Intradendritic recordings from hippocampal neurons. Dendritic activity in guinea pig hippocampal CA1 and CA3 pyramidal neurons was examined by using an in vitro preparation. Histologically confirmed intradendritic recordings showed that dendrites had an average input resistance of 47.0 M omega and average membrane time constant of 33.3 msec. Active spike responses could be evoked by intracellular injection of outward current or by the activation of synaptic inputs. The predominant activity was burst firing. A typical intracellularly recorded dendritic burst consisted o spikes on a slowly increasing depolarizing potential. The spike components of the burst were of two distinct types: low threshold, fast spikes; and high threshold, slow spikes. Tetrodotoxin (1 microgram/ml) blocked the fast spikes, but slow spikes could still be evoked with direct intracellular stimulation. In contrast to dendritic responses, direct depolarization of CA1 somata did not give rise to burst generation. Orthodromic stimuli evoked large-amplitude excitatory postsynaptic potentials, followed by inhibitory postsynaptic potentials in dendrites of CA1 and CA3 neurons. In two instances, simultaneous recordings were obtained from coupled pairs of elements that were presumed to be soma and dendrite of the same CA3 pyramidal neuron. Depolarization of either element led to burst generation at that site, and the underlying slow depolarization appeared to evoke a burst at the other site. This potential postsynaptic amplifying mecahnism was not ordinarily functional because even suprathreshold orthodromic activation did not normally evoke bursting in dendrites.


Nonlinear systems analysis: comparison of white noise and sum of sinusoids in a biological system. The Gaussian white noise and the sum-of-sinusoids methods of systems analysis provide equivalent descriptions of nearly linear and strongly nonlinear transductions in the cat retina. Smoothness in the frequency domain is a common characteristic of biological transductions. This permits a substantial improvement in the signal-to-noise ratio by using the sum-of-sinusoids method, as is demonstrated for the transductions of the cat retina.


The pineal gland: a pacemaker within the circadian system of the house sparrow. Transplantation of pineal tissue into the anterior chamber of the eye rapidly reestablishes rhythmicity in arhythmic pinealectomized sparrows and also transfers the phase of the donor bird's rhythm to the host. Thus, the transplanted pineal does not merely permit rhythmicity to be expressed but rather transfers an oscillation that controls the remainder of the circadian system and restores the capacity for self-sustained rhythmicity. Long-term recordings, during which sparrosw were exposed to various lighting conditions, demonstrate a remarkable similarity between the circadian system in normal birds and that in birds bearing pineal transplants.


Effects of a diazoxide inhibition of insulin release on food intake of normal and hyperphagic hypothalamic rats. In order to clarify the role of endogenous insulin in generating normal and pathological feeding behaviors, the effect of an anti-insulin drug, Diazoxide, on the meal pattern has been investigated in both normal and VMH rats. A dose-dependent reduction of food intake under Diazoxide treatment was found in normal rats. The same percentage reduction was obtained at night with a higher dose than required in the daytime. Conversely, hyperphagic VMH rats exhibited a dose-dependent reduction which was identical in the two portions of the diurnal cycle. The dose effective in entirely suppressing eating in VMH rats was twice that required for normal rats in the daytime period and identical at night. The results are discussed in relation to earlier findings concerning the diurnal insulino-secretory pattern in normal and VMH rats.


[Interrelationship between purine, carbohydrate, lipid and aminoacid metabolism, in hyperuricaemia and gout (author's transl)]. The AA, have studied the literature concerning the interrelationship between purine, carbohydrate, lipid and aminoacid metabolism, in hyperuricaemia and gout. The behaviour of uricaemia and purine metabolism in the glycogen storage disease type I, in the glutathione reductase variant, after ethanol ingestion, after fructose load, the levels of lipoproteins and triglycerides in gouty patients and the reason for their increase, have been taken into special consideration. The AA. underline the evidence that gout and hyperuricaemia are metabolic defects which are not limited to purine biosynthesis, but involve also other sections of metabolism. Only some of these alterations are known; this interrelationship must be further investigated from a biochemical and genetic point of view.


[Comparative studies between various amalgams]. A number of dental amalgam products have been compared in the context of a thesis. Four products, each of them possessing different characteristics, have been selected. Six Eighty Amalgam Alloy is a conventional product; Fluor Alloy contains a quantity of SnF2; Amalcap non gamma2 belongs to the group of the so-called non gamma2-alloys; Indiloy is spherical and contains indium. Each product was subjected to a series of tests and investigations: structure, dimensional changes after condensation, compressive strength, behaviour during a relaxation-test and resistance to corrosion. Indiloy was the product with the most interesting structure and it could be ascertained the mercury especially attacked silver and indium of the original alloy. Thus a sort of matrix is formed. The measuring of the dimensional changes was done by introducing a new method. Fluor Alloy and Indiloy present a behaviour that differs a lot from the expected one: at first a contraction followed by a more important expansion. A relaxation-test is an alternative to the creep-test and the connection between both is demonstrated. Combining the results of the resistances to the compressive forces with those of the relaxation-tests shows Indiloy possesses superior mechanical properties while those of Six Eighty Amalgam Alloy are rather inferior. A final series of tests concerns the resistance to corrosion. Amalcap non gamma2 and Indiloy have a much greater rough resistance to corrosion than the two other ones.


Ultrastructure of the subgingival microflora in juvenile periodontitis. The ultrastructure of the subgingival deposits on the root surfaces of teeth affected by juvenile periodontitis was studied on 12 teeth from nine individuals, 15--30 years of age. The deposits consisted of either microbial masses associated with a pellicle, or of a cuticular material almost free of bacteria. Gram-negative rods and filaments were the predominant microorganisms. "Corncob" configurations consisting of filamentous bacteria surrounded by Gram-positive cocci, and "bristle brush" formations comprising corncobs surrounded by long rods were observed in the superficial layer of the plaque. Spirochetes and flagellated rods constituted a major segment of the microflora. The present data indicated that the deep pockets in juvenile periodontitis harbor a sparse but relatively characteristic microbial population.


Salivary agglutinin and secretory IgA reactions with oral streptococci. S. mutans, S. salivarius, S. mitis and S. sanguis strains were isolated from three subjects of blood groups A, B and O. Parotid saliva samples obtained from the same subjects induced aggregation of some of the bacteria, the S. sanguis and the S. mutans strains in particular. While parotid saliva from the three subjects gave almost identical reactions, slight interindividual differences were observed for a few strains with the submandibular sublingual salivas. In parotid saliva, secretory antibodies reacting with all strains were present. The antibody levels differed between the three subjects but no specific pattern was observed when homologous strains were compared with heterologous strains.


Histomorphologic investigations of dentinogenesis in incisors of offspring of cyclophosphamide-treated pregnant rats. Eight days old offspring of six rats treated with single doses of 40 mg/kg and 50 mg/kg of cyclophosphamide on the 20th day of pregnancy constituted two experimental groups. Group 1 (40 mg/kg) comprised 21 animals, Group 2 (50 mg/kg) 14 animals. Histomorphologic investigations of the maxillary and mandibular incisors revealed the following changes: (1) dental constrictions, (2) niche-like dentinal defects, (3) scalloping of the amelodentinal junction, (4) incremental line in the pre-experimental tooth segment, (5) external resorptions, and (6) diffuse edema in the pre-experimental part of pulp. Constrictions and niches qualitatively concurred with those previously observed in adult rats of the same strain, but the lesion frequency was essentially higher in the offspring. Further, the additional change of external resorptions was evinced by the offspring incisors, and changes only rarely observed in adults, such as scalloping of the dentinoenamel junction and a dentinal incremental line, constituted frequent findings in the offspring material.


Combined extracellular sucrolytic enzyme power from a strain of Streptococcus mutans, and purification results. Streptococcus mutans has been shown to produce extracellular invertase, dextransucrase, and levansucrase. The purpose of this work was to study the relative quantities of these enzymes in pure culture supernatant, and in samples from commonly used purification methods. The strain "Ingbritt" was selected because it is a well-defined human strain, available, and with well-known growth requirements. The samples were incubated with sucrose for the determination of free monohexoses, and the polysaccharide from ethanol precipitation was hydrolyzed as previously described. In cell supernatant the inversion effect exerted 75% of total sucrolytic power, the dextransucrase 20% and the levansucrase 5%. No method, tested in this work, could separate all the activities completely.


Sex and age differences in bone morphology of mandibles. Histomorphometric analysis of mandibular specimens has been performed in order to demonstrate possible sex and age differences in percent bone mass and bone activity in the mandible. The material consisted of 32 autopsy specimens from the right premolar region of the mandibular body in subjects with sudden unexpected death and without known bone disease. The subjects were divided in a young group (20--43 years of age) and an old group (60--90 years of age); each group consisted of eight females and eight males. Microradiograms of buccolingual ground sections of 100 micron were used. Quantitation of (1) percent bone area of cortical and trabecular bone and (2) total bone surface/bone area and resorption surfaces/total bone surface in trabecular bone, were done by electronic point-counting. The analysis did not reveal any significant sex or age differences in the trabecular bone with respect to percent bone mass, trabecular coarseness and bone activity. In the buccal and lingual cortices a significant age difference was demonstrated, but there was no sex difference in percnet bone mass. Cortical porosity in mandibles clearly increases with increasing age, but seems to be independent of sex.


Distortion of mandibular kinesthesia induced by vibration of human jaw muscles. Kinesthetic experience accompanying vibration of human jaw muscles was investigated in 12 healthy subjects. Vibration of the masseter muscle with the jaw in a 20-mm opened position caused the subjects either to underestimate jaw closing effects or to experience jaw opening movements depending on whether the mandible was free to move or kept in a constant position. During vibration of the depressor muscles with the mandible in its rest position the subjects underestimated an opening movement, but fixation of the mandible caused no illusions of movement. All kinesthetic illusions perceived during vibration corresponded to elongation of the muscles under study beyond their actual length. Distortion of kinesthesia was independent of the amplitude and frequency of vibration and it persisted during anesthesia of the temporomandibular joints and loading of the mandible. It can be concluded that jaw muscle receptors may contribute to mandibular kinesthesia.


