexamined over a period of 24 months (Fig 5). Some slight yellowing has been noted in the endodontically treated tooth, but it has not appreciably affected appearance. The patient did not object to the discoloration and no replacements or additions were done. The restorations showed no indications of excessive wear or physical damage during the examination period.


Tissue considerations for mandibular subperiosteal implants. The criteria for the preoperative evaluation of the residual alveolar tissue for a potential implant patient have been discussed. To ensure a firm epithelial attachment around the implant post, the residual tissue at the point of oral penetration should be: (1) sufficient in amount or thickness and attached to the periosteum, (2) fibrous, not loose, areolar mucosa, and (3) positioned midway over the stress-bearing area for the implant and overlying prosthesis. If the existing tissue does not meet the above criteria, a free palatal graft can be placed over the point of oral penetration to improve the potential for tissue adaptation around the post.


Effect of rapid curing procedures on polymer implant materials. This investigation of standard curing methods for PMMA implants has demonstrated that alternate means of using the air oven may produce good strength properties along with a considerable degree of porosity, when desired, in a relatively short period of time. Curing of polymers in a pressure pot offers few advantages owing to the length of time required to produce, at best, equivalent strength for the porous materials. The method also poses dangers inherent in the use of superheated salt solution or hot glycerin. The autoclave is widely used in dental offices for sterilizing and will fully and consistently cure polymers within 30 minutes. The best properties for the PMMA resin were achieved with this method (61 MPa or 9,130 p.s.i., tensile strength). The microwave oven has become relatively inexpensive in recent years, and it offers time savings of up to 90 per cent which would be beneficial in implant dentistry or in dental laboratory procedures in general. The exact condition for curing particular polymers must be carefully determined to adjust the time of irradiation in order not to under- or overcure the polymer object. Curing polymers which contain intrinsic foaming agents under pressure conditions slightly reduced the total pore volume. But, pore volume and pore diameter in the large-bead polymers are determined predominantly by packing conditions, not curing conditions. Biologic tolerance to materials cured by these methods in primates is presently being evaluated.


Desmoplastic fibroma of bone. A case in the mandible. A case of desmoplastic fibroma of the mandible in a 25-year-old white man, expanding from the first molar to the ramus, is presented. This is a rare primary central neoplasm. It grows expansively and may destroy the cortex. Few cases in the mandible have been reported. Its diagnosis is important because the experience reported by different authors has shown the tendency for recurrence when treatment consists of less than radical resection.


Myofascial pain syndrome masquerading as temporomandibular joint pain. Myofascial pain syndrome of the TMJ region is not uncommon. It is important to realize that these patients often have a history of TMJ trauma, frequently have positive physical findings of the TMJ, and often have positive roentgenographic findings which continue following successful therapy of myofascial pain syndrome mimicking pain of the TMJ. Because of this, the malady is often diagnosed as TMJ disease, refractory to treatment, rather than correctly as myofascial pain syndrome. Continued investigation of myofascial pain syndrome of the TMJ region is indicated.


Solitary intraoral keratoacanthoma.

Solitary intraoral keratoacanthoma. A case of keratoacanthoma of the maxillary gingiva in a 12-year-old white boy has been presented. This is only the fourth case of solitary intraoral keratoacanthoma reported in the English-language literature. A review of the literature on solitary and multiple mucosal keratoacanthomas and the incidence of ectopic sebaceous glands has been included. In all mucous membrane locations where keratoacanthomas have arisen, there have been other reported cases of ectopic sebaceous glands in these areas. These findings have led us to consider that intraoral and perhaps all mucous membrane keratoacanthomas arise i, sebaceous glands or their ducts, whether they be normal in their location, as in the buccal mucosa, or ectopic.


The effects of sterilization techniques on the properties of intracanal instruments. Three common sterilization techniques, namely, autoclaving (15 and 25 minutes at 250 degrees F.), salt sterilization (5 and 10 seconds at 480 degrees F.), and dry heat (one hour at 340 degrees F.), were used to sterilize 420 root canal reamers and files, both carbon and stainless steel. These intracanal instruments were then tested in tension. An extra eighty-four intracanal instruments were tested without being subjected to any sterilization techniques and served as controls. It was found that carbon steel intracanal instruments were affected more by the different modes of sterilization than were the stainless steel instruments. Time of sterilization did not seem to have an effect on the properties of either instrument.


An attempt to correlate dentin and pulp changes in human carious teeth. The purpose of the present investigation was to study the dentin and pulp changes in the two halves of bisected carious teeth in order to determine if they are comparable. The dentin was studied by means of contact microradiography. Hypo- and hypermineralized zones, which were fairly similar in extension and degree of mineralization, were seen in the primary dentin of both halves of the teeth. If secondary dentin had formed, comparable amounts were usually present in the two halves. The pulp was studied, using demineralized 5 mum thick paraffin serial sections. In teeth with deep carious lesions severe inflammation with abscess formation was often observed in one half, whereas only scattered inflammatory cells were present in the other half. It seems questionable, therefore, whether the study of dentin and pulp reactions to caries in different halves of bisected teeth is a suitable method in investigations concerning a possible correlation between these reactions.


Electronic ohmmeter. An electronic device for the determination of the root canal length. The electronic ohmmeter was devised for the accurate determination of root canal length. Fifty-one maxillary anterior teeth of 43 patients and 25 posterior root canals from 10 patients were selected for the investigation. The presence of a lesion in periapical tissue, wide root apex, and exudates in the root canal contributed to inaccuracy in the determination of the root canal length. Correct length can be found if precautions are taken. The inaccurate results were corrected by repeating the procedures and taking precautions during the estimation of root canal length. Measurement in the dry canal gave correct estimation of the root canal length. When distilled water or normal saline was used as conducting medium in root canals, accuracy was not as good as in dry canals. The electronic ohmmeter is a useful and economical device and an endodontic aid for determination of the root canal length.


An estimation of somatic hazards to the United States population from dental radiography. Recently, data have become available pertaining both to the estimated somatic hazard from exposure of populations to low doses of ionizing radiation and to the extent of exposure resulting from dental radiography. This has made possible an estimation of the somatic hazard to the United States population from dental radiography. It is concluded that the greatest risk of lethality would result from induction of leukemia, but that the actual hazard is probably quite low. It is advised that all procedures which will reduce the radiation exposure to the patient consistent with diagnostic requirements should be employed in order to minimize the potential risk.


Osteochondroma of the mandibular condyle. Case report and its management. 1. A case of osteochondroma of the temporomandibular joint simulating a unilateral condylar hyperplasia is presented. 2. The need to divide the zygomatic arch to facilitate removal of large tumors is noted. 3. The removal of the growth resulted in normal functioning of the jaws with the disappearance of the features of unilateral hyperplasia. 4. Occlusal grinding is often necessary to correct the compensatory occlusal adjustment that occurs with the rotation of the mandible in these lesions. 5. The possibility of the presence of a tumor must be kept in mind when patients present with symptoms of unilateral condylar hyperplasia.


Cranial dislocation of mandibular condyle. The ninth case of condylar dislocation into the middle cranial fossa is reported. The previously reported cases are reviewed and the clinical findings which they have in common are pointed out. Because difficulty in establishing the diagnosis seems to be the most serious aspect of this clinical entity, it is advised that films of the temporomandibular joint be taken more frequently. Finally, although treatment varied from physical therapy to intracranial condylectomy, our case of closed withdrawal of the condyle from the cranial fossa is the first case on record so treated.


Central papillary atrophy of the tongue. Twenty-eight cases of central papillary atrophy of the tongue (CPA) are presented. Vegetative Candida species were commonly but not invariably seen on cytologic and histologic examination. Follow-up of fifteen cases showed spontaneous resolution of three. It is suggested that CPA of the tongue represents a clinical rather than a pathologic entity, and that the underlying disease process may not be identical in all cases.


Subacute thyroiditis as a cause of facial pain. Subacute thyroiditis is an inflammatory condition of the thyroid gland in which pain may be referred to the jaws. The clinical features of the condition are outlined and emphasized through an illustrative case report. Clinicians should include this disease in the differential diagnosis of facial pain. It is important that, in an area so fraught with emotional overlay, a precise and careful history be taken from all patients and that these data be married to a concise classification of potential causes.


Amyloidosis associated with multiple myeloma. Amyloidosis is a rare, fatal disease caused by deposition of a sulfated mucopolysaccharide in various tissues and organs. Seven to ten per cent of patients with multiple myeloma, a disease of abnormal myeloid cells, have associated amyloidosis. A case of amyloidosis associated with multiple myeloma is described and a differential diagnosis for oral amyloidosis is presented to familiarize the practitioner with this entity.


