Mucogingival changes resulting from mandibular incisor tooth movement. This study involved a cephalometric analysis of 1,150 fully treated orthodontic cases evaluated by Kodachrome slides, plaster casts, and cephalometric films to determine changes in the width of keratinized gingiva relative to lower incisor tooth movement and to ascertain the incidence of mucogingival problems in orthodontic patients. It was apparent that in a small percentage of cases visible mucogingival changes occurred and could be statistically correlated with the magnitude and direction of tooth movement. In this group of patients 1.3 percent (sixteen) showed a decrease in the width of keratinized gingiva with either minimal movement or some labial movement of the mandibular incisors; 0.69 percent (eight) had an increase in keratinized gingival width concomitant with significant lingual positioning of the lower incisors. The salient point to be made is that with an initial minimal or inadequate width of keratinized gingiva (0 to 2 mm.), mandibular incisor tooth movement over a period of treatment could significantly affect the final quality of gingival health in the critical mandibular anterior region.


Cephalometric standards for American Negro children. 1. Our findings are comparable to the measurements of Drummond and Altemus. 2. Most skeletal measurements of the Alabama Negro are greater than those of Caucasians. 3. There is no difference between Caucasians and Negroes in the mean of the facial plane--SN angle. 4. The maxilla is proportionately more anteriorly placed than the mandible in the Negro. 5. The upper and lower incisors are more procumbent and protrusive in Negroes. 6. Standard deviations are about the same for whites and blacks, other than those for skeletal measurements. 7. Neither Angle's Class II nor Class III malocclusions occur as frequently in the black population as in the white population.


Prenatal growth patterns of the human mandible and masseter muscle complex. Since experimental and clinical evidence supports some role of musculature in determining the form and size of facial bones during the active periods of growth after birth, this study addresses the same basic relationships between muscle and bone during the periods of active growth before birth. The relationship between the masseter muscle and the mandible, including its ramal and body components, was chosen as the model for study in nineteen human fetuses (ages 16 to 36 weeks). Cross-sectional cephalometric data indicated that, although increases in the size of the muscle and mandible were linearly related to increasing age, the ramal portion of the mandible was more closely related to changes in the masseter muscle than to changes in the mandibular body. Moreover, it appears that reorientation of the muscle anteriorly and downward precedes a similar reorientation of the ramus, with the combination of both fetal events leading to the typical relationships of the two structures expected after birth. Although this study does not get to cause-and-effect relationships, and although the fetal specimens cannot be monitored longitudinally over time, the parallelisms between our prenatal findings and those reported for postnatal periods certainly lend further support to the observation that many aspects of morphogenesis and growth are continual processes spanning the periods on either side of birth.


Mechanics, growth, and class II corrections. Growth of the orofacial region is quantitatively described by locating the center of mandibular rotation relative to the cranial base. The center of mandibular rotation is positioned by the ratio of vertical facial growth (AFH/PFH) and the direction of condylar growth. Appliance therapy is associated with changes in the means of both of these parameters. These changes reduce or stop favorable anterior mandibular rotation and redirect the mean condylar growth vector more posteriorly. When appliance therapy is stopped, these parameters return toward their resting values. The mean direction of the condylar growth vector became even more anteriorly directed after treatment than the pretreatment mean value. These data support the hypothesis that orthodontic appliances significantly alter the facial growth pattern and when they are stopped, the growth pattern tends to rebound to or beyond the pretreatment values.


Orthodontic force production by closed coil springs. The effects of wire size, lumen size, and wire type on the production of force by closed coil springs were determined. Force production was affected as follows: (1) Keeping the lumen size constant, an increase in wire size produced an increase in force. (2) Keeping the wire size constant, an increase in lumen size produced a decrease in force. (3) For a given wire size, force varied with different wire types. This study has shown that the current recommendations for the use of closed coil springs produce forces of greater magnitude than is necessary for orthodontic tooth movement. The clinician should take care to select the proper closed coil spring for specific clinical situations.