Microleakage around preventive composite fillings in occlusal fissures. The purpose of this study was to evaluated the microleakage around preventive composite fillings used in occlusal fissures with incipient caries, and to assess the influence of the consistency of the composite resin upon the leakage. The fissure enamel of 30 extracted maxillary premolars were partially removed using a small round bur (Ash No. 1/2). Dentin was not exposed. The cavities were etched with phosphoric acid and filled with undiluted composite (Adaptic) or composite diluted with different amounts of liquid resin (Adaptic Bonding Agent). Five teeth were not etched before filling, and served as a control group. The teeth were cycled thermally between two dye solutions and the marginal penetration of dye was evaluated by examining sections of the crowns in a dissection microscope. Marginal leakage occurred in all the control teeth and in none of the acid-etched teeth. It may be concluded that the preventive composite filling therapy provides good sealing of pits and fissures with incipient caries, and that the consistency of the composite used is not of primary importance.


Relation between symphyseal and condylar developmental stages in the human fetus. In 51 human fetuses from the first half of the prenatal period, developmental stages in the symphysis menti and the mandibular condyle were assessed by histochemical reactions. The study showed the association between the timing of the developmental stages in the two mandibular growth zones.


Fluoride concentrations in saliva in relation to chewing of various supplementary fluoride preparations. Fluoride concentrations were measured in whole saliva samples collected from 16 subjects at different intervals up to 60 min after chewing of various supplementary F preparations: chewable F tablets (0.21 mg F), plain F tablets (0.25 mg F) or F-containing chewing gum (0.25 mg F). Each of the F preparations was administered in a low dose (0.21--0.25 mg F) or in a high dose (0.42--0.50 mg F). Mean resting levels of fluoride in saliva ranged from 0.03 to 0.05 parts/10(6). Peak values averaging 15--25 parts F/10(6) in the low-dose group and 25--40 parts F/10(6) in the high-dose group were recorded within 5 min after intake. After 30 min, the salivary fluoride concentrations in both groups had decreased to levels below 1 part/10(6) and approached resting levels 60 min after intake. The availability of fluoride in saliva, as estimated from AUC values (areas under curves, relating fluoride concentrations to the time from 0 to 60 min), was similar with each of the preparations applied in the low dose. When used in the high dose, the chewing gum and also the plain tablets provided significantly more fluoride in saliva than the chewable tablets. The data may suggest that unflavored plain F tablets are equally suitable as a vehicle for fluoride aiming at a topical cariostatic effect as specially designed chewable tablets or chewing gum.


Vincristine's effect on dentinogenesis in rat incisor. Vincristine was administered to 60 rats in four groups in doses of 0.1, 0.3, 0.5 and 0.7 mg/kg. Histomorphologic investigation of the dentin and odontoblasts in the maxillary incisors after 1, 2 and 3 weeks revealed a moderate to severe disturbance of dentin production in some parts of the incisors. In some of the affected areas the effect seemed to be reversible in that normal-appearing dentin was found pulpal to the dentinal derangements after 2 and 3 weeks. The distribution and severity of the lesions were similar to those previously observed 3 days after injection of the same doses of vincristine.


Denture stomatitis with multiple intramucosal fistulae. A hitherto undescribed clinical and histologic entity occurring in the palate of 13 denture-wearing patients is described. Clinically it is characterized by the presence of small yellowish areas in the hard palate, which on pressure yield a whitish creamy material through multiple openings. The surrounding mucosa may exhibit various degrees of erythema. The histologic changes are characterized by the presence of intramucosal fistulae lined with unkeratinized squamous epithelium. The content of the fistulae, which corresponds to the creamy material expelled, consists of desquamated epithelial cells. These changes have mostly been noticed in elderly females, all wearing maxillary dentures for many years. This entity is considered a type of denture stomatitis characterized by intramucosal proliferation of epithelium, possibly because of long-standing chronic irritation from dentures. The origin of the intramucosal fistulae is unknown. The fistulae are believed to originate either from the ductus of the minor salivary glands or from the surface epithelium of the palate.


Saliva secretion following long-term antidepressant treatment with nortriptyline controlled by plasma levels. Eight patients undergoing antidepressant therapy with nortriptyline for 1--4 years were investigated. The period of the investigation was 7 weeks and included a 2-week placebo period, blind for the patients. Total saliva secretion measurement, the nortriptyline plasma level, and signs and symptoms of depression and side effects were obtained once a week during the study. The results of the investigation were: (1) long-term treatment with nortriptyline is followed by hyposecretion or xerostomia, (2) the reduction of the secretion is reversible, (3) re-establishment of treatment with dosage leading to the same serum level of nortriptyline is immediately followed by a drop in saliva secretion, and (4) the changes in salivary secretion are useful as an indicator of side effects. The practical importance of the investigation is discussed.


A case of pure monocytic leukaemia in a child - characterization of cellular morphology, membrane markers, surface glycoproteins and karyotype. A case of pure monocytic, 'Schilling-Type' leukaemia in a 9-year-old boy is described. The leukaemic cells resembled monocytes and were abundantly present in blood and bone marrow. They were strongly alpha-naphthyl-acetate-esterase positive, contained fine PAS-positive granules and did not stain by Sudan B. They were negative for surface bound and intracytoplasmic IgG, but had a high density of membrane Fc-receptors and showed phagocytosis. The surface glycoprotein pattern resembled that of monocytes, but was clearly different from those of lymphocytic and myelocytic cells or those of acute lymphocytic leukaemia cells. The karyotype of bone marrow cells was 44,X, -15, -21, +mar,del(2)(p11), with the missing Y-chromosome located in the marker chromosome. Especially the surface glycoprotein and membrane receptor analyses aided in the accurate classification of the monocytic origin of the leukaemic cells.


Development of acute myeloid leukaemia in a patient with psoriasis treated with oral 8-methoxypsoralen and longwave ultraviolet light. Acute myeloid leukaemia developed in a patient with psoriasis treated with oral 8-methoxypsoralen and longwave ultraviolet light (PUVA) 2 years earlier. Attention is called to the possibility that the effect of PUVA on DNA synthesis may not be limited to the areas of the skin being treated but - through damage to circulating multipotential stem cells - may also lead to haematological malignancies.


Morphologic studies of the erythropoietic part of bone marrow in myeloid leukaemias. The erythropoietic part of the bone marrow has been morphologically analyzed in 147 patients with various forms of myeloid leukaemias and in 20 healthy controls. In all the patients the percentage of basophilic erythroblasts was abnormally high and correlated to elevated mitotic indices. Megaloblastic changes were found to be  relatively common in the patients. All these findings are compatible with an ineffective erythropoiesis where the normal differentiation towards more mature erythroblasts becomes in creasingly blocked during the course of the disease regardless of the type of myeloid leukaemia.


Cytogenetic remission in a Ph1-positive case of chronic myelogenous leukaemia. Unusual cytogenetic findings in a case of chronic myelogenous leukaemia in the course of an aplastic crisis induced by busulfan therapy are reported. The proportion of Ph1-positive cells in bone marrow aspirates fell from 100% before treatment to 8.6% following aplasia. It increased gradually during recovery, and normal cells still represented 25.7% of the metaphases 20 months later. After a 38-months' remission without therapy the disease relapsed and the Ph1 chromosome was found in 100% of the bone marrow cells.


Control of oscillations in hematopoiesis. Results of a mathematical analysis of models of hematopoietic systems introduced by Mackey and Glass are given. The models include a constant time lag, and it is shown that this lag has a critical value above which oscillations in blood cell concentration occur. To reduce the likelihood of disease associated with such oscillations, physiologists should seek to learn how to increase this critical value of the lag.


Childhood and adult acute leukaemia in Johannesburg blacks. Thirty-four Black patients (14 children and 20 adults) suffering from acute leukaemia were assessed at the haematology clinics of Baragwanath Hospital and Johannesburg General Hospital during a recent 2-year period. It is evident that acute leukaemia in Blacks has become more prevalent in the Johannesburg area than it was 20 years ago, the increase being most striking in the younger age group. The incidence of acute myelocytic and lymphocytic leukaemia in Black children was the same. In adults acute myelocytic leukaemia predominated. The remission rate of 90% achieved in patients with acute lymphoblastic leukaemia was similar to the rates described in Europe and the USA. Results in patients with acute myelocytic leukaemia were less favourable (35% with initial complete remission). The problems of management (limited isolation facilities), complications related to prolonged hospitalization (loss of earnings, problems of visiting), and difficulties with follow-up examination are outlined. In underdeveloped and developing countries, training paramedical personnel to assist with the outpatient care of patients with neoplastic disease might alleviate some of these problems.


[Spleen irradiation and splenectomy for treatment of hypersplenism in chronic myeloid leukemia and chronic lymphatic leukemia (author's transl)]. Hypersplenism is characterized by cytopenia, splenomegaly (possibly hyperplastic bone-marrow), and lienal hypersequestration. It is necessary, in view of the rather important surgical risks of splenectomy, to clarify if the hypersplenism may be influenced by splenic irradiation in case of chronic myeloid leukemia (CML) or chronic lymphatic leukemia (CLL). References in literature are rare and do not present a reliable differentiation of the syndrome, according to its present definition. Of our patients, three cases with hypersplenism verified by radioiron studies are reported: in one patient with chronic myeloid leukemia, irradiation of the spleen had no effect, whereas pancytopenia was completely repaired by means of splenectomy. The same results were seen in a patient with chronic lymphatic leukemia. In the last patient, however, who had chronic lymphatic leukemia, fractionated irradiation of the spleen led to a distinct improvement of anemia and thrombopenia, but the recovery lasted only six months. This effect is due to transient normalization of the lienal hypersequestration.


[Clinical morphological, cytogenetic and genealogical studies of patients with chronic monocytic leukemia]. The introduction in clinical practice of modern methods of cytogenetic assays offers new opportunities in studying the nature of leukemia. Up to date, however, no due attention was given to the recognition of chromosome disorders in patients with chronic monocytic leukemia (CML). Study on the karyotype in 20 patients with chronic monocytic leukemia indicated that chromosome anomalies lie in both the changed chromosome number and their structure, in the phase of marked clinical manifestations these changes being increased, while in the stage of remission--being reduced. A rather high incidence of malignancies in near relations of patients with CML supports a suggestion of the related pathogenetic mechanisms underlying leukemia and malignant tumors.