Ultrastructure of sclerotic cemental masses. Electron microscopic findings in a focus of early calcification in a case of sclerotic cemental masses of the jaws are described. The lesional cells generally resemble typical collagen-producing cells, except that many contain unusually large numbers of intracytoplasmic actinlike filaments. This and other fine structural features are reminiscent of fibroblasts involved in active tissue repair. These observations suggest that the lesion is basically reactive in its biologic nature. The most characteristic portion of the mineralized component, the rounded calcified globules, ultrastructurally resembles primary cementum.


Electron microscopic study of peripheral giant-cell reparative granuloma. Six giant-cell tumors have been examined by electron microscopic methods in order to determine their histogenesis and to expand knowledge of cell structures. The examination of giant cells revealed an abundance of cell organelles, especially mitochondria. Apart from typical stromal cells, such as fibroblasts, macrophages, and mast cells, clusters of stromal "light" cells were often found with an intimate relation between their cell membranes. The role and function of these cells is not well known. Between fibroblasts of regular appearance with a small number of cytoplasmic organelles, others were found with an incrased number of mitochondria. These cells often formed aggregates. This suggests that giant cells develop through the association of stroma fibroblast cells.


Hairlike variations of filiform papillae in the human tongue. The ultrastructural characteristics of the hairlike variations of filiform papillae in the human tongue were studied by scanning and transmission electron microscopy. The scanning electron microscope gives evidence of a three-dimensional image of abnormally long secondary papillae with the epithelial cells arranged like roof tiles. These are partly adhering, partly detached, and then protruding from the core, thus forming the hairlike structure. Transmission electron microscopy of ultrathin sections shows single or partly adhering, orthokeratinized epithelial surface cells, mostly with distinct signs of degradation, surrounded by microorganisms. The pathomorphologic picture of elongated, hairlike filiform papillae was observed on the tongue coating of patients with clinically diagnosed hairy tongue but also on some small areas of the tongue of infants. These latter findings cannot be characterized by the clinical term "hairy tongue" but must be considered to be hairlike variations of filiform papillae.


Cytochemical detection of homocysteine in pernicious anemia and in chronic erythremic myelosis. Utilizing a unique ability of homocysteine to form a yellow-brown precipitate with nickel chloride, a cytochemical test was developed in an effort to identify this amino acid. Among a variety of types of anemias studied, bright yellow-colored erythrocytes and erythroid precursors were found only in marrows from patients who had untreated pernicious anemia and chronic erythremic myelosis. The results of the study support the "methyltetrahydrofolate-trap" hypothesis in vitamin B12 deficiency, in which decreased activity of the methylocobalamin-dependent methyltransferase enzyme is believed to lead to accumulation of methyltetrahydrofolate and homocysteine in the deficient cells. The findings also raise the possibility that similar intracellular accumulations of homocysteine may occur in chronic erythremic myelosis, perhaps as a result of  a defect in the methyltransferase enzyme.


Surgical correction of the long face syndrome. The combined efforts of different specialists are needed for the successful treatment of patients with the long face syndrome. Both surgeons and orthodontists who recognize their own capabilities and limitations must combine their skills to achieve the best possible occlusion and facial esthetics. The surgical and orthodontic plan of therapy is designed to correct the patient's dentofacial deformity. Surgical reduction of facial height and proper alignment of the teeth by orthodontic means are common denominators of successful treatment. By properly planned and executed Le Fort I maxillary osteotomies, the vertical dimensions of the face can be shortened to improve the esthetic balance between the nose, upper lip, teeth, and chin and achieve lip competency. Variable open-bite and nonopen-bite maxillary deformities in forty adults with the long face syndrome were corrected by Le Fort I osteotomy and orthodontic treatment. The technical problems encountered in planning and executing treatment are discussed and illustrated by selected case reports.


Facial growth: before, during, and following orthodontic treatment. A longitudinal growth study was done on nineteen persons, involving three types of malocclusion and several types of treatment. Facial growth direction of the middle and lower face was compared during pretreatment, treatment, and posttreatment phases of the individuals. The individuals in the sample varied in direction of facial growth, Some individuals had an almost horizontal growth direction, and others had a vertical growth direction. The individuals in the sample varied in their degree of response to orthodontic treatment. Several had no change from their normal growth direction. Several had a deviation in direction associated with orthodontic treatment. The deviation was clockwise in nature and the direction changed from horizontal to vertical or from vertical to slightly backward of vertical. Middle and lower face tended to move in conjunction during all phases. If ANS moved in a horizontal direction, pogonion tended to move in a horizontal direction. If ANS moved in a vertical direction, pogonion tended to move in a vertical direction. If ANS stopped moving forward, pogonion stopped moving forward.


Successful treatment of acute leukemia during pregnancy. Combination therapy in the third trimester. Aggressive treatment with cytarabine, vincristine sulfate, and prednisone for acute myelogenous leukemia, administered from the 31 st week of pregnancy, resulted in both sustained complete remission of the leukemia and delivery of a normal infant with a normal birthweight and a normal male karyotype. It is concluded that chemotherapy with cytarabine combinations can be administered in the third, and probably the second, trimester of pregnancy without risk of serious damage to the developing fetus.


Enhanced osteosarcoma growth produced in rats by osteosarcoma allografts. Transplanted syngeneic osteosarcomas (induced by 32P in DA rats) grew significantly larger in DA rats receiving a simultaneous transplant of allogeneic osteosarcoma than in rats receiving syngeneic tumour only (P less than 0-01). Two other malignant allogeneic tumours, and allogeneic spleen cells, did not alter the growth of the transplanted syngeneic osteosarcomas. When the allogeneic osteosarcoma was given 7 days before the syngeneic tumour, the reverse effect (retardation) occurred. When given 7 days after the syngeneic tumour cells, the effect on both syngeneic and allogeneic tumour growth was variable. Some possible reasons for these findings are discussed, and the argument is presented that immunological phenonema are involved in the reaction.


Interacting cell populations in cultures of leukocytes from normal or leukemic peripheral blood. Kinetic studies in cultures containing 2 X 10(5) peripheral leukocytes from patients with acute myelobastic leukemia revealed extensive, radiation-sensitive increases in thymidine incorporation without parallel increases in cell number. Modest and variable stimulation of 3HTdR incorporation was seen with the addition of either leukocyte-conditioned medium prepared with phytohemagglutin (PHA) or PHA alone. However, using the method of limiting dilution, stimulation was always observed and ranged from 3- to 20-fold in individual patients. By mixing small numbers of intact cells with larger numbers of irradiated autologous cells, quantitative evidence was obtained for a cellular interaction between irradiated, PHA-stimulated populations capable of 3HTdR incorporation. Similar evidence for cell-cell interaction was obtained for normal leukocytes.


Ph1-positive acute lymphocytic leukemia with chromosome 7 abnormalities. A 56-yr-old woman with acute lymphocytic leukemia showed the presence of a Philadelphia chromosome in 90% of the bone marrow metaphases and in 10% of the peripheral blood metaphases. Part of the long arm of a G22 chromsome was translocated to the long arm of a C9 chromosome. A second cytogenetic abnormality was found in chromosome 7. Monosomy 7 was found in 60% of the marrow and in 20% of the peripheral blood metaphases. Chromosome 7q- was also found in a small percentage of the metaphases examined. Three months later, when the patient was in partial remission, only 10% of the marrow cells showed chromosome 7 monosomy and a Ph1  chromosome. During complete remission, no chromosomal abnormalities were found, except for a high breakage rate. The finding of a Ph1 chromosome in acute lymphocytic leukemia indicates that different precursors, both granulocytic and lymphocytic, may be involved in the Ph1 process.


An improved percutaneous jetting system for use during microlaryngeal operations. Studies carried out in the laboratory have shown that an S-shaped cannula for trans-laryngeal jet ventilation provides a distinct advantage over conventional straight ones. Tidal volumes are larger and the cannula is more stable in position. The tendency of perforate the posterior wall of the trachea during introduction is also minimal. Blood gas data obtained from patients being operated upon with this technique of anaesthesia show that it provides very adequate ventilation and can be effectively used with balanced anaesthesia if a nitrous oxide-oxygen blender is incorporated into the jetting system. It can be put in position before induction of anaesthesia to enable preoxygenation and assist ventilation and can be left in place at the end of the operation until the patient is breathing adequately. If necessary, a tracheostomy can be done with the cannula in situ. It is not proposed that this should be the standard mode of anaesthesia or ventilation for patients undergoing operations on the larynx, but in stituations where other methods are not adequate and when significant upper airway obstruction is present, this is an excellent alternative.