Applicability of autotransplantation in cases of missing upper anterior teeth. No immunologic problems are involved in autotransplantation, as they are in allotransplantation. One is justified in stating that the prognosis for autotransplantation of teeth is favorable, at least in young persons. In this report six cases are presented to demonstrate that autotransplantation can contribute to more satisfactory solutions to the problem of missing anterior teeth than can otherwise be achieved. It is difficult to form general rules regarding the indications for autotransplantation in such cases. Each case must be assessed on its own premises: the substitution need, the availability of a transplant, the long-term prognosis, and the advantages and disadvantages of a solution with autotransplantation versus solutions without autotransplantation. It should be admitted that the applicability of autotransplantation is limited. However, the therapist who realizes that the applicability in young patients is primarily a question of the availability of transplants may find that this is greater than he has previously realized.


The palatally impacted canine: a new approach to treatment. A method for the application of traction to misplaced maxillary canines in the palate is described. The treatment approach is from the palatal side, with initial traction applied in a lingually downward direction to prevent interference with the neighboring teeth. Emphasis is placed on the suitability of the method as an adjunct to almost any of the established techniques. In this way improving their efficiency in treating the over-all orthodontic problem.


The modified sagittal osteotomy of the mandible: two case reports. Two case reports of a modified sagittal split osteotomy of the ramus of the mandible are presented which illustrate a technically simplified modality of treating various dentofacial abnormalities. A brief review of the literature is presented and observations are made on the procedures. The need for future documentation of intraoperative and postoperative results on this type of procedure is recommended.


A study of waste gas scavenging in operating theatres. Measurements of atmospheric nitrous oxide concentrations were made in eight hospitals, using 30 anaesthetic machines and locations, during 41 anaesthetic administrations or simulations. All areas were air conditioned, two by laminar flow devices. All anaesthetic machines and ventilators were fitted with commercially available gas collector (scavenger) valves. In all areas except one, venturi suction was used to exhaust gases. Pollution levels during endotracheal anaesthesia did not exceed the recommended 30 ppm. except where leaking anaesthetic machines or nitrous oxide supplies were used. In two instances where paediatric anaesthesia was administered through uncuffed endotracheal tubes nitrous oxide levels were also excessive. Of nine anaesthetics administered through face masks, only in one was the ambient nitrous oxide concentration acceptable. During induction of anaesthesia using nitrous oxide, unacceptable peaks of concentration were encountered. In two air conditioned recovery rooms tested, nitrous oxide concentration was acceptable. The collector valves performed their function satisfactorily, but laminar flow air conditioning was insufficient in itself to maintain acceptably low nitrous oxide concentration without the use of scavenging.


Splenectomy in chronic myeloid leukemia. We review splenectomy in chronic myeloid leukemia, emphasizing recent studies that have evaluated early splenectomy during the chronic phase of the disease. Despite current interest in splenectomy in chronic myeloid leukemia, uncontrolled clinical trials to date suggest that the operation during the early phase neither delays the onset of blastic transformation nor prolongs survival. Immediate operative mortality of splenectomy during the chronic phase is low, generally less than 1%. The morbidity of the procedure, however, remains formidable due to infectious and thromboembolic complications. Splenectomy during chronic-phase chronic myeloid leukemia permits easier control of the disease in patients who are thrombocytopenic due to busulfan toxicity or sensitivity. Splenectomy during the chronic phase may also palliate those patients who suffer from acute splenic events or massive splenomegaly. Splenectomy in blast-phase disease should be considered a heroic measure providing little benefit to most patients.


Standards for hospital infection control. The American Hospital Association and the Center for Disease Control, together with other national bodies, have made major efforts in the past 20 years in calling attention to problems of nosocomial infection in U.S. hospitals. Current requirements of the Joint Commission on Accreditation of Hospitals reflect their efforts but further reflect a profound lack of acceptable data from which rational priorities in hospital infection control might be deduced. Accreditation requirements should be limited to procedures whose effectiveness in either clearly documented or strongly suggested by available data. Research and educational goals in hospital epidemiology must be identified and met in order to provide a scientific basis for hospital infection control procedures.