[Ultrastructure of a giant cell tumor of the bones and of osteogenic sarcoma]. A comparative electrone microscopic investigation of osteogenic sarcomas and giant-cell bone tumors has revealed the ultrastructural differences between a mononuclear component of the giant-cell tumor and the most frequently observed type of osteogenic sarcoma cells (a well-developed ergastoplasma in cells of osteogenic sarcoma and moderately developed one- in the giant-cell tumor of bones, different rate of development of the mitochondrial apparatus, the character of nuclei) that indicates different genesis of these two tumor types. In giant-cell bone tumors a definite ultrastructural similarily between some mono- and multinuclear cells (a large number of mitochondrial, similar character of nuclei) may speak in favour of the common source of their development and explains the high activity of oxidoreduction enzymes in them revealed histochemically.


[Secondary hyperlipoproteinemias].

[Secondary hyperlipoproteinemias]. In a survey report pathological aspects and clinical importance of the secondary forms of hyperlipoproteinaemia are dealt with. At first are taken into consideration the relations between hyperlipoproteinaemia and diabetes mellitus. Furthermore is referred to the secondary hyperlipoproteinaemias in kidney diseases, pancreatitis, alcoholism, thesaurismoses, endocrine diseases and liver diseases as well as under different medicaments. Finally the therapeutic problems of the secondary hyperlipoproteinaemias are concerned.


[Glycogen disease caused by disorders in the liver phosphorylase system]. Concentration of glycogen and activity of enzymes, participating in its metabolism, were studied in punctates of liver tissue obtained from three patients with clinical manifestations of hepatic forms of glycogenosis. Accumulation of glycogen in liver tissue of the patients was caused by distinct decrease in the phosphorylase activity. In two patients low activity of phosphorylase A was due to impairment of one of the enzymes, activating the phosphorylase in liver tissue, and in one patient phosphorylase B itself exhibited low activity. The in vitro data on glycogen metabolism were correlated with those, obtained in study of glycogen turnover in vivo, after loading with adrenaline. The data obtained enable to develop methods for treatment of the patients with impairments in activity of liver phosphorylase.


Skeletal maturation of the hand in Iceland. The mean time at onset of the stages of skeletal maturation of the hand, PP2=, MP3=, S, MP3cap, DP3u, PP3u, and MP3u, in a cross-sectional sample of Icelandic school chidren in Reykjavík, a total of 1426 (690 boys and 736 girls), was assessed on radiographs of the hand and compared with results published from Denmark and Greenland. On the whole, the Icelandic children were most ahead, while S appeared at about the same time in all three nations. Otherwise, the mutual relationship between the skeletal stages was very similar. Girls reached all stages significantly sooner than boys, and this agrees with the findings in Denmark and in Greenland. The sex difference was most marked in the Icelandic material. The accidental error due to method in assessing the differences in skeletal maturation proved to be less than 5%, similar to that reported by others.


Matrix formation in craniofacial cartilages of the rat. [35S]-sulfate incorporation studies. Various cartilaginous zones in the craniofacial region of rats were studied using radioactive sulfate incorporation. Chondroitinsulfate represents a major part of the cartilaginous matrix. By measuring the cpm/DNA ratio in the tissue samples, one will get an expression of the matrix formation activity of the zones investigated. An increase in the cpm/DNA ratio was found in all zones between the 14th and the 17th day. This increase corresponds with a period of great proliferative activity. Autoradiography of the mandibular condyle revealed no sulfate labelling centrally indicating that this structure grows purely by surface apposition.


Fractured and avulsed permanent incisors in Finnish children. A retrospective study. The frequency of traumatic injuries to permanent incisors was studied in a sample of 1614 children from the city of Lahti in Southern Finland. The children, 801 girls and 813 boys, ranged in age from 6 to 16 years. Injuries to hard dental tissues and exarticulations of teeth were recorded. The prevalence of injuries was 19.8%--14.6% in girls and 25.0% in boys. A rapid growth in the prevalence rates was found at the ages of 9--11 years, at which the estimated mean annual incidence was about 5% in girls and 7% in boys. In 78.4% of the children with injured incisors, one tooth only was injured. The teeth most commonly injured were the upper central incisors, 81.7%; and the most frequent type of injury was an uncomplicated crown fracture, 90.5%.


Inverse relationship between fluoride and cancer in mouth and throat? For all the 121 municipalities in Southern Norway where 60% or more of the inhabitants get water from registered water supplies, the municipal average concentration of natural fluoride in the water has been determined and the municipalities divided into three groups with fluoride level 0--0.05 mg/1, 0.06--0.10 mg/1, and 0.11--0.50 mg/1, respectively. The average, age-adjusted municipal mortality rate of cancer in the mouth and throat was then determined for each of these groups by sex. The resulting figures show that the mortality rate declines for both sexes with increasing fluoride level: For males from 4.7 deaths per 100 000 per year on the low fluoride level, to 3.9 deaths per 100 000 per year on the medium fluoride level, and to 3.1 deaths per 100 000 per year on the high fluoride level. For females the corresponding figures are 1.5, 1.3 and 0.5. Arguments to show that these figures are unbiased from different tobacco consumption habits, differences between urban and rural municipalities, and differences in population size are presented. Possible, explicatory models are discussed.


The effect of different sulfonamides on phenytoin metabolism in man. The influence on the metabolism of phenytoin of some sulfonamides given in common clinical doses has been studied. In single dose experiments sulfaphenazole increased phenytoin half-life (T/2) by 237% and decreased phenytoin metabolic clearance rate (MCR) by 67%. Sulfadiazine, sulfamethiazole, sulfamethoxazole + trimethoprim and trimethoprim increased phenytoin T/2 by 80, 66, 39 and 51% respectively, and decreased phenytoin MCR by 45, 36, 27 and 30% respectively. Sulfamethoxazole gave a small but significant increase in phenytoin T/2 but not a corresponding fall in phenytoin MCR. No changes were found in phenytoin T/2 and MCR after treatment with sulfamethoxypyridazine, sulfadimethoxine and sulfamethoxydiazine. Steady state experiments confirmed the findings of the single dose experiments. It is suggested that sulfaphenazole, sulfadiazine, sulfamethizole, sulfamethoxazole + trimethoprim and trimethoprim inhibit hepatic metabolism of phenytoin.


Radioimmunoassays of T3, r-T3 and r-T'2 in human serum. Simple radioimmunoassays for 3,3',5-triiodothyronine (T3), 3,3',5'-reverse-triiodothyronine (r-T3) and 3,3'-diiodothyronine (r-T'2) in human serum are described. The princple of the methods is the same and based on a system using 8-anilino-1-naphthalene sulfonic acid as an inhibitor of nonspecific protein binding, a simultaneous addition of the antibody and the labelled hormone, an overnight incubation at room temperature and a separation of bound and free hormone with dextran-coated charcoal. The methods require 15 microliter, 50 microliter and 100 microliter (or 333 microliter for ethanol extraction) serum respectively. Serum concentrations (mean +/- SD) of T3, r-T3 and r-T'2 from normal subjects are 144 +/- 19 ng T3/100 ml (n = 52), 32 +/- 7 ng r-T3/100 ml (n = 36), 3.8 +/- 0.7  ng r-T'2/100 ml (ethanol extraction, n = 18) and 8.2 +/- 1.6 ng r-T'2/100 ml (unextracted, n = 16).


The effect of suppressive therapy of nontoxic diffuse goiter on serum levels of thyroxine, 3,5,3'-triiodothyronine and 3,3',5'-triiodothyronine. We studied the effect of suppressive therapy with graded doses of thyroxine (T4) on serum levels of T4, 3,5,3'-triiodothyronine (T3) and 3,3',5'-triiodothyronine [rT3] in patients with diffuse, nontoxic goiter. For comparison and in order to elucidate the degree of suppression of the pituitary thyroid axis by T3 the effect of suppressive therapy with T3 was studied in the same type of patients. We found that T4 in serum rose significantly to a constant level during T4 treatment (0.10, 0.15 and 0.20 mg/day). Dose-related rises in T4  were only seen after 3 months of treatment. T3 and rT3 only changed minimally. The T4/T3 ratio rose to a constant level during the initial 3 months of treatment. T3/rT3 ratio remained unchanged. No dose-related differences in T4/T3 and T3/rT3 ratio were observed. Treatment with T3 in doses of 0.06 mg per day caused a significant but slow fall in T4  and rT3 to hypothroid levels while T3 only rose slightly. The T4/T3 ratio dropped significantly during T3 therapy.


The influence of propranolol on the extrathyroidal metabolism of 3,3',5'-triiodothyronine (reverse T3). The effect of propranolol 80 mg daily on the metabolism of 3,3',5'-triiodothyronine (reverse T3, rT3), 3,3',5'-triiodothyronine (T3) and thyroxine (T4) was studied by means of a non compartmental kinetic method in seven females with severe pretreatment hypothyroidism. The patients were maintained euthyroid on a constant L-T4 replacement therapy. Serum rT3 levels increased significantly during propranolol (p less than 0.02). This increase was explained by a decrease in metabolic clearance rate (MCR) (p less than 0.02), since the conversion rate from T4 and the distribution volume of rT3 were unchanged. By contrast the decreased serum levels of T3 were due to a significant decreased conversion from T4 (p less than 0.02) in spite of a decreased MCR. The results are compatible with the assumption of two different monodeiodinating enzymes, a 5-deiodinase responsible for the diodination of T4 to rT3 and a 5'-deiodinase responsible for the deiodination of T4 to T3.


TSH and thyroid stimulating antibodies (TSAb) activate thyroid adenylate cyclase through different pathways. Adenylate cyclase activity in human thyroid homogenates was studied after stimulation with thyrotropin (TSH) and thyroid stimulating antibodies (TSAb). The results show: 1) TSAb prepared from different patients with Graves' disease show different adenylate cyclase activation patterns and a lag phase is frequently observed. 2) TSH and TSAb appear to cause mutually inhibitory activation of thyroid adenylate cyclase. 3] The maximal adenylate cyclase activation is higher with TSH than with TSAb, but this could possibly be due to contamination of TSAb preparations with an adenylate cyclase inhibitor. 4) There is no absolute copurification of TSH sensitive and TSAb sensitive adenylate cyclase in various subcellular fractions of thyroid homogenate. 5) Incubation of thyroid homogenate with cortisol cause a dose dependent decrease in the adenylate cyclase response to TSAb whereas the response to TSH is either increased or unchanged. The results indicate that TSH and TSAb activate thyroid adenylate cyclase through different pathways in the plasma membrane.