Fluidics and pneumatics: principles and applications in anaesthesia. This article describes the construction and operation of fluidic and pneumatic devices in current use, as well as the principles of their use in medical devices. The designs for an automatic blood pressure cuff inflator, a blood pump and a high performance ventilator are presented.


Blindness during remission in two patients with acute lymphoblastic leukemia: a possible complication of multimodality therapy. Two patients with acute lymphoblastic leukemia treated on the same protocol became blind during complete remission. Therapy consisted of systemic combination chemotherapy, prophylactic central nervous system irradiation and monthly intrathecal cytosine arabinoside. Eight months after CNS irradiation visual acuity in both patients began to decrease. Meningeal leukemia in the area of the chiasm was suspected but despite additional radiotherapy, steroids and continued intrathecal therapy, both patients were blind within 6 months. Numerous lumbar punctures were negative for leukemic cells. Extensive investigation, including craniotomy in one case, failed to reveal the cause of blindness. Biopsy of the optic nerve in one case was compatible with radiation toxicity. We postulate that potentiation of radiation toxicity to the optic nerves and chiasm by systemic chemotherapy, intrathecal chemotherapy, or both, may have led to blindness. The patients continue in complete hemotologic and CNS remission 12 and 29 months after becoming blind.


An experimental approach to relate a tumor-associated enzyme marker to tumor cell numbers. Alkaline phosphatase was monitored in 17 mice with s.c.-implanted tumors to relate the total circulating alkaline phosphatase to the total number of tumor cells in each mouse. There was a semilogarithmic relationship between the alkaline phosphatase units and the number of tumor cells. A time-independent standard plot of alkaline phosphatase and the number of tumor cells was used to estimate the size of disseminated and localized tumors. In animals treated with cyclophosphamide, the alkaline phosphatase marker was used to monitor the regression and recurrence of the neoplasm in vivo.


Effect of hexamethylene bisacetamide on the commitment to differentiation of murine erythroleukemia cells. Friend virus-transformed murine erythroleukemia cells express the program of erythropoietic differentiation under the influence of the previously described, potent inducing agent, hexamethylene bisacetamide. Commitment to differentiation, defined as the ability to continue the processes of differentiation in the absence of inducer, has been examined at the single-cell level, with a combination of suspension and cell-cloning techniques. Recruitment of committed cells is shown to occur prior to the detectable accumulation of hemoglobin or the appearance of morphological changes characteristic or erythroid maturation. The stability of the commitment of murine erythroleukemia cells to differentiate is found to be dependent upon both the concentration of hexamethylene bisacetamide and the duration of exposure to the inducing agent. Under conditions less than optimal for induction, a single cell can give rise to a colony containing both differentiated and undifferentiated cells. On the basis of these findings, it is suggested that fully stabilized differentiation, in addition to the previously demonstrated requirement for the inducing agent to be present during a cell-cycle S phase, involves subsequent stabilizing event(s) caused by a direct or indirect action of the inducing agent.


L-Asparaginase, vincristine, and prednisone for induction of first remission in acute lymphocytic leukemia. L-Asparaginase was added to vincristine and prednisone for induction of first remission in 815 children with acute lymphocytic or acute undifferentiated leukemia. This combination resulted in an overall remission rate of 93%. The addition of L-asparaginse to the standard induction regimen using prednisone and vincristine did not significantly increase the morbidity or mortality rate during the induction period. The most common side effect was transient L-asparaginase-induced hyperglycemia. The safe administration of L-asparaginase i.m. and the dose efficacy of 6000 I.U./sq m were confirmed. For these reasons, L-asparaginase should be combined with vincristine and prednisone for the initial induction of children with acute lymphocytic or acute undifferentiated leukemia.


Toxic psychosis due to cyproheptadine in a child on hemodialysis: a case report. In 1971 Simmons et al. presented evidence that children receiving regular dialysis therapy required approximately seventy percent of recommended caloric intake to achieve normal growth. Since that time, pediatric nephrologists and dietitians have strived to meet that requirement. In an effort to attain adequate caloric intake, cyproheptadine, a known appetite stimulant, was prescribed to a child on chronic hemodialysis. The following reports the unexpected complication of toxic psychosis that resulted.


Clinical trial in mentally retarded of chlorhexidine dental gel: bacteriology. A dental gel containing 1 % chlorhexidine was applied daily to the teeth of mentally retarded patients for a period of 6 months. Although possible antimicrobial effects were noted, the gel had no practical value in reducing the numbers of different plaque bacteria. It is suggested that the lack of effect may be due to changes in susceptibility of the oral flora surviving in the mouth, allowing subsequent recolonization of the teeth.


WHO activities in oral epidemiology.

WHO activities in oral epidemiology. Standard methods to facilitate the collection of data on a global basis have been developed by WHO. Data collection in accordance with criteria proposed by WHO began in 1969 from existing sources and was subsequently supplemented by new data collected using the standard methods. Associated with these methods developments, a WHO Global Oral Epidemiology program was begun with the objective of facilitating comparison of data and their use in planning, replanning, and evaluating oral health services according to needs and economic possibilities. That program provides an orderly storage and retrieval system and a visual representation of contrasts in prevalence of those oral diseases which are among the most common known to man. In selecting data for inclusion in the WHO oral epidemiology data bank, a liberal policy has been pursued to make maximum use of available material. The system of classification allows for data retrieval at various levels and for specific ages. Data on caries are available for 95 countries and on periodontal diseases for 50 countries.


Plaque, caries, periodontal diseases, and acculturation among Yanomamö Indians, Venezuela. The number of DM and d teeth and surfaces was recorded for 220 Yanomamö Indians from three groups of villages with different degrees of contact with Western culture. Specimens of plaque were taken from the teeth, transported in a holding solution, cultured, and examined for specific oral streptococci. In addition, the periodontal health and oral hygiene of one group of villagers were assessed using the Russell PI and the Greene & Vermillions OHIS. Caries experience among the Yanomamö was shown to be positively associated with exposure to Western culture. S. mutans was recovered with about the same frequency from specimens taken from the teeth of Indians living at all three village locations. However, the presence of S. mutans alone did not account for the disparity in dental caries scores. The examinees had abundant and persistent accumulations of soft deposits on their teeth accompanied by markedly inflamed gingival tissues. However, periodontal pockets and loss of appreciable amounts of bone did not appear as early in life nor were they as severe as reported for some other populations which practice little oral hygiene. Those disparities in the distribution of plaque-induced oral diseases between Western populations and the Yanomamö warrant further study.


Oral conditions in a population of young adults in Strasbourg. The oral conditions of 1,993 young adults, 16-30 years old, constituting a statistically representative random sample of the population of Strasbourg, were studied. Plaque, calculus, and gingival indices were determined as well as DMFT and DMFS caries indices. All these indices showed a highly statistically significant linear correlation with age. Sex had a significant influence on caries indices but not on plaque, calculus, or gingival indices. Socioprofessional conditions had a very significant influence on caries and gingival indices but not much on plaque index and not at all on calculus index.


Epidemiology of dental caries in the premolar and second molar teeth of Scottish children in relation to pits and fissures. To evaluate the potential benefits from elimination of dental caries in the fissures of teeth, surface patterns of decay were calculated for all surfaces of the premolar and second molar teeth of 98 children followed longitudinally for 5 years, between ages 11 and 15 years. Tooth eruption and susceptibility were also examined in relation to the administration of sealant programs. The children who were part of the control group of a fluoride dentifrice study on the Scottish Isle of Lewis, had low exposure to fluorides, high caries attack and very low restorative treatment levels; so true surface caries distribution was not masked. Variation in tooth eruption and susceptibility suggested that semiannual applications of preventive agents at each year age 10 through 15 might be required. Using hypothetical percentage reductions, the substantial potential benefits for caries control of the early use of completely retained occlusal, as well as buccal and lingual (molars), fissure sealants are conclusively demonstrated. However, improvements in the present technology of fissure sealants and their application are apparently required if these benefits are to be extended to large groups of children.


An epidemiologic study of factors affecting extrinsic staining of teeth in an English population. A survey is described in which extrinsic staining of teeth was assessed by practising dentists during routine clinical examinations. Habits information was also supplied by patients. The results show that extrinsic staining is markedly influenced by smoking habits and age, and that males tend to have more staining than females. The effect of tea and coffee consumption was not pronounced. No effect attributable to the use of a stannous fluoride toothpaste was observed.