Development of ketonemia in fasting patients with hyperthyroidism. Concentrations of ketone bodies, free fatty acids, glycerol, lactate, glucose, insulin, glucagon and cortisol were determined 6-hourly during 36 hours of fasting in 4 hyperthyroid patients and in 4 euthyroid controls. The concentrations of ketone bodies were elevated in hyperthyroid patients from the beginning and increased during fasting more rapidly and to higher values as compared to the controls. After 6 hours of fasting the blood ketone concentrations were 1.1--1.8 mM in hyperthyroid patients and 0.3--0.6 mM in the controls. After 36 hours the concentrations had increased to about 3.5 mM and 1.4 mM in hyperthyroid and control subjects, respectively. The concentrations of free fatty acids were identical in the groups compared postprandially, but increased significantly more in the hyperthyroid patients than in the controls during fasting. The glycerol concentration was higher in the hyperthyroid group throughout the observation period. The concentrations of insulin were slightly higher in the hyperthyroid group than in the control, whereas the concentrations of the "ketogenic" hormones, glucagon and cortisol were identical in the compared groups. It is concluded that hyperthyroidism leads to an increased tendency to ketosis, that is partly explained by increased concentrations of free fatty acids and that might also involve a direct action of long term thyroid hormone excess on enzyme activities (e.g. carnitine acyltransferase in liver).


Incidence of insulin-dependent diabetes mellitus (0--29 years at onset) in Denmark. Incidence data from Denmark on the insulin-dependent diabetes mellitus in the age group 0--29 years have been collected in two different geographical areas (West and South Jutland plus Copenhagen and North Zealand). An incidence of 13.3 per 100,000 per year (range 12.5--13.6) was registered (N = 792). No difference was found between the two areas. The male incidence exceeded the female incidence by 25.4 per cent. The age distribution showed rising values until a peak in the early puberty with a decline until a rather constant level after puberty. From year to year a seasonal variation of onset was demonstrable with maximum in the winter and minimum in the summer for males only. Ascertainment was found to be between 87.7 and 98.6 per cent and the annual number of new insulin-dependent diabetics in Denmark in the age group 0--29 years can be calculated to 310-350.


Sexual function and pituitary axis in insulin treated diabetic men. The prevalence of sexual dysfunction and the pituitary-gonadal function were studied in 72 consecutive diabetic male patients. Sexual dysfunction was found in 43% and in these patients peripheral neuropathy was significantly more frequent than in patients with normal sexual function. Sexual dysfunction was more frequent in patients at the age of 50--55 years than in young diabetics (age 25--30 years). No significant correlation between sexual dysfunction and the duration of the disease and no difference in the serum concentrations of luteinizing hormone, follicle stimulating hormone, prolactin, testosterone and oestradiol-17beta between patients with normal and reduced sexual function was found. It is concluded, that sexual dysfunction is not accompanied by altered serum concentrations of testosterone, oestradiol 17beta, gonadotrophins or prolactin. Sexual dysfunction correlates with peripheral neuropathy, but the high prevalence of dysfunction in males with short duration of diabetes without neuropathy makes other causes likely.


Protein correction of serum calcium in mild primary hyperparathyroidism. Simultaneous determinations of serum total calcium(TOCa), protein corrected total calcium (TOCac), ultrafiltrable calcium (UFCa) and ionised calcium (Ca++) were undertaken in 63 controls and in 76 patients with primary hyperparathyroidism. Raised levels of Ca++ were used as one criterion of the diagnosis which was confirmed by operation in all. For the purpose of estimating the relative value of TOCa and TOCac in the detection of mild hyperparathyroidism we selected all patients with TOCa values below 3.00 mmol/l (n = 46). As a group these patients turned out to be mildly hypoproteinaemic (p less than 0.01), probably because of high age and complicating conditions. Further subdivision of this group into frank hypercalcaemia, borderline hypercalcaemia and normocalcaemia was undertaken according to the respective 99% and 95% confidence limits of normal. Twenty-seven patients were classified as frankly hypercalcaemic by TOCa as well as by TOCac. The distribution of the remaining 19 patients within the three categories was 1:6:12 as judged from TOCa while TOCac gave a better distinction from normal, 9:4:6 (p less than 0.01). This compared well with the classification obtained by UFCa, 10:5:4. It is concluded that TOCac is definitely advantageous to TOCa in the detection of hypercalcaemia in mild primary hyperparathyroidism.


Impairment of vitamin D and bone metabolism in patients with bypass operation for obesity. Thirty-four patients were studied 2--6 years after jejunoileal bypass for morbid obesity. The serum concentration of 25-hydroxyvitamin D (25-OHD) were reduced and related to the frequency fo stools and to the weight reduction. Fifteen patients were not able to normalize serum 25-OHD following a long-term regular vitamin D intake. The serum immunoreactive parathyroid hormone concentration (iPTH) and the alkaline phosphatase levels were elevated in this group, indicating a secondary hyperparathyroidism. The mean bone mineral content of the forearm was reduced 3--6 years after the operation, most severely in those with elevated serum iPTH. The desired weight reduction by jejunoileal shunt was obtained at the expense of a severely disturbed vitamin D metabolism. We suggest, that all patients with an intestinal bypass for obesity should receive regular vitamin D supplement, and serum 25-OHD should be measured in order to monitor the effect of therapy.


Clinical evaluation of hepatic scintigraphy. The diagnostic accuracy of liver scintigraphy concerning focal liver diseases was evaluated. Two groups of patients were examined. The first group was examined with a rectilinear scanner and a definite diagnosis was obtained in 176 cases. The predictive diagnostic values of the scintigraphic diagnosis: focal liver lesion present (PV pos.) was 71% (57--83), focal liver lesion not present (PV neg.) was 84% (76--90) (95% confidence limits in brackets). The second group was examined with a gamma camera and a definite diagnosis was obtained in 41 cases. Here the PV pos. was 56% (21--86) and the PV neg. 97% (84--100). A motion correction devise did not improve the interpretation. A survey of the literature indicates that the accuracy despite progressive technological development has not improved during the last 6 or 7 years. Despite its limitations the author finds liver scintigraphy indicated in patients with suspected or proven cancer.


Kinetics of propylthiouracil in the elderly. The pharmakokinetics of propylthiouracil was evaluated in 9 elderly patients and compared to previous results from 6 younger subjects. By giving the drug both by the intravenous and oral route of administration it was possible to estimate the rate and extent of bioavailability. The various kinetic parameters were calculated according to a two-compartment model by use of two different methods: a graphical hand drawn one and by a special developed computer program based on a least squares minimalisation. While no significant differences could be demonstrated between the two age groups concerning volumes of distribution, clearance and extent of absorption, a large difference was found with regard to the absorption rate constant ka, which was about 3 times higher in the younger than in the elderly subjects, presumably due a reduced gastric emptying time. Considering the comparison between the two methods of calculations all the kinetics parameters were similar except ka and the slow disposition rate constant betw which were underestimated by the graphical method. It is concluded that no-age dependent changes exist concerning the kinetics of propylthiouracil except for a decreased rate of absorption. Graphical methods in pharmacokinetics are useful in obtaining distribution and elimination data but seem often biased for the evaluation of absorption rate constants.


Paracetamol (acetaminophen) clearance in patients with cirrhosis of the liver. The pharmacokinetics of paracetamol were studied in 11 patients with cirrhosis of the liver and 12 controls. The average biological half-life after oral administration of 1 g paracetamol was significantly prolonged in patients with hepatic cirrhosis compared to the controls (3.7 hr vs.2.1 hr) and, correspondingly, the average  plasma clearance was significantly reduced from 337 ml x min-1 in the controls to 162 ml x min-1 in the patients with cirrhosis of the liver. After subchronic dosing of paracetamol with 1 g paracetamol t. i. d. the plasma half-lives of paracetamol remained unchanged. Steady-state levels of paracetamol were significantly increased in the patients with cirrhosis of the liver. A significant correlation between the values of plasma clearance of paracetamol and prothrombin time (r = +0.88), galactose elimination capacity (r = +0.66), plasma albumin (r = +0.85) was found. No clinical or biochemical signs of hepatotoxicity were observed during the study.


Urinary excretion of dimethyltryptamine in liver disease. The urinary excretion of N,N-dimethyltryptamine (DMT) was higher in patients with severe liver disease than in normal subjects. This difference remained significant when patients with all grades of hepatic encephalopathy were excluded. Patients with liver disease whose mental states were normal excreted amounts of DMT similar to those of patients with a hospital diagnosis of schizophrenia.


Pretherapeutic morbidity in the prognostic staging of acute leukemia. To classify the clinical severity of acute leukemia, we have used the degrees of pretherapeutic infection and hemorrhage to construct a taxonomy containing three "stages". The stages are associated with survival gradients that are clinically and statistically distinctive in both acute lymphoblastic leukemia and acute nonlymphoblastic leukemia. Median survival ranged from 64.0 months for stage 1 to 10.5 months for stage 3 in acute lymphoblastic leukemia, and from 7.1 months for stage 1 to 1.2 months for stage 3 in acute nonlymphoblastic leukemia. The gradients, which persist when other prognostic factors and secular therapeutic changes are taken into account, are more distinctive than those found with other forms of stratification.


Nervous system involvement in type IV glycogenosis. A 30-month-old girl exhibited the 19th known case of type IV glycogenosis. Extensive involvement of the nervous system was found at autopsy. This represents only the second patient in whom the fine structure of the CNS and skeletal muscle has been described. We have also identified the abnormal polysaccharide in peripheral nerve, a finding that, to our knowledge, has not been reported previously. Our review of the literature indicates that approximately 50% of these patients exhibit signs or symptoms referable to the neuromuscular system. Most clinical and pathologic studies have focused on the severe liver involvement; insufficient attention has been directed toward the nervous system. This emphasizes the need for more detailed neurologic and neuropathologic examinations of children with type IV glycogenosis.


Ewing's sarcoma of the mandible.

Ewing's sarcoma of the mandible. Ewing's sarcoma of the mandible occurs rarely; there have been less than 50 reported cases in the past 30 years and none of these have been in the otolaryngologic literature. They usually present in the second decade of life with pain and swelling of the soft tissue overlying the mandible. The diagnosis can only be made by an adequate mandibular biopsy, although x-rays and clinical presentation are helpful. Current treatment consists of radiation therapy and sequential adjuvant chemotherapy.


Serum ferritin in pregnancy.

Serum ferritin in pregnancy. Serum ferritin levels were measured in 200 consecutive pregnant women at their first antenatal visit; 64 (32%) were found to have levels below the normal range. The results were correlated with haemoglobin concentration, serum iron levels, gestation, parity, and social class. The results indicate that low iron stores occur with increasing frequency as gestation advances, that ferritin assay is a better indicator of iron status than serum iron and haemoglobin levels, and that all patients should be given iron supplements in pregnancy, irrespective of social class or parity.


Antepartum stress cardiotocography using buccal oxytocin. The use of buccal pitocin in the performance of stressed antenatal cardiotocography was studied. Sixty-three tests were performed on 40 patients. All the patients were followed through labour and delivery. The results were evaluated and compared with those where an intravenous oxytocin infusion was used. Buccal pitocin produced comparable uterine contractions to those obtained by intravenous oxytocin, with similar test results. The avoidance of venepuncture and infusion was a positive advantage of this method of applying the stress.


A review of the use of Barton's forceps for the rotation of the fetal head from the transverse position. The technique of use of Barton's forceps is described. A series of 248 patients in a 4-year period has been assessed to determine the safety of the instrument. It is concluded that the forceps can be used with safety for both mother and baby under pudendal block anaesthesia, in mid-cavity and low-cavity deliveries.


Placenta accreta, percreta and praevia accreta. Placenta accreta is a rare complication of pregnancy which contributes significantly to maternal morbidity and mortality. Five cases are presented which illustrate different modes of presentation and problems of management; one of the patients (with placenta praevia accreta) died following Caesarean section and subtotal hysterectomy.


An hypothesis for high multiple pregnancies after clomiphene. A triplet and a quadruplet pregnancy following induction of ovulation with clomiphene are described; in each patient secondary amenorrhoea followed oral contraceptive use and several anovulatory or inadequate menstrual cycles had occurred on initial clomiphene therapy. Conception occurred in the first cycle after increasing drug dosage or the addition of human chorionic gonadotrophin (HCG) to the treatment regimen. We suggest, in explanation of these pregnancies, that repeated suboptimal stimulation of the ovaries as a result of clomiphene therapy develops several follicles to a critical stage; a subsequent greater ovulatory stimulus allows for synchronous development of several large follicles and multiple ovulation.


Effects of Danazol on pituitary gonadotrophins in post-menopausal women. Multiple sampling was carried out in 4 postmenopausal women for measurement of LH and FSH before and at the end of a 1-week treatment period with Danazol (400 mg daily). A small but significant depression of FSH was found in 3 of 4 subjects, while a significant depression of LH was only seen in 1 subject. In view of the very modest gonadotrophin suppression demonstrated in these women it is possible that Danazol also exerts its profound and sometimes rapid effects through inhibition of positive oestrogen feedback and by direct actions on the ovaries and endometrium.


Sexual counselling--a dual counselling approach. A technique has been described which utilises a dual counselling approach to handle problems of a sexual nature. The methods used to structure counselling sessions are discussed as well as the benefits and the drawbacks of using a male and female counsellor to assist people who have some failure in their sexual lifestyle.


Prognostic aspects of endometrial carcinoma. A retrospective analysis of 91 patients with endometrial carcinoma is presented with emphasis on important factors in relation to survival. Patients with Stage 1 carcinoma were treated with a standardized mode of preoperative radiation and extended abdominal hysterectomy. An 87.1% 5-year survival rate was obtained for patients with well differentiated lesions, with only 1 patient developing a vault metastasis. The assessment of residual tumour after intracavity radiotherapy proved reliable in predicting prognosis and should prove of benefit in directing additional therapy for endometrial carcinoma.


Urinary stress incontinence and common sense. Retropubic bladder neck suspension has been used to treat 352 women presenting with the primary complaint of urinary stress incontinence. The author's concept of the proper assessment and management of such patients, in whom previous surgical treatment has failed, is stated. A plea is made for the abandonment of traumatic surgical methods and the confusing multiplicity of names that accompanies them.


A survey of tubal ectopic pregnancy, with particular reference to cases following sterilization. In a series of 47 ectopic pregnancies occurring over a 2-year period, 5 followed tubal sterilization. Foreknowledge of the previous sterilization resulted in delay of surgical management. Sterilization techniques should be revised to prevent the incidence of ectopic pregnancy.


The incarcerated intrauterine device.

The incarcerated intrauterine device. Complete embedding or incarceration of the IUD is likely to cause difficulty at removal. Attempts at vaginal removal with 'heavy' instrumentation are hazardous and should be abandoned in favour of an abdominal approach. A trial demonstrating the superiority of the latter approach is described. The characteristics of patients with an incarcerated loop make concomitant tubal ligation possible in most instances.


Fallopian tube presenting as a uterine polyp. A case is reported of a patient who presented with the clinical diagnosis of a uterine polyp extruded through the cervix. Subsequently, the "polyp" was found to be a Fallopian tube which had been pulled into the uterus through a fundal perforation of curettage performed 10 months previously.


Ultrastructural studies on AMML and ocular granulocytic sarcoma. The ultrastructural analysis of the leukemic cells in twelve cases with AMML was considered a valuable tool in the diagnosis of this type of leukemia. Furthermore intracytoplasmic structure resembling virus like particles were observed in three bone marrow and one eye sample of the patients studied. The role of C-type RNA viruses in the etiology of leukemia was discussed.


Diagnostic use of an antiserum made against acute lymphoid leukemia associated antigen. Anti-ALL serum is used to distinguish common non-T, non-B ALL from Thy-ALL and "lymphoid" from myeloid blast crisis in Ph1-positive leukemia. This has prognostic and therapeutic implications.


Hematologic and cytologic characterization of 8/21 translocation acute granulocytic leukemia. Cytogenetic studies were performed in 546 patients with acute leukemia between 1968 and 1975. Two hundred thirty-four patients were aneuploid (42.9%), and 312 patients were diploid (57.1%). Among these, 32 patients were found to exhibit similar chromosomal alterations that appeared to involve specifically chromosomes 8 and 21. Banding studies in at least 15 of these patients confirmed the presence of a translocation between these two chromosomes. The cytogenetic findings were correlated with the hematologic and clinical data. It was found that each of these individuals had a typical picture of acute granulocytic leukemia with Auer rod-positive and peroxidase-positive cells. Ultrastructurally, the patients in this group also consistently demonstrated the presence of a nuclear bleb that has been positively associated with aneuploidy in acute leukemia. Clinically, they seemed to respond better to therapy than other adult patients with acute granulocytic leukemia. It is proposed that the 8/21 translocation acute leukemia represents a definite subgroup within the general category of acute granulocytic leukemia, with an incidence of approximately 7.3%.


Emergence of a cell line with extreme hypodiploidy in blast crisis of chronic myelocytic leukemia. Cytogenetic studies in a patient with chronic myelocytic leukemia (CML) demonstrated the emergence of an extremely hypodiploid cell line at the time of blast crisis, a modal chromosome number of 35, with the modal karyotype 35,XY, -3, -4, -5, -7, -9, -11, -12, -13, -15, -16, -17, -19, -20, -22, + t(9;22) (q34;q11, + Mar1, + Mar2, + Mar3. Giemsa-banding confirmed complex chromosome rearrangements and demonstrated distinct banding patterns for the marker chromosomes. Cytologic characteristics of the leukemia blasts were predominantly myeloid. There was no important clinical response to chemotherapy, including vincristine and prednisone, or to radiotherapy.


Unusual angiographic appearances of the left ventricle in 2 cases of Pompe's disease (glycogenosis type II). The angiographic and haemodynamic findings in 2 cases of Pompe's disease (glycogenosis type II) indicated an abnormal trabecular pattern, not previously reported, on the left ventricular angiogram of both patients. This feature may be helpful in distinguishing Pompe's disease from other forms of myocardial abnormality.


Leukaemia classification: a study of the accuracy of diagnosis in 456 patients. A panel of five haematologists has examined, without consultation or prior knowledge of the diagnosis, blood films and bone marrow smears from 456 patients with a diagnosis of leukaemia. A diagnostic classification which recognized various subtypes of acute myelogenous leukaemia was used but no attempt was made to subdivide acute lymphoblastic leukaemia. Complete agreement with the initial diagnosis was low (56.4%) and was particularly poor (45.7%) when the patient had one of the forms of acute leukaemia. However, disagreements which would have involved the patient in a change of treatment were unusual (2.0%). We conclude that a high degree of diagnostic agreement for patients with leukaemia is unlikely from morphological classifications alone.


New translocations in chronic granulocytic leukaemia: t(X;22)(p22;q11) and t(15;22)(q26;q11). Two cases of Ph1-positive chronic granulocytic leukaemia with hitherto undescribed translocations are presented. In case 1 the deleted part of chromosome number 22q- was translocated to the short arm of the X chromosome, t(X;22)(p22;q11). Pronounced basophilia, trisomy 19 in the majority of metaphases, and a partial cytogenetic normalization of the bone marrow during busulphan induced remission were additional remarkable features of this case. In case 2 a translocation t(15;22)(q26;q11) was found. In this case the disease was characterized by an increase of unusually small megakaryocytes, thrombocytosis, and an accelerated course.


Diagnosis of haematological disease using anti-i. II. Distinction between acute myeloblastic and acute lymphoblastic leukaemia. Leukaemic blast cells were obtained from the blood of six patients with acute lymphoblastic leukaemia (ALL) and 15 patients with acute myeloblastic leukaemia (AML). The blasts were compared with lymphocytes from normal subjects in cytotoxicity and 125I-labelled antibody binding tests using several examples of anti-i. As much i antigen was detected on ALL blasts as on normal lymphocytes; much less i antigen was detected on AML blasts. Studies of three patients with morphologically undifferentiated acute leukaemia suggest that, in tests with anti-i, blasts from such patients react either like lymphoblasts or myeloblasts despite the absence of the corresponding morphological features.