Relationships between fluoride in enamel, DMFT index and fluorosis in high- and low-fluoride areas in South Africa. The DMFT Index, degree of fluorosis (DEGF), and enamel fluoride concentration (F) were determined in 88 children living in a high- and 79 children living in a low-fluoride area in South Africa. The following interrelationships between these parameters were found: in both areas there was a significant negative correlation between log F and age; in the high-fluoride area there was a significant positive correlation between log F and DEGF; and in the combined data from the two areas there were significant correlations between log F and area, log F and age, and log F and DEGF, and a significant association between DEGF and area. There were no significant correlations between DMFT and log F and between DMFT and DEGF.


Sweetened drinks as a source of sugar intake in selected teenagers in south-east England. Two hundred and forty-six young teenagers taking part in a dental survey in the South-East of England were questioned about their usual drinks. The overwhelming majority of these drinks contained sugar. There were significantly more girls than boys in the group choosing unsweetened beverages. Dissatisfaction with their appearance due to acne or obesity was the main factor which had persuaded a small number who had previously sweetened their tea or coffee to reduce their sugar consumption, use a sugar substitute, or abstain altogether from sweeteining their beverages.


[Follow-up studies on the caries susceptibility and gingival irritation by partial dentures]. Caries incidence and gingival irritation were studied in 245 teeth with partial crowns of 62 patients of a dental practice after an average 3.24 years of wearing such crowns. At the beginning of the treatment, the group of patients tested showed an average caries incidence with a DMFT index of 14.9 +/- 4.0. In the follow-up, the mean value of the simplified OH index was 1.16 +/- 0.34. None of the partial crowns had to be re-cemented because of insufficient retention in the period covered by this study. Secondary marginal caries developed in only 0.4%, primary caires in 6.1% of the teeth with partial crowns. Marginal inflammation was significantly more frequent in teeth with partial crowns than in teeth without crowns. When evaluating the individual sections of the crowns, the highest degree of inflaterproximal region.


[Studies on the halfside comparison of heterotopic transplantation of mucosa with and without epithelium]. In patients with symmetric recessions in their canine and premolar regions, one side was supplied with an epithelium-containing and the other with an epithelium-free graft from the hard palate. Both sides were studied and compared. After six months, the size of the connective tissue transplants was reduced by 50% (that of the epithelium transplants by 0%). Within half a year, the width of the attached gingiva had decreased by 36% in the case of connective tissue transplants (epithelium transplants by 15%) and the vertical graft width by 60% (epithelium transpltnas 17%). Our clinical and histological findings suggest that grafting of heterotopic connective tissue transplants is not equal to epithelium-containing transplants.


[The effect of various orthodontic treatment technics on the gingiva]. Out of a group of 30 patients aged from 11 to 15 years, 10 each were treated with either fixed appliances, or removal plates, or by functional orthodontics. Prior to the beginning of the treatment, and one week and six weeks thereafter, pocket depth, SB index, sulcus fluid flow rate, and OH index were recorded. The inflammatory symptoms of the gingiva were shown to be a function of the OH index. Moreover, the OH index grew worse during orthodontic treatment, especially in the group with fixed appliances.


[A mathematical model of the alveolar periodontal function]. The process of loading and relieving dental and periodontal tissue is algebraically defined. The mathematic definition allows an energy balance to be established. The energy deficit observed after loading permtis the biotechnical analogy of the unit tooth-periodontium as a biological shock absorber, whose functioning can be controlled.


[Clinical methods for the objective evaluation of oral hygiene]. Thus, it was the object of this investigation to test the common plaque indices with regard to their usuability and to compare them with a newly developed approximal space plaque index (API).


Forensic dentistry and the human dentition in individual age estimations. The forensic dentist can estimate the age of an individual by observing the developing dentition. Systematic observations can provide accurate age estimations depending of the criteria used and the experience and training of the dentist. Anatomical, histological, and radiographic examinations of the teeth are of great value. Admittedly, some of the aforementioned methods are complicated and require prolonged time periods to perform. Alternative methods of age estimation may be required when rapid results are demanded by the police or other agencies. It is, however, the obligation of the forensic dentist to provide the precise age data. Therefore, all available resource materials must carefully evaluated, including the possible factors that may cause variations. Only after data is carefully evaluated can the error in age estimations be reduced.


Blood group determinations in forensic dentistry. The identification of A, B, and H substances is a useful tool in forensic examinations. At the present time fresh blood or blood stains are used most extensively for blood group detection in forensic cases. Various body fluids from secretors also contain A, B, and H substances, and recent techniques have increased the reliability of the determination of blood group substances present. Soft and hard tissues also contain blood group substances, but at the present time these are not used routinely in forensic examinations. However, adaption of the more sensitive assays may increase the utilization of these tissues. Of particular value would be the development of simpler methods for blood group substances in teeth, since teeth are more resistant to putrefication than most other substances.


Suicidal wishes and depression in suicidal ideators: a comparison with attempted suicides. A depression inventory was administered to a sample of psychiatric patients who had some suicidal ideation. A factor analysis of their responses to the inventory resulted in a factorial structure similar to that obtained for attempted suicides. The suicidal ideators were found to have higher depression scores on the inventory than the attempted suicides. It was suggested that this study supported the notion that individuals who show differing kinds of suicidal behavior nonetheless may show similar psychological phenomena.


Survey of curriculum and instruction: oral medicine. Oral  medicine programs in U.S. and Canadian dental schools generally concern the nonsurgical management of oral and surrounding tissues as related to the total health of the patients. A survey was conducted to determine the current status of program administration, curriculum, graduate programs, and continuing education in oral medicine. A wide variance in responses received indicated a general lack of consensus on the teaching of oral medicine.


Pulpal reaction to polycarboxylate and zinc phosphate cements used with inlays in deep cavity preparations. The purpose of the present investigation was to compare histologically pulpal reactions beneath inlays cemented with either a zinc phosphate or a polycarboxylate cement. No inflammatory reaction was seen beneath any of the 39 deep cavity preparations in teeth without pulpal lesions and with an inlay cemented with polycarboxylate cement. In the contralateral teeth, under 39 inlays cemented with zinc phosphate cement, an inflammatory reaction was seen beneath two cavity preparations. In one, bacteria were found on the floor of the preparation. On the basis of this result and the findings of our earlier investigations, it may be warranted to conclude that neither the polycarboxylate cement nor the zinc phosphate cement has any notable irritating effect on the pulp. If the irritation occurs after cementation of the restoration, it may be caused by debris containing bacteria and left behind on the prepared surfaces by bacterial growth from the surface of the tooth. The findings underline the importance of removing grinding debris and bacteria before cementation of the restoration.


A statistical evaluation of 952 endosteal implants in humans. Of the 952 alloplastic endosteal implants studied for up to 108 months, only the endodontic endosteal implant demonstrated long-range success. A success rate of 49% after 72 months was found in all but the endosteal implants. The evaluation of individual implant designs demonstrated that long, straight shaft lengths such as the transosteal impland survived for long periods. Future efforts should be applied to studies on the use of porous metals, polymers, ceramics, and carbons in laboratory animals, to evaluate attachment phenomena and stability of the gingival cuff. In this manner, we may establish reliable standards and procedures that may be used confidently by the practitioner.


Odontogenic keratocyst treated by the Partsch operation and delayed enucleation: report of case. A large keratocyst was conservatively treated for four years. The use of the Partsch operation, with subsequent cyst enucleation after several years, prevented paresthesia, allowed bone healing, and facilitated surgical access. Because of the high incidence of recurrence, we will continue to follow up on the patient's condition.


Oral health of airmen: analysis of panoramic radiographic and Polaroid photographic survey. An oral health survey of 5,783 basic airmen was conducted. In this study, emphasis was placed on detection of periodontal disease. Numerous pathologic conditions were found and recorded. In addition, the presence or absence of evidence of previous dental care and its nature were reported. We believe that panoramic radiographs and Polaroid intraoral photographs have merit in mass screening of large numbers of persons for the detection of periodontal disease. Through the use of these diagnostic aids, various degrees of periodontal disease could be diagnosed. Other pathologic entities that might have been missed with routine dental radiographs were observed. However, although the diagnostic aids used in this report are a helpful adjunct, in their present state of development they should not be used to replace standard dental radiographs and clinical examination.


Ecological effects of a deodorant and a plain soap upon human skin bacteria. The effects of a commercial trichlorocarbanilide-containing deodorant soap and a commercial plain soap upon the cutaneous flora of individuals were compared. Using a cross-over design, 21 volunteers (10 women and 11 men) washed their forearms at least once a day with one soap for 3 weeks and then switched soaps for another 4 weeks use. By analysis of variance no significant difference in total colony counts was noted among individuals in their use of the two soaps. With the exception of individual variation, neither sequence of use, sex, nor any combination was influential. However, in 20 of 21 subjects an alteration in the composition of skin flora was observed. The deodorant soap, which in six cases increased total flora, tended to reduce or eliminate diphtheroids in 12 to 17 carriers (71%). Fewer kinds of bacteria were also noted. More Staphylococcus epidermidis was seen with the plain soap, but washing with the deodorant soap seemed to favour Acinetobacter calcoaceticus and Micrococcus luteus. The impact of this alteration and the use of total counts to measure effectiveness of deodorant soaps were brought into question.


Cold water, ultra-high pressure cleaning of abattoirs. Cold water (10 degrees C) at ultra-high pressure (38-5--49 kg/cm2) was compared with (a) hot water 65-6--82.2 degrees C) at low pressure (4-2--5-6 kg/cm2) and (b) hot water containing a detergent (2% (w/v) sodium silicate). Seven sites were examined in a beef abattoir and six in a bacon factor. Three surfaces in the beef abattoir had lower residual colony counts (higher reductions) after hot water/low pressure than after cold water/high pressure. However, the differences were not significant (P greater than 0-05). The range of the mean log10 count/cm2 before cleaning was 4-02-5.15, and after cleaning 1-73-2.32 (hot water) and 1-9--2-85 (cold water). On three of the remaining sites, the three methods were compared. The total differences between treatments were not significant (P greater than 0-05), although there was an effect of surface and an interaction between surface and treatment. The cold water produced lower residual counts on three sites in the bacon factory than the hot water (45--54 degrees C). However, the differences were not significant on the remaining surfaces.


Hospital Salmonella johannesburg infection and its possible role in the community spread of the infection in Hong Kong. Salmonella johannesburg (1, 40: b: e, n, x), a previously rare salmonella serotype, has established itself rapidly as an important and highly prevalent cause of gastroenteritis among children. The clinical features of the infection are usually mild but chronic. It has been suggested that S. johannesburg was introduced into Hong Kong through imported foods but no common vehicle could be traced as the source of infection. A thorough investigation of one paediatric ward in a general hospital revealed that non-infected patients admitted to the ward usually acquired S. johannesburg infection within 3-7 days, with or without symptoms. Thus hospital cross-infection could be a significant factor in contributing to its rapid spread in the community. Furthermore, the rapidity with which S. johannesburg spread was facilitated by (a) its tendency to produce a chronic infection, (b) its multiple resistance to antibiotics, and (c) the higher infectivity of S. johannesburg over other salmonellas endemic in this locality. These factors combined with the overcrowded conditions in many of the hospitals in Hong Kong facilitated the occurrence of hospital infection, which in its turn contributed to the spread of the infection in the local community.


Salmonella dublin infection in adult cattle: a slaughter house and knackery survey in South West Wales. A survey was carried out between June 1970 and December 1971 in which gall bladders from cattle either slaughtered for food consumption or disposed of through knackeries were cultured for salmonellas. Salmonella dublin was isolated from 28 of 1917 gall-bladders of adult cattle killed in the slaughterhouse at Carmarthen, and from 23 of 197 gall-bladders obtained from adult cattle sent to a knackery at Abergwili, near Carmarthen. The results are compared with a similar survey carried out in 1947 and 1948. Between June and November 1971 gall-bladders and uteri were also obtained from a slaughterhouse in Newcastle Emlyn, North Carmarthenshire, and a knackery in Tanygroes, South Cardiganshire. S. dublin was cultured from two gall-bladders but from none of the uteri of the 161 slaughterhouse cases. Seven of the 46 cows from the knackery yielded S. dublin on culture: 2 in the gall-bladder only, 3 in the uterus only and 2 in both gall bladder and uterus.


Thermal comfort of patients in hospital ward areas. The patient is identified as being of prime importance for comfort standards in hospital ward areas, other ward users being expected to adjust their dress to suit the conditions necessary for patients comfort. A study to identify the optimum steady state conditions for patients comfort is then described. Although this study raises some doubts as to the applicability of the standard thermal comfort assessment techniques to ward areas, it is felt that its results give a good indication of the steady-state conditions preferred by the patients. These were an air temperature of between 21-5 degrees and 22 degrees C and a relative humidity of between 30% and 70%, where the air velocity was less than 0-1 m/s and the mean radiant temperature was close to air temperature.


Decline of maternal antibodies to plague in Norway rats. The decline of maternal antibodies to the fraciton I antigen of Yersinia pestis was investigated in newly weaned Rattus norvegicus obtained from dams vaccinated with strain EV76(51F) of Y. pestis. IHA titre decreased by 50% each 7-3 days and CF titre declined 50% each 10-0 days in young rats. An analysis of available data indicated that maternal IHA and CF antibodies could persist to 3 months of age. Therefore, positive serologic reactions in young R. norvegicus, detected in the course of serological surveys, could be the result either of active immunization after exposure to the plague bacillus or of transient passive immunization (i.e. maternal antibody).


Prevalence of antibody to hepatitits B surface antigen among staff in an Edinburgh hospital. Antibody to hepatitis B surface antigen was detected by radioimmunoprecipitation in 74 (5-5%) of 1336 staff members in a large general hospital in Edinburgh, in 14 (2-9%) of 480 volunteer blood donors in the area, and in 12 (6-1%) of 197 pregnant women attending for the first time at the ante-natal clinic in the hospital. Rates of antibody prevalence rose with age in the sample of hospital staff and in that of the blood donors, particularly among males. On the other hand, in the ante-natal patients antibody prevalence declined with age. The rates in hospital staff were higher than those in blood donors of comparable age and sex, and high titres of antibody were more common in the staff group. However, no association was found between antibody prevalence and a history of clinical hepatitis, blood transfusion, or recognized contact with cases of hepatitis. Staff who had previously worked in an infectious disease hospital did not show increased antibody prevalence, indicating that simple isolation measures have been adequate to minimize exposure to hepatitis B. No particular prevalence of infection was seen in physicians and surgeons, in the nursing staff, or in workers in clinical diagnostic laboratories, hospital administration or other areas. One group clearly showing increased antibody prevalence was staff currently working, or who had worked, in the Haemodialysis Unit; this correlated with the outbreak of dialysis-associated hepatitis in 1969--70. However, no evidence suggested that significant dissemination of infection had occurred to other defined groups of hospital staff. Elevated rates were also observed in a small sample of kitchen and portering staff, and in obstetric medical and nursing staff; the latter observation indicate a need for further investigation to identify unsuspected exposure to hepatitis B virus.


The susceptibility of Tatera indica, Nesokia indica and Bandicota bengalensis to three anticoagulant rodenticides. Three South-Asian rodent past species were tested for susceptibility to anticoagulant rodenticides. Wheat fluor containing 0-025% warfarin 0-0375% coumatetralyl or 0-005% difenacoum was fed to 260 Tatera indica, 140 Nesokia indica and 81 Bandicota bengalensis for 1-56 days. Tatera was about as susceptible to anticoagulants as Rattus has been reported to be. Nesokia and Bandicota were extremely variable: though the majority were highly susceptible, the slopes of the dose-mortality curves were close to zero. The difenacoum diet appeared to be more toxic than the warfarin diet to all three species, but less toxic than the coumatetralyl diet to Tatera and Nesokia. All of the anticoagulants were eventually lethal to all of the animals tested.


Speech and lingual behavior before and after mandibular osteotomy. A procedure was applied to compare the oral behavior of five patients before and after mandibular osteotomy for correction of Class III malocclusions. It was found that observable changes in oral behavior do occur after mandibular osteotomy. Fewer errors were found in sibilant articulation, while more maladaptive lingual behaviors were found in lingual diadochokinetic tasks. Changes were also found in swallowing behaviors. Performance tasks of speech, diadochokinetics, and swallowing were recorded on audio-videotape.


An evaluation of bupivacaine for regional nerve block in oral surgery. Bupivacaine provided profound local anesthesia for the removal of impacted third molars in 49 of 50 patients with a minimum of side effects. The drug provides rapid onset and prolonged duration of anesthesia and has good tissue-penetrating properties.