Distinctive properties of mammalian DNA polymerases. DNA polymerase-alpha and -beta can be distinguished from one another by the differential effects of N-ethylmaleimide, KCl, ara-CTP and temperature, as well as on the basis of sedimentation. The sensitivity of DNA polymerase-beta to elevated temperatures as compared to DNA polymerase-alpha provides a new means of distinguishing between these two enzymes even in crude extracts and a possible probe for determining their function. DNA polymerase-alpha and -beta share several properties in common, including the ability to readily incorporate dUTP in place of dTTP. The Km for dUTP varies from 10 to 30 micron with different preparations of DNA polymerase-alpha and -beta. Thus, in mammalian cells, dUMP could be incorporated into DNA, and if excised by an endonuclease, would lead to discontinuities. Initial analyses of fidelity in direct comparative studies indicate that beta-class DNA polymerases are highly accurate in base selection when copying poly[d(A-T)]. Less than one molecule of dGMP is incorporated for every 12 000-45 000 molecules of dAMP and dTMP polymerized. DNA polymerase-alpha is somewhat less accurate, making one mistake for every 4000-10 000 correct nucleotides incorporated. Since both polymerases lack an exonucleolytic activity, this accuracy must be the result of selectivity for the complementary nucleotide by the polymerase.


Quantitative assay of the N-methylated metabolites of tryptamine and serotonin by gas chromatography mass spectrometry as applied to the determination of lung indoleethylamine N-methyltransferase activity. A specific and sensitive method is described for the identifcation and quantification of the N-mono- and dimethylated derivatives of tryptamine and serotonin by gas chromatography mass spectrometry. Deuterated analogues of the amines have been prepared for use as internal standards. The technique has been applied to the determination of indoleethylamine N-methyltransferase activity in rabbit and human lung. No interference from the beta-carboline formation or other side reactions between the substrates and the methyl donor was observed.


Analysis of 5-methoxytryptamine in brain by gas chromatography mass spectrometry. A quantitative gas chromatographic mass spectrometric method using a deuterated analogue as internal standard were developed for the analysis of 5-methoxytryptamine in brain. The internal standard was synthesized in two steps and possessed high isotopic purity. The analytical procedure involves the addition of the internal standard to the homogenizing medium containing the tissue, followed by homogenization, extraction with chloroform and derivatization with pentafluoropropionic anhydride. The identification and quantitation of 5-methoxytryptamine is based on monitoring the ions at m/z 306, 319 and 482 for the pentafluoropropionyl derivative of 5-methoxytryptamine and m/z 308, 322 and 486 for the internal standard. Using this procedure 5-methoxytryptamine was identified and quantitated in the sheep pineal gland. The mean 5-methoxytryptamine level (N = 12) was 545 +/- 180 pmol g-1.


Terminal erythroid differentiation in normal and leukemic mouse cells. Friend virus-transformed murine erythroleukemic cells (FL cells) have been used as an in vitro model for the study of the expression of the genetic program involved in the final stages of erythroid differentiation. Treatment of the FL cells with chemical inducers such as dimethylsulfoxide results in their differentiation from 'pro-erythroblasts' to orthochromatic normoblasts and the appearance of several erythroid markers including hemoglobin, enzymes of the heme pathway, heme, glycophorin, and spectrin. These markers appear in an ordered sequence, suggesting that two genetic programs are involved in the erythroid differentiation of the cells. Preliminary studies with erythropoietin-stimulated fetal liver cultures in vitro suggest that the same is true for normal erythroid differentiation.


Methotrexate and asparaginase combination chemotherapy in refractory acute lymphoblastic leukemia of childhood. Two groups of children with refractory acute lymphoblastic leukemia were treated with a regimen of methotrexate (MTX) and asparaginase (Asn'ase) based on studies of the effect of MTX in vitro on human lymphoblasts exposed to Asn'ase. Induction therapy in 12 children produced 4 complete remissions, 3 partial remissions, and 5 failures. Responsiveness to Asn'ase seemed necessary for successful induction with the drug combinations. Maintenance therapy in 18 children produced a median hematologic remission of 31 weeks (range 3-85 weeks). During remission, 2 children developed central nervous system leukemia and 2 died of infection. The mean maximally tolerated dose of MTX was 361 mg/m2. The results of this trial suggest therapeutic synergy in maintenance therapy and the capability of Asn'ase to attenuate MTX toxicity.


Internal hemipelvectomy--excision of the hemipelvis with limb preservation. An alternative to hemipelvectomy. Our results indicate that it is technically possible to resect the hemipelvis and maintain a viable extremity. Functional results are remarkably good and tumor control has been equivalent to standard hemipelvectomy. Excision of the ilium with preservation of the extremity in selected cases would appear to be a reasonable alternative to the standard hemipelvectomy, which involves amputation of the extremity.


Evaluation of computed tomography in the detection of pulmonary metastases: a prospective study. Conventional linear x-ray tomography is often used to search for pulmonary metastases but tends to underestimate extent of disease when compared with operative findings. In a prospective study, operative findings were correlated with computed axial tomography and conventional linear tomography performed on 25 patients with a history of extrathoracic malignancy and pulmonary nodules. Computed tomography detected 69 nodules of which 31 proved to be metastases. Conventional linear tomography detected 38 nodules of which 25 were metastases. Of the 54 resected nodules measuring greater than 3 mm, computed tomography detected 42; whereas conventional tomography detected 32. Only six of the 31 additional nodules (20%) detected by computed tomography and not by conventional tomography proved to be metastases. These results suggest that computed tomography is more sensitive than conventional tomography in detecting small pulmonary nodules; however, there is diminished specificity in identifying metastatic nodules.


Leukemic host influence on normal erythrocytic and granulocytic colony formation in in vivo plasma clot diffusion chamber cultures. The effect of a leukemic environment on normal erythroid and granulocytic colony formation was examined in in vivo plasma clot diffusion chamber cultures implanted into Shay chloroleukemic rat hosts at varying stages of the disease. Normal bone marrow cells isolated in plasma clot diffusion chamber cultures in leukemic hosts displayed significant differences in the pattern of normal bone marrow colony growth. Granulocyte colony-forming units were significantly inhibited by leukemic hosts throughout the course of the disease. The size of developing colonies was reduced to under 100 cells; however, maturation within these clusters appeared unaffected. Erythroid colonies showed a slight inhibition during the early stages of the leukemia, a significant stimulation of 100 to 350% in the midleukemic period, and a significant inhibition of 50 to 65% during the terminal stages of the disease. Burst formation was also inhibited in the late leukemic stages. The transient increase in erythroid colony-forming units on Days 7 and 8 of the leukemia was concomitant with the onset of the anemia associated with the disease. Since the normal bone marrow cells were compartmentalized within the plasma clot diffusion chamber cultures, the suppression of erythroid and granulocytic colony development appears to be directly due to the release of diffusible inhibitory substances from the leukemic animal.


Combination chemotherapy for acute myelocytic leukemia during pregnancy: three case reports. The cases of three patients with acute myelocytic leukemia presenting during the second trimester of pregnancy are summarized. All three patients were treated with combination chemotherapy. One patient, while in remission, underwent elective abortion of an apparently normal fetus. This patient is alive and free of disease 2 years after bone marrow transplantation. Each of the other two patients was spontaneously delivered of a premature infant. Transient bone marrow suppression occurred in one of these infants. Both children were small for their gestational age. One patient died 9 days after her infant was delivered and the other survived for 13 months.


Age-related pharmacokinetics of high-dose methotrexate in patients with osteosarcoma. Plasma methotrexate (MTX) concentrations were determined in 52 patients after 409 infusions of high-dose (HD) (50-250 mg/kg) MTX with citrovorum factor (CF) rescue. In addition, detailed pharmacokinetic studies were conducted in nine of these patients. Plasma drug levels were compared at 6, 24, 48, and 72 hours from the start of MTX infusions in four different age groups (less than or equal to 10, 11-14, 15-17, and greater than or equal to 18 years of age). At the same drug dose, the younger patients had lower plasma MTX levels than the older patients at 6 and 24 hours. This difference increased in significance with increasing MTX dose. However, MTX plasma levels became similar at 48 and 72 hours, regardless of age. The half-life for the first phase of biphasic MTX clearance in children was shorter than that in adults. In addition, the urinary excretion of MTX was faster in younger children at all doses. The younger patients had a greater apparent volume of distribution of MTX after HD infusion. These results indicate that the age-dependent pharmacokinetics can be attributed to greater distribution and elimination of MTX in the younger patients. The potential difference in the metabolism of MTX between children and adults is currently under investigation. Our observations suggest that age exerts a dominant effect on the pharmacokinetics of HD-MTX.


High-pressure liquid chromatographic analysis of 3-deazauridine-5'-triphosphate in human cancer cells. A rapid high-pressure liquid chromatographic assay for the detection and quantitation of 3-deazauridine-5'-triphosphate (deazaUTP), the active metabolite of the anticancer drug 3-deazauridine (deazaUrd), in cell extracts is described. This procedure permits the simultaneous detection and quantitation of CTP, the cellular concentration of which is affected by treatment with deazaUrd. Human lymphoblastoid cells (line CCRF-CEM) treated with 100 nmols of deazaUrd/ml in culture accumulate deazaUTP to greater than 25 nmols/10(7) cells after 4 hours. The concentration of CTP in these cells decreased exponentially with a half-life of 1.1 hours. After these cells had been incubated with 100 nmols of deazaUrd/ml and were resuspended in drug-free medium, the intracellular deazaUTP concentration decreased exponentially with a half-life of 3.4 hours. This assay has been applied to clinical studies of deazaUrd; high cellular deazaUTP concentrations have been detected in brain tumor tissue after deazaUrd infusion.


Levels of resistance to six synthetic insecticides in the Borneo housefly. The resistant levels of the 4 strains of the housefly collected in Borneo to six insecticides, namely DDT, Chrysron, DDVP, Baytex, Sumithion and Diazinon, were examined. It was found that most housefly population in Borneo showed a higher susceptibility than that of the Takatsuki strain of Japan, especially to DDT.