Retrieval of an upper third molar from the infratemporal space. A case of dislocation of a maxillary third molar into the infratemporal fossa is described. The diagnostic and therapeutic problems are discussed. The tooth was removed through an osseous window that was made in the posterior wall of the maxillary sinus. The healing was uncomplicated, without maxillary sinusitis, and the reduced ability to open the mouth returned to normal. A slight diplopia persisted.


Osteochondroma of the mandibular condyle: report of case. A case of osteochondroma of the mandibular condyle has been presented. The facial and occlusal deformities produced by the tumor are described. After the surgical treatment and concomitant orthodontic treatment, satisfactory occlusion and facial contour were established.


Odontogenic adenomatoid tumor: report of case and review of the literature. An unusual case of odontogenic adenomatoid tumor in the mandible of an 11-year-old Ethiopian girl is described. This case is unique because of the extensive size of the tumor (12 cm), long duration, the number of associated impacted teeth (seven), the pronounced areas of radiopaqueness, the multiocular configuration, the anomalous tooth form, and the fact that deciduous teeth were involved.


Ameloblastic fibroma.

Ameloblastic fibroma. A case of an ameloblastic fibroma in the mandible of a 14-year-old boy with a six-month follow-up is reported. A brief comparison is made between the ameloblastic fibroma and the simple ameloblastoma.


Lengthening of mandibular body by gradual surgical-orthodontic distraction. Lengthening of the mandibular body in two dogs was achieved with a technique that involved osteotomies and the use of an experimental orthodontic appliance; the approximation of the resected mandibular segments was maintained. There was no damage to the mandibular nerve and no conspicuous alterations of the nerve fibers. On the basis of results in experimental studies, the technique is proposed for use in correction of large discrepancies in length in persons with excessive mandibular retrusion.


The age factor in human extraction wound healing. Age as a factor in extraction wound healing was studied. The healing time in individuals in the second decade of life was compared to that in individuals in the sixth decade and older. In the first ten-day postextraction period, no significant differences in the rate of healing between young and older individuals was noted. At approximately ten days, the rate of regeneration of the tissues of younger individuals began to accelerate. At approximately 20 days, after a lag phase, the rate of regeneration of tissues of older individuals began to accelerate. At approximately 30 days, the rates of healing were equal between young and older individuals. These findings of the period of most active regeneration of reparative marrow tissue in younger and older individuals may have significance in the timing of donor material in marrow transplant procedures. This aspect is currently under investigation.


Recurrent cementifying fibroma of the maxilla: report of case. A case of recurrent cementifying fibroma of the maxilla has been presented. When the lesion was excised in 1948, it was reportedly well delineated from surrounding bone. There was no delineation of the tumor from the surrounding bone at the time of the operation in 1972.


Fracture-dislocation of the mandibular condyle: report of case. A rare type of ramus fracture-dislocation has been presented. The inadequacy of standard mandibular fracture radiographic views for proper diagnosis of variable dislocations has been stressed. It was noted that proper positioning of the mandible in panoramic radiography would facilitate a satisfactory radiographic survey of the glenoid fossa and the condyle. In this case, interpositional silastic gap arthroplasty was performed to correct an extraarticular ankylosis and to restore mandibular function.


Fatal massive edema of the head and neck secondary to scalp laceration: report of case. A case of fatal massive edema of the head and neck secondary to subgaleal involvement from a scalp laceration has been presented. Subgaleal infections have been rare since the advent of antibiotics. The unusual and serious nature of the condition is made evident, with considerations of differential diagnosis included.


Sagittal osteotomy of the mandibular horizontal ramus for correction of apertognathia: report of case. A case of anterior skeletal open bite was successfully treated with a sagittal osteotomy of the mandibular horizontal ramus. Advantages of this technique are good access and ease of surgery, broad medullary contact at osteotomy sites, and elimination of the need for a bone graft. Close cooperation between speech pathologist and surgeon is essential when apertognathia is acquired by tongue-thrust or abnormal oral habits. Removal of causal factors and adequate immobilization will reduce the chance for relapse often seen in open bite surgery.


Evaluation of the surgical stability of 20 cases of inverted-L and C osteotomies. Twenty cases of inverted-L and C osteotomies were analyzed retrospectively to evaluate the stability of the surgical results. The incidence and degree of relapse are reported for each procedure. Possible compensatory mechanisms, which may be active in counteracting the skeletal relapse observed, are discussed. Several methods of compensating for the anticipated relapse are described. Since tabulation of the original data, 12 of the 20 patients have been followed up for an additional 6 to 12 months. Seven patients had been treated with the inverted-L osteotomy. In these patients, there was an additional 4% loss of the amount of correction in anterior facial height and 8% loss in posterior facial height. Five patients were in the C osteotomy group. An additional 3% of the initial advancement was lost in this interval. Significant occlusal changes were not observed in any of the cases and the skeletal results were still acceptable.


Production and origin of oral malodor: a review of mechanisms and methods of analysis. Organoleptic studies indicate that the oral cavity is usually the principal source of physiologic malodor associated with the early morning halitosis. In all individuals, regardless of the age or health status of the oral tissues, the most intense oral malodor is exhibited after prolonged periods of reduced saliva flow and abstinence from food and liquid. This results from normal metabolic activity in the oral cavity and is accentuated in cases with periodontal involvement. Physiologic oral malodor is transient in duration as it can be controlled to varying degrees in most individuals by oral hygiene measures, such as tooth brushing, dental prophylaxis, tongue scraping and rinsing with antiseptic mouth washes. Experimental evidence strongly suggests that putrefaction of sulphur-containing proteinaceous substrates by predominantly gram-negative oral microorganisms is the primary cause of oral malodor. Optimum putrefactive activity occurs in low carbohydrate environment, physiological pH, and anaerobic conditions. Salivary sediment containing the exfoliated epithelial cells is the primary source of substrate which exists in a disulphide state. Proteolysis and reduction of disulphide bonds precedes the formation of odor. The odor intensity of putrescent saliva and plaque head-space vapor has been correlated with the concentration of volatile sulphur compounds consisting of hydrogen sulphide, methyl mercaptan, dimethyl sulphide and dimethyl disulphide. Except for dimethyl disulphide, the same sulphur-containing compounds have been found in mouth air of all tested individuals. Hydrogen sulphide and methyl mercaptan emanate an offensive putrid odor and account for approxiamtely 90% of the total sulphur content of mouth air. In half of the population tested, methyl mercaptan and hydrogen sulphide content of early morning mouth air is sufficiently high to account for the oral malodor. Brushing studies indicate that both plaque and tongue are important sources of malodor with most of the odor emanating from the dorso-posterior surface of the tongue. None of the gas chromatographic or mass spectrometric analyses have detected the presence of amines, indole, or skatole in the head-space, mouth air, or breath vapor samples.


A photometric study of the color of health gingiva. An apparatus was developed that was found suitable for measuring gingival color in terms of reflectance at 6328 A. A total of 445 readings were taken on 95 Caucasian subjects in order to determine certain properties of healthy gingival color. It was determined that: 1. Healthy adult gingival color ranged in reflectance from 17% to 45% of the magnesium oxide standard, with a mean of 32%. 2. Gingival color of children was lighter than that of adults. The reflectance of children's gingiva ranged from 31% to 43%, with a mean of 35%. 3. Gingival color did not vary with the sex of the individual. 4. Gingival color was lighter in individuals with blonde hair than in individuals with brown hair. 5. Gingival color was darker in individuals with darker eye color. 6. Gingival color was lighter in individuals with geographic origins that are commonly related to lighter complexions. 7. Gingival color did not vary with age, within the adult range covered in this study. 8. Gingival color did not vary with the following physiological and physical factors: menstrual period, use of oral contraceptives, smoking habits, moistness or dryness of the gingiva, which side was measured, time of day, or time after toothbrushing, smoking a cigarette, eating an apple, or drinking a hot beverage.


Preserved scleral allografts in periodontal defects in man. II. Histological evaluation. 1. The scleral grafts appeared to be well accepted as there were no signs of antigenicity or untoward reactions. 2. The gingival connective tissue, periodontal ligament and the periosteum were observed intertwined with sclera at the interface. 3. Sclera was invaded by host fibroblasts, capillaries, and appeared in some areas to be raplaced by a dense connective tissue. 4. Areas of cementogenesis could be observed in all specimens. 5. There were no signs of osteogenesis within the scleral grafts. 6. The alveolar crest appeared relatively nonreactive to sclera. 7. There were no signs of external root resorption or ankylosis. 8. Sclera may be able to be used to fill in osseous craters, other periodontal defects and as a scaffolding in conjunction with osseous grafts. This requires further investigation. 9. Sclera may possibly be used in areas where there was loss of gingival contour or need for ridge augmentation.


The rotation flap for covering denuded root surfaces - a closed wound technique. A rotation flap for covering denuded single root surfaces with attached gingiva has been described and illustrated. This was performed utilizing a closed wound technique. The single flap provided attached gingiva coverage for a moderate area while a double flap provided coverage for a larger area. Although more attached gingiva is required from the donor site than for the laterally positioned or sliding flap, the technique may be performed where a moderate degree of attached gingiva is available.


Scanning electron microscope study of scalers. Scanning electron microscopy was used to examine factory-sharpened, dulled, and resharpened scalers. The following observations were made: 1. The factory sharpened scalers exhibited metallic extensions from the lateral surface (wire edges). 2. The machine-resharpened instruments resulted in nonfunctional wire edges from the facial surface. Honing produced an exact meeting of facial and lateral surfaces. 3. Hand sharpening, using an Arkansas stone (grit 500) against the lateral surface away from the cutting edge, effected an exact meeting of the facial and lateral surfaces and no evidence of wire edges. 4. From this study an optimum cutting edge for a scaler is characterized as having a smooth, contiguous meeting of the facial and lateral surfaces free of wire edges. If a wire edge is present, it should be functional.


Subacute administration of Plak-Lite sodium fluorescein solution in hamsters. The purpose of this research was to evaluate the potential toxic effects of Plak-Lite disclosing solution, which contains 0.75% sodium fluorescein U.S.P. in buffered glycerol in hamsters under defined and exaggerated conditions. In oral dosing experiments, volumes calculated at least 50, 200 or 1000 times the human daily use level were administered. For intraoral application the 1000 X human use level was selected. The control group was dosed orally with the 1000 X dose volume of water. All animals were treated once a day for 31 or 92 days. Daily examination of animals revealed no overt drug or dosing-related effects. Weights recorded at 31 or 92 days were similar for all groups. Histological evaluation performed on tongue, oral mucosa, cheek pouch, stomach (3 sections), liver, kidney, spleen, small intestine (3 sections), large intestine and bladder revealed no pathological changes. This study demonstrates the safety of Plak-Lite disclosing solution when administered at exaggerated dose levels via routes simulating human use.


A scanning electron microscopic study of the relationship between the most apically located subgingival plaque and the epithelial attachment. Twelve teeth with chronic periodontitis were extracted and examined in the scanning electron microscope. Subgingival plaque in deep pockets was usually covered by a surface coating, which was absent in the apical part. The apical plaque displayed an organized structure, although varying form one tooth to another. The microorganisms were sometimes overlapping the epithelial cell remnants. Coccal forms were seldom found, but on a morphologic basis, rod-like, filamentous, spiral and branching forms were identified. Both bacteria and spirochetes seemed to have the capacity to invade the epithelial remnants on the tooth surface. The epithelium in direct contact with the microorganimsm showed a widening of the intercellular spaces and a change in surface morphology. This was in contrast to cell layers more distant from the plaque, which appeared normal and homogeneous. Similar reactions were also seen in gingival epithelial-like cell cultures infected with plaque of human origin.


An evaluation of the Navy Periodontal Screening Examination. Ninety-eight young adult patients were examined and scored according to the criteria of the Navy Periodontal Screening Examination. The population examined had a 98% incidence of inflammatory periodontal disease. The relationship of the Navy Periodontal Disease Index and the Navy Plaque Index total scores was determined to +0.55 (P 0.01). The relationship of the gingival score of the NPDI and the NPI was found to be +0.75 (P 0.01). The Navy Plaque Index, like others reported, has a better relationship to a reversible index of inflammatory periodontal disease. The use of the NPDI total is recommended as an aid in determining treatment recommendations.


Healing following simulated fiber retention procedures in rats. Healing responses of a simulated fiber retention procedure in rats has been presented. In the area of attached, but severed supracrestal fibers, a loss of cells was observed in the initial stages of repair. Subsequently, connective tissue cells migrated into this area as did blood vessels. A very distinct interface was seen at about 1 week after surgery between the advancing soft tissues from the flap wound surface and the attached, but severed supracrestal fibers. By 4 weeks after surgery, such distinction was absent and supragingival fiber bundles appeared continuous from their cemental attachment over to the adjacent alveolar crest. However, no evidence of cementogenesis was seen at this site which suggests that these attached fibers were attached prior to surgery. The position of the new junctional epithelium appeared to be limited to the level of the retained supracrestal fiber fragments. However, in areas where cementum, and thereby attached fibers, had been removed during surgery, an altered epithelial adherence was usually seen. This altered adherence was in the form of a long junctional epithelium or a short junctional epithelium on top of parallel oriented collagen fibers. The latter also appeared to adhere to the tooth surfaces.


Bone remodeling in periodontal lesions.

Bone remodeling in periodontal lesions. This study was designed to investigate sites of major alveolar bone formation as a result of resorption of the interdental crest in periodontal lesions. Bone samples were taken from twelve patients requiring surgery as part of their periodontal treatment. Tetracycline was used in all cases to label bone recently formed. The selected areas were periodontal pockets ranging in depth from 6 to 8 mm. The bone deformities were of crater-form configuration. The buccal and lingual plates were removed. Later, the dehydrated speciemns were embedded in bioplastic and cut to sections 70 mu thick. Controls were healthy pieces of bone taken from the same patient in unaffected areas. Yellow fluorescent tetracycline labeling was observed in both periosteal and trabecular bone. In the trabecular bone, labeling was exhibited in the lamella of some Haversian systems, away form the bone resorption. There was a direct relationship between bone resorption and bone apposition as seen by the presence of tetracycline in the buccal and lingual alveolar plates. Controls showed only minimal labeling. The results of this study have posed the question as to whether inflammation could be the stimulus in the reactivation of osteocytes or bone formation, in the buccal and lingual walls of the periodontal lesions.


Amino acid composition of experimental salivary pellicles. The amino acid compositions of pellicles formed in vitro from submandibular, parotid, and mixed saliva were determined and compared. Samples of the total pellicles as well as the relatively acid-soluble supernates and acid-insoluble sediments were collected and analyzed. In each instance striking differences in composition between the pellicle and the saliva from which it was formed indicate that pellicle formation is a highly selective process. The similarity in composition of the total and fractionated submandibular-parotid pellicle samples indicated a representative dissolution of the total mixed pellicle in the collection acid, rather than a preferential dissolution of part of the total pellicle. In the case of the pellicles formed from the isolated submandibular and parotid salivas, the supernate and the total pellicle were quite similar in composition, but differed somewhat from the sediment. Those results indicate that most of the salivary pellicle is soluble in the dilute acid used to collect the pellicle, and that a portion of the total submandibular or parotid salivary pellicle dissolves preferentially. The compositions of the total parotid pellicle and the parotid supernate and sediment were remarkable similar to the counterparts formed from submandibular saliva alone, suggesting similar origins and mechanisms of formation.


Elastic response of the temporo-mandibular joint to very small forces. The mechanical mobility of the temporo-mandibular joint (TMJ) was measured by applying small sinusoidal forces at different frequencies to the teeth and measuring the resultant motion of the teeth. Velocity/force ratios were recorded versus frequency at maxillary and mandibular teeth and the results were interpreted in terms of linear spring-mass-dashpot models. Differences in results obtained at maxillary and mandibular teeth indicate that the TMJ has an effective spring constant of 9 X 10(7) dynes/cm when excited by forces of approximately 2 X 10(3) dynes. Displacements occurring in the TMJ due to orthodontic elastics will be in the order of 20 mum which is between one and two orders of magnitude smaller than could be detected by radiography.


Denture stomatitis and methods influencing its cure. A review of the etiology and pathology of chronic denture stomatitis is presented, and two current methods of treatment have been evaluated. The concept of use of tissue conditioning materials is discussed and has proved to be helpful. The physical condition of the patient and his cooperation during and after treatment were observed to be significant factors in the treatment of chronic denture stomatitis. This study was preliminary in nature. Before more conclusive judgements can be made, standard methods should be developed for quantifying the improvement for patients with chronic denture stomatitis. In a more comprehensive study, steps could be taken to guard against investigator bias.