Effect of cardiac output on pulmonary shunt. The effect of cardiac output on pulmonary shunt was studied in living lungs of human patients and dogs which had alveoli and blood vessels, and also in artificial lung (bubble-type oxygenator) which had no such structural factors. In spite of such a structural difference, quite similar results were observed in both living and artificial lungs, and this suggests that some common factors other than the change in blood vessels result in the change in pulmonary shunt. It was observed that pulmonary shunt increased as the saturation of mixed venous blood became higher.  It was clarified that the oxygen-receiving capacity of blood decreased as the oxygen saturation of mixed venous blood became higher. It was clarified that the oxygen-receiving capacity of blood decreased as the oxygen saturation became higher, i.e., the amount of reduced hemoglobin became less. The reduction in oxygen-receiving capacity of blood results in the reduction in oxygen-transfer efficiency from alveoli to blood and hence pulmonary shunt increases, and this can be regarded as a kind of shunt-like effect. It can be concluded that the change in pulmonary shunt by cardiac output is not due to the change in the lung function but is caused by the change in the oxygen-receiving capacity of the mixed venous blood.


A preliminary key to the common calliphorid flies of peninsular Malaysia (Insecta: Diptera). A key to the common Calliphorid flies of Peninsular Malaysia is presented. Illustrations of the genitalia of some rare species, list of new localities, altitudes and other ecological data are also presented. The following species were recorded for the first time from Peninsular Malaysia; Catapicephala sinica, C. kurahashii, Taninanina javanica, Hemipyrellia tagaliana, Lucilia sinensis, Blaesoxipha kasterni, Boettcherisca javanica, Parasarcophaga misera, P. orchidea, P. albicephs, Sarcosolomonia crinita, Thyrsocnema bornensis, Sarcorohdendorfia antilope and Lioproctia pattoni.


The relationship between lip pressure and facial growth after cleft lip repair: an experimental study. Two different methods of lip repair were used on rabbits with surgically created unilateral clefts of the lip, alveolus, and palate. Control groups involved both unoperated animals and those with unrepaired surgically created clefts. The resulting lip pressure in the rabbits with repaired cleft lips was found to be significantly higher than in the control groups. Direct skull measurements showed that the rabbits whose lips had been surgically repaired also had significantly shorter maxillae that did the control groups. The correlation found between the amount of lip pressure and the degree of growth inhibition indicated a causal relationship.


TONAR calibration: a brief note.

TONAR calibration: a brief note. Measurements were made of the frequency response characteristics of the microphone-separator components of TONAR II instrumentation. The results of our calibration studies revealed 1) appreciable non-uniformity in frequency response of the two microphones, 2) a considerable degree of mismatch in frequency response between the microphones and, 3) dynamic interactions among microphone, separator cavity, and talker cavity resonant characteristics. Findings are discussed in terms of their implications regarding the validity of TONAR II based nasalance ratio measures.


The types of hearing loss and ear pathology noted in screening craniofacial patients. Seventy patients who underwent craniofacial reconstruction were screened by otological and audiological examinations. Thirty-seven patients had visible ear pathology, thirty-six had conductive hearing impairments. No sensorineural losses were detected. The high incidence of otological pathology in craniofacial patients emphasizes the importance of multi-disciplinary care. Otological rehabilitation should be integrated into the treatment plan to provide maximum function throughout the period of craniofacial reconstruction. Suggestions are made to facilitate communication in the immediate post operative period.


Accuracy of birth certificate data for detecting facial cleft defects in Arkansas children. A comparison of facial cleft defects reported on birth certificates during the period 1943 to 1974 that were reported on birth certificates was made with records maintained by the Arkansas Crippled Childrens Services (CCS). A total of 506 cases were reported of which 331 (65%) were recorded on the birth certificate. Moreover, the accuracy of the reporting was not good. Only 243 (48%) cleft malformations were correctly classified on the birth certificate. Birth certificate information is an inadequate measure of the true facial cleft occurrence in Arkansas. Caution must be exercised when this data source is used in epidemiological surveys because over one-third of such defects were not recorded. These findings serve to reemphasize the national need to improve the quality of such vital health statistics sources.


Self concept of the cleft lip and or palate child. This investigation examined the relationship of the self-concept of children with cleft lip and/or palate to the self-concept of noncleft children. Thirty-four cleft lip and/or palate children between the ages of 11 and 13 were individually matched with thirty-four noncleft school children. Each child was given the Piers-Harris Children's Self Concept Scale. Children with clefts, regardless of sex, reported a significantly greater dissatisfaction with physical appearance. A significant interaction effect between sex and presence or absence of cleft was found on three cluster scores with cleft girls reporting greater unhappiness and dissatisfaction, less success in school, and more anxiety.


Cognitive, self-concept, and body image measures of normal, cleft palate, and obese adolescents. Using discriminant function analyses, this study attempted to establish linear combinations of variables that would identify group membership correctly. Groups of normal (N = 100), cleft palate (N = 51), and obese (N = 22) adolescents responded to measures of cognitive sytle and structure, body image, and self-concept. Linear combinations of congitive measures were not effective in differentiating group membership. Body image measures, in combination, clearly distinguished obese adolescents from the other two groups. A linear combination of self-concept measures differentiated adolescents with clefts from normals, with the former group having a pattern of higher self-esteem and lower perceived acceptability by their parents.


Maternal and child locus of control and field-dependence in cleft palate children. The cleft palate experience includes events which are beyond the control of cleft palate children and their mothers. To investigate whether the experiences relate to other maternal and child variables, 44 cleft palate children, 9--18 years of age, and their mothers were compared to 61 control children and their mothers. Maternal variables included locus of control and perceived reactions to the child's birth. Child variables included locus of control, field dependence, parental perceptions, and teacher ratings. Mothers of children with cleft palates indicated a significantly greater negative impact at their children's births but did not indicate greater externality. Children with clefts were significantly more external in control, were more field-dependent, perceived parental reactions as more negative, and had more negative academic ratings. Mothers who were more external in locus of control had children who were more field-dependent and had more external control.


Parental needs and professional responses: a parental perspective. Parental needs are discussed as they have been revealed during a six-year period in a Boston parents' group, Prescription Parents, Inc. In addition, professional responses at various stressful periods during cleft palate rehabilitation are examined and certain responses suggested. Emphasis is given to the professional-parent partnership in developing the child's self-image and also to the relationship between professionals and the patient, particularly from age six through adolescence. The role of the peer group as it interacts with the home environment is also stressed. Specific suggestions are offered concerning the influence of a parents' group and the specific services such groups can provide.


A racial comparison of cleft patients in a clinic population: associated anomalies and recurrence rates. Clinical files of 22 black and 88 white cleft palate patients, under 16 years of age, were studied. Data on the distribution of cleft types, associated birth defects and recurrence rates were obtained for the two racial groups and analyzed through the use of the X2 test. It was found that blacks had a significantly higher (p less than .005) rate of associated birth defects when compared to whites. No significant differences were found in recurrence rates between the racial groups.


Information and experience with cleft palate: students, parents, professionals. More than 1,200 students, parents, and professionals completed a questionnaire designed to assess knowledge and experience with cleft palate. Professionals knew more about cleft palate and had had more experience with it than either parents or students. Parents, however, knew more about cleft palate and had had more experience with it than had students. There was also an apparent relationship between knowledge and experience because those who knew more about cleft palate had also had more experience and training.  The results reemphasize the need for pre-professional and continuing-education programs.


Caries experience of Danish children evaluated by the child dental health recording system. The purpose of this report is to describe certain features of the child dental health care in Denmark. The caries picture and the caries distribution pattern in Danish children aged 2--15 years are demonstrated and some regional variations are analyzed. The study is based on epidemiologic data collected in the school year 1977--78 from about 500 000 children being treated in accordance with the Child Dental Care Act. The data collection is being effectuated annually under a child dental health recording system, and the aim and function of this system is discussed. The mean defs- and DMFS-indices are illustrated for individual age groups reflecting the natural history of dental caries. Certain trends in relation to different geographical distributions of caries and in relation to different cohorts of children from 1972 to 1977 are discussed. The analysis of the caries picture is extended by means of the distribution pattern according to caries severity zones. Finally, the use of caries epidemiologic data for planning and resource allocation purposes is illustrated and some policy implications for the development of the child dental health services in Denmark are discussed.


Dental caries prevalence in 5-year-old children in Mallow (a non-fluoridated area), Cork, Ireland. 295 5-year-old children were examined in Mallow, a non-fluoridated town in North Cork to ascertain the dental status of children commencing first level education. The results were compared with those found in Baja, Hungary and in Barnsley, England. The def in Mallow was found to be 5.15 and the Met Need Index 14%. The authors suggest that the programmes of dental care should be re-examined in the light of these findings and more emphasis placed on the prevention and treatment of caries at an earlier age.


Comparison of two groups of patients with TMJ-disorder. A total of 49 patients seeking treatment for TMJ-disorders in a district in Northern Norway during a period of 3 months, were described according to social, medical and dental characteristics, amount and type of symptoms, and clinical findings. Data were compared with those obtained from a group of TMJ-patients at the Dental Faculty, University of Oslo. In both materials women were heavily overrepresented. In the group presently studied, the age profile and the amount of reported stressors were higher, and the social class composition somewhat lower, than those in the material obtained at the University. These inequalities should be seen in context with the demographic composition of the two communities. It is anticipated that the main characteristics of the university group are generally valid for patients with TMJ-disorders in Norway.


Public opinions on dentists in Norway.

Public opinions on dentists in Norway. Interviews on the dentist-patient relationship were carried out among 1,221 persons representing the dentulous part of the Norwegian population aged 15 and over. Two thirds of the interviewees said that their dentists explained the treatment plan, and of these, every second interviewee received reasons for the treatment. One third said they discussed different treatment alternatives with the dentist. One third of the respondents said that the dentist had urged them to clean their teeth thoroughly and to use fluoride. Inly a minority thought that the dentist had sought to influence their dietary habits. When asked to give priority to alternative characteristics and qualities of dentists, accuracy and professional skills were those ranked the highest. Carefulness, willingness to listen and to discuss dental problems, and finally effective working habits were the qualities ranked thereafter. Out of the sample, 96% thought that their dentist did very good or good work, and 82% wanted to choose their own dentist.


Attitudes concerning water fluoridation among graduating Swedish dentists. The purpose of the investigation was to assess the attitudes concerning water fluoridation among Swedish dentists just having completed their dental education. All senior dental students (168) at the four Swedish dental schools were handed a questionnaire during the last week of November 1974. By the end of February 1975, 98% of the respondents, now dentists, had returned their questionnaires. Water fluoridation was considered by the average respondent to be quite economical and effective but only slightly advisable; 72% expressed approval and support of water fluoridation; 15% expressed indecisiveness; 12% expressed negative views. The negative attitudes were associated with misconceptions concerning economy, technical efficiency, safety and effectiveness. Many respondents, even those who expressed support of water fluoridation, displayed misconceptions concerning the effectiveness of water fluoridation in relation to topical application of fluorides and to the administration of fluoride tablets.


Recent reorganization of the public dental health service in Greenland in favor of caries prevention. The Danish dental health service in Greenland has not succeeded in its attempts to subdue a steadily growing caries problem in this rapidly changing society; surveys from 1974 and 1977 show that DMFS indices in this country are among the highest in the world. A comparison between the 1974 and 1977 surveys indicates that the DMFS indices reached a maximum around 1974. Pressing needs for other health services have left only small resources for a reorganization of the dental health service; at the same time, a certain lack of initial administrative support has hampered design and implementation of an adequate preventive program. Recently, a comprehensive plan for the training in Greenland of Greenlandic auxiliary personnel was put into effect, but at a time of economic depression. As a consequence, the dental health service now finds itself compelled to limit its previous scope of "comprehensive care", to be able to spend a reasonable part of existing resources on preventive programs utilizing indigenous auxiliary personnel.


Validity of information concerning the use of dental services obtained in interviews. Two hundred and fifty-two persons out of a population of 358 were interviewed concerning their use of dental services. The validity of the information was tested by comparing the answers from each respondent with the contents of his/her dental treatment record. Replies to a question about the time interval since the last dental visit showed a high degree of validity. The validity of information concerning the type of treatment received at the last course of dental visits showed high validity for a single treatment and low validity when the treatment services were mixed. Responses about the regularity of treatment attendance demonstrated decreasing degree of validity with increasing number of dental visits during the last 5 years. The demographic and socioeconomic characteristics of the respondents showed little relation to the validity of their answers. However, the degree of validity decreased with increasing number of teeth.


Evaluation of periodontal status in a Finnish industrial population. Occurrence of periodontal disease was investigated in an industrial population by a modified Peridontal Treatment Need System (PTNS). The study comprised an initial clinical examination and a follow-up examination of 165 persons 1 year later. The reproducibility of the modified PTNS was satisfactory; in a subsample studied twice the weighted kappa with its 99% confidence limits was 0.80 +/- 0.18. Only 3% of the dentulous subjects had no treatment need because of gingival or periodontal disease in the first clinical examination, in spite of the low mean age (33.2 years) of the population. The periodontium of the maxillary teeth was significantly (P less than 0.001) than that in the mandibular teeth, but there were no significant differences between right and left side of jaws. During the 1-year follow-up period the periodontal condition of 23% of subjects improved, whereas in 9% it deteriorated.


[Dental caries and the necessity of treatment in pre-school children]. A study concerning the intensity of caries, the oral hygiene, and the necessity for treatment was carried out with 816 children between the ages of three and five. The findings indicated age-related relationships, which are independent of sex and kindergarten enrollment. On the basis of the results, the conclusion was drawn that prophylactic measures for caries should be instituted as early as possible; kindergarten teachers and the parents should be instructed in the essentials of oral hygiene.


[The effect of knowledge of caries prevention on oral hygiene]. The Quigley-Hein Index was determined and knowledge of prophylactic treatment for caries was tested in 171 senior high school students between the ages of 15 and 17. The findings indicated that the knowledge of caries prophylaxis was good; oral hygiene however was found to be poor (mean Quigley-Hein Index: 3.1). The correlation between plaque index and number of incorrect answers on the test of the knowledge of prophylactic treatment for caries was extremely low.


[Caries-statistical results after 15 years of fluoridation in Basle]. Fluoride (1 ppm) has been added to the drinking water in Basel, Switzerland, since May of 1962. The effects of this fluoridation on the teeth was studied at five year intervals in a total of 9042 school children between the ages of seven and fifteen. During the course of the control examinations, a statistically significant reduction in the frequency and experience of caries for all age groups was observed. Caries were reduced by 60% and more. The increase in the number of children with caries-free teeth in all age groups was statistically significant.


[Teratological aspects of CaF2 medication]. CaF2 was studied in animal experiments to determine its effect over a period of several generations. The negative effects of AcF2 on embryogenesis increase as the dosage is increased. The effects however are slight compared with other fluorides.


[Follow-up studies on 50 pulpotomies (tricresol-formaldehyde method) after 3 years]. Fifty pulpotomies were carried out on the deciduous teeth of 39 children. Three years later the children were examined clinically and radiologically. Treatment appeared to be successful in 78% of the cases. Success of treatment seemed to be related to meticulousness of the treatment and number of appointments.


[Functional disorders in juvenile jaws]. A wide variety of symptoms and findings taken from 172 patients between the ages of 10 and 26, who presented for diagnostic examinations of function, were compared. The amazingly high frequency of functional disturbances appearing in this age group demands special study.


[Problems of conservative and surgical therapy of juvenile jaw fractures]. Fractures of the mandible in children represent a special problem in the therapeutic concept of traumatology. These injuries differ from similar injuries in adults in terms of the mechanism of the fracture, therapeutic possibilities, elasticity of the bone, healing of the mandibular fracture, presence of tooth buds, and cooperativeness of the patient. Operative procedures should be carried out if necessary, but treatment should basically be as conservative as possible. The primary principle for therapeutic procedures on growing maxillofacial bones is avoidance of late sequelae and restoration of function.


[State of the dentition in 3--10 years old children in the Munich region]. A questionnaire was sent to the parents of 1000 3- to 7-year-old children in and around Munich whose teeth we had examined. We inquired as to the oral hygiene and the socioeconomic conditions. The def and DMF mean values were evaluated according to the age group. The results indicate that the condition of the teeth of our young people can only be improved if measures for dental hygiene and caries prophylaxis in general are intensified and improved at the kindergarten level.


[Blood pressure and pulse in treatment resisting children]. Cardiovascular parameters increase as the fear of dental treatment increases. Recordings of pulse rate and blood pressure were used to illustrate the various situations (i.e., children willing to be treated and children unwilling to be treated).


[Experimental studies on root canal fillings with addition of corticoids]. No clinical symptoms are usually produced by dental procedures utilizing endodontic medicines with corticoid additives. Root fillin pastes with corticoid are particularly deserving of attention. Whether the effect of such root filling pastes is limited to the apical tissue or whether endocrine reactions are also evoked was studied in animal experiments. The possibility of endocrine reactions cannot be definitely excluded. Given the possibility of such counter effects and their sequelae, the discussion of the indications and/or the counterindications for the use of root filling paste with corticoid additives for permanent treatment of root canals should in no way be considered concluded.


[Critical evaluation of the endodontic treatment administered in 1975 by students of the dental department, Mainz]. The endodontic work of students in the department for tooth conservation at the Dental Hospital in Mainz, FRG, during 1975 was described. A total of 850 cases were studied in regard to the following: 1)  cause and type of endodontic treatment, 2) type of root filling material, 3) number of appointments, 4) temporary root canal filling with limited period of storage, 5) degree and homogeneity of the filling.


[The wall of the root canal after treatment with various instruments]. Root canal walls of freshly extracted teeth were examined with a scanning electron microscope before and after routine instrumental treatment of the root canal. The results indicated that the root canal wall must be freed of soft-tissue remnants and smoothed, and the orifices of the dental tubules blocked via meticulous use of broaches and files if the material used for a root canal filling is to be properly sealed.


[Plaque flora and dental caries. I. Occurrence of Streptococcus sanguis types in caries-free and caries susceptible school children]. The reported results suggest that changes in dental plaque flora and its importance for cariesinitiation in man can only be learned about by 1) investigation into different pre- and early caries phases, 2) by still more differentiation of potentially cariogenic microorganisms, according to their biochemical behavior, and 3) by considering other factors influencing the dental plaque flora like toothbrushing habits. The data presented suggest that Strep. sanguis type I and IIW might cause cariesinitiation with daily toothbrushing individuals.


[Biochemical studies on the metabolic behavior of the human salivary and plaque microflora towards L-sorbose]. Whether and if so to what extent the microflora in human saliva and plaque metabolizes L sorbitol, a sugar exchange substance, was studied. The Warburg technique was used for this investigation. It was established that only traces of L sorbitol were present in the saliva and the plaque deposits. It may therefore be assumed that L sorbitol has an extremely low cariogenic effect.


[Microstructural studies on abraded facettes in the dentin]. Using transmission electorn microscopy, a homogeneous deposition on abrasion facets in the dentin was observed in sections. This deposition ranged between 0.2 and 0.74 micrometer in thickness. In the area of the dental tubules, this layer may be dissolved with a 5% solution of acetic acid. It however is basically preserved in the region of the intertubular dentine.


[The surface structure of dentin after routine treatments]. A scanning electron microscopic study was made of the dentinal surface following preparation with various devices used routinely in the dental practice. The dentine prepared with diamond points showed deep fissured tracks from the individual diamond crystals, even when only slightly magnified. Compared with the untreated dentinal fracture surface, the orifices of the dentine tubules were crushed and obstructed. The surface is smoothed via finishing; the orifices of the dental tubules are no longer present. The picture remained unchanged after washing with H2O2 and cauterization with Ca(OH)2.


[Variations of the etching patterns of enamel surfaces after treatment with various caustics]. Conditioning the enamel is extremely important for the prophylactic treatment of caries with sealers. The possibility of dentition depends on the depth and pattern of etching. Incisors and molars were etched with seven etching agents. The depth of etching was examined via microradiography; the etching pattern, with the scanning electron microscope. The best etching agent proved to be a 50% solution of H3PO4 + 2% solution of NaF; The depth of etching was greater in the molars than in the incisors. The etching pattern produced with this agent was also the most even. The etching pattern could not be predicted on the basis of the etching agent.


[The effect of methyl-methacrylate monomer on L-cell metabolism]. The total serum protein synthesis, amino acid assimilation, rate of cell division, and DNA synthesis with various concentrations of methyl methacrylate monomer in medium was determined in a culture of L 929 fibroblasts of the mouse. DNA synthesis was inhibited after 12 hours of incubation. The normal course of cell division was completely supressed with a concentration of 3.2 . 10(-2) mol/l. A decrease in protein synthesis was observed after 24 hours of incubation. This decrease may be considered the result of DNA inhibition.