Porcelain shade stability after repeated firing. There were no color changes detected in the first five firings for both air- and vacuum-fired porcelain. Slight changes were noticed in subsequent firings. These color changes were more noticeable in the air-fired samples than in the vacuum-fired samples. However, changes in the porcelain color after repeated firing were not sufficiently significant to cause rejection of the samples. The porcelain shade remains stable with repeated firing if the firing procedure is carefully carried out.


DID: a direct measure of delegation.

DID: a direct measure of delegation. The DID measures the degree of delegation existing in a dental practice at a given time. Its four elements are: 1) the delegable tasks, 2) the personnel involved, 3) the task frequency, and 4) the task time. The formula yields the ratio of the Maximum State of Delegation to the Actual State of Delegation or, in other words, the theoretical potential for delegation divided by the observed state of actual delegation. Both are expressed in cost-related terms based upon the relative costs of the personnel in the practice. The DID has merit as a diagnostic tool to aid the practitioner in assessing his/her staff use. For example, a low DID might indicate an overqualified staff for his/her patient load, or underutilization of auxiliaries. The DID can also be used to compare levels of delegation between several practices at a given point in time. Such an application was made for 17 Washington private practices. In using the DID, it was found that delegation levels varied among the 17 practices; however, on the average the degree of delegation approached only one third of the maximum allowed under law. The DID, in its direct approach to task delegation, is a concept that can be applied to dental practices and, with appropriate adaptation, to other health care settings as well. All the influences on the DID and delegation, however are not fully understood and further study is warranted.


A comparison of two oral hygiene indexes for measuring the effectiveness of dental floss in plaque removal. The purpose of the present study was to compare the OHI-S and the two versions of PHP Index in measuring the effectiveness of dental floss in the removal of dental plaque. The study demonstrated that the PHP Index provides a higher sensitivity than the OHI-S in measuring the effectiveness of approximal cleansing aids, such as dental floss. This, it seems that using the PHP Index in dental floss studies is preferable to using the OHI-S.


Synthesis of mono- and bifunctional alpha-methylene lactone systems as potential tumor inhibitors. Synthetic nono- and bifunctional alpha-methylene lactone derivatives including deoxyvernolepin and kihydrodeoxyvernolepin were tested as inhibitors of the growth of CCRF-CEM human lymphoblastic leukemia cells in culture. The range of ID-50 values for compounds 1-7 (ca. 10(-5)-10(-6)M) was roughly comparable to the doses observed earlier in the CCRF-CEM cell system with synthetic alpha-methylene-gamma-butyrolactones. Of significance is that dihydrodeoxyvernolepin and deoxyvernolepin were at least an order of magnitude more active than natural vernolepin.


Enhancement of tumor induction in rats with Moloney murine sarcoma virus by a "new" method based on direct injection into fetuses. Undiluted, fivefold-diluted, and 25-fold-diluted doses of a stock of Moloney murine sarcoma virus were injected directly, in a volume of 0.025 ml, into the backs of fetal Sprague-Dawley rats by laparotomy through the uterine wall at 18 days of gestation. During the first 8 weeks after birth the young responded to the virus with remarkably high but dose-dependent incidences of neoplasms. When a one-fifth dilution of the virus preparation was inoculated at fetal ages 16, 18, and 20 days, the incidences of lesions decreased with advancing fetal age. The tumors developed preferentially at the virus inoculation site and/or in the proximal parts of the extremeties; all were considered to be of mesenchymal derivation, i.e., malignant mesenchymoma, rhabdomyosarcoma, osteosarcoma, fibrosarcoma or fibromyxosarcoma, hemangiosarcoma, plasmacytoma, and a giant cell tumor. This injection procedure provided us with a valuable experimental tool for the rapid screening or testing of potential chemical carcinogens and other biologic studies.


A new familial cancer syndrome? A spectrum of malignant and benign tumors including retinoblastoma, carcinoma of the bladder and other genitourinary tumors, thyroid adenoma, and a probable case of multifocal osteosarcoma. An 11-year-old Caucasian girl who had been cured of bilateral retinoblastoma developed non-radiation-induced osteosarcoma in multiple sites of the extremities. Investigation of the medical histories of 36 of her family members through six generations revealed that 8 relatives on the maternal side (22%) had malignant tumors, predominately genitourinary carcinomas, 2(6%) had benign tumors only, and 2(6%) had both benign and malignant neoplasms. The histologic variety of these tumors, the predominance of genitourinary carcinoma, the higher than expected frequency of tumor appearance over six generations, and the occurrence of malignant tumors in direct lineage suggest that the case of retinoblastoma followed by osteosarcoma is part of a familial cancer syndrome.


Ultrastructural study of liver sinusoids of mice during invasion by leukemic myelocytes. Results of an ultrastructural study of liver of RF mice during invasion by leukemic  myelocytes were reported. In early stages of infiltration, leukemia cells adhered to the endothelial cells of the sinusoidal wall; gaps 1-4 mu in diameter then developed in the endothelium, and leukemia cells passed through the gaps to enter the extravascular space. Other sinusoids became occluded by leukemic myelocytes, the endotheilium disintegrated, and the occluding cells thus became extravascular. In late stages of infiltration, when leukemia cells migrated back into the sinusoids, the endothelium was continuous and leukemia cells passed through temporary pores located within endothelial cells.


Intratibial Moloney sarcoma virus-induced osteosarcoma in the rat: tumor incidence and pathologic evaluation. Osteosarcomas were induced in approximately 80% of young New Zealand Black rats by the intratibial inoculation of Moloney murine sarcoma virus from day 1 to day 5 after birth. The neoplasms were composed of a spectrum of well-differentiated to poorly differentiated osteoblasts, osteocytes, and osteoclasts. Budding of C-type viral particles was associated with tumor induction. Compared to rats inoculated on day 1 after birth, rats inoculated at 4 days of age developed consistently more osteoproliferative bone tumors that often were associated with hypercalcemia, increased serum alkaline phosphatase, and elevated urinary hydroxyproline.


Vinylethylnitrosamine: a potent respiratory carcinogen in Syrian hamsters. Vinylethylnitrosamine (VEN), an alpha-beta unsaturated analogue of diethylnitrosamine (DEN), which may be formed by the enzymic conversion necessary for carcinogenesis, was synthesized and its biologic effect was examined by sc administration to Syrian hamsters. Distribution studies showed that the maximum amount of unaltered compound was found in various tissues 45 minutes after injection. The chemical was only partially excreted unchanged after 5 hours. Weekly treatment for life resulted in high incidence of malignant respiratory tract neoplasms with short latencies and in tumors of the upper digestive tract and pancreas. The effects of VEN were compared to those of the assumed parent compound, DEN.


Successful treatment of varicella pneumonia with prolonged extracorporeal membrane oxygenation in a child with leukemia. A 5-year-old boy with acute lymphoblastic leukemia in complete continuous remission developed life-threatening varicella pneumonia and acute respiratory insufficiency (ARI). The child recovered after 92 hours of partial venoarterial perfusion with a membrane oxygenator. Functional asplenia developed. Serial pulmonary function tests after perfusion indicate moderately severe restrictive lung disease which has slightly improved during an 18 month period.


Gilles de la Tourette's syndrome: clinical, genetic, psychologic, and biochemical aspects in 21 selected families. Eighty-one patients and relatives with Tourette's syndrome, members of 21 selected families, participated in a 1-day clinic. In 12 of the 13 Jewish families and six of the eight non-Jewish families, there were multiple members with motor and vocal tics by observation or history. Males predominated among those with persistent symptoms, but among those with spontaneous clearing, females predominated. Twelve propositi had troublesome sexual and aggressive impulses, differing only quantitatively from normal. No evidence of abnormality was found in plasma dopamine beta hydroxylase, or norepinephrine levels.


Residual acid maltase activity in late-onset acid maltase deficiency. Residual acid maltase activity was found by a sensitive fluorometric assay in muscle biopsies from 15 patients with late-onset acid maltase deficiency (mean, 6.91 percent; range, 2.4 to 12.2) but not in biopsy or autopsy muscle from three patients with the infantile form. Electrophoresis, kinetic characteristics, and subcellular fractionation indicated that the residual activity was lysosomal acid maltase and not a contaminating isozyme of neutral maltase. There was no correlation between the amount of residual acid maltase activity and the severity of the clinical picture or glycogen accumulation. The presence of acid maltase activity in muscle, liver, and, to a greater extent, leukocytes in late-onset but not infantile acid maltase deficiency and the failure of the two disease forms to occur in the same family suggest that they are genetically distinct.