Hormonal control of progesterone receptors. Uterine progesterone receptors are under dual hormonal control. Estrogen increases the concentration of receptor through a mechanism that depends on synthesis of both RNA and protein. Progesterone decreases the concentration of its own receptor, probably by enhancing its inactivation rate. This regulation explains receptor variations during the estrous cycle. In both guinea pig and rat uteri, cytosol receptor concentration is maximal at the preovulatory period and decreases after ovulation. Nuclear receptor was measured in the rat. Its concentration is also maximal at proestrus, but the higher nuclear to cytosol receptor ratio was observed at metestrus. There is a good correlation (r = 0.78) between nuclear receptor concentration, on one hand, and the product of cytosol receptor concentration times the plasma progesterone concentration, on the other hand. Autoradiographic studies show that receptor variations during the estrous cycle occur simultaneously in all cell types of uterine horn, cervix, and vagina, which suggests that similar mechanisms control receptor concentration in all of these cells. Progesterone receptor was also measured during pregnancy in rat uterus. Cytosol receptor concentration is low at the beginning of pregnancy (approximately 6000 binding sites per cell), declines slightly on Day 5 (approximately 4000 binding sites per cell), and then increases progressively during the remainder of pregnancy to attain its highest value on Day 22 (26,000 binding sites per cell). Nuclear receptor concentration is very low on Day 3 (1200 binding sites per cell), increases slightly on Day 5 (1900 binding sites per cell), decreases on Day 6, and then increases again to attain a plateau between Days 9 and 15 (approximately 2600 binding sites per cell). Thereafter, its concentration begins to decrease rapidly. On Day 22, the mean concentration is very low (700 binding sites per cell); in some animals (probably on the verge of parturition), no nuclear receptor can be detected.


Androgenic, synandrogenic, and antiandrogenic actions of progestins. In addition to their action on the uterus and vagina, progestins exert diverse metabolic effects on a variety of tissues. These actions include androgenic, synandrogenic, and antiandrogenic effects on androgen-responsive tissues of rats and mice. The androgenic and antiandrogenic effects of progestins have been demonstrated in multiple tissues. These actions appear to be mediated via the androgen receptor. A synandrogenic effect of progestins has also been detected in some tissues. However, there are few data to indicate how this response is mediated. Progestins may also alter androgen action indirectly through changes in steroid synthesis and metabolism. The overall biologic effect of a steroid may thus be determined by the sum of its actions on a variety of tissues.


Glucocorticoid activity of various progesterone analogs: correlation between specific binding in thymus and liver and biologic activity. When tested in an in vitro assay system, progesterone and various analogs of this steroid were shown to compete with [3H] triamcinolone acetonide (TA) for specific glucocorticoid receptors in both rat liver and thymus. Of these analogs, the following derivatives of progesterone were potent competitors of TA binding and, when injected into adrenalectomized rats, induced regression of the thymus and marked increases in hepatic tyrosine aminotransferase activity: 11 beta-hydroxyl, 6 alpha-methyl, 6 alpha, 16 alpha-dimethyl, and 6 alpha-methyl-17 alpha-hydroxyl. In contrast, progesterone, 16 alpha-methyl, and 17 alpha-hydroxy progesterone competed with TA in vitro but failed to elicit either gluco- or antiglucocorticoid activity in vivo. Also, we observed that the oral contraceptive 6 alpha-methyl-17-(1-propynyl)testosterone competes very effectively with TA in a cell-free preparation of rat liver and induces an increase in hepatic tyrosine aminotransferase activity. The 11 beta-hydroxyl group has previously been thought to be essential for glucocorticoid activity. Our studies indicate that substitution of progesterone or testosterone with a 6 alpha-methyl group negates the need for an 11 beta-hydroxyl substitutuent as a prerequisite for glucocorticoid activity.


Cerebral necrosis following radiotherapy of extracranial neoplasms. We have examined 6 patients with delayed cerebral necrosis following irradiation of extracranial neoplasms. Four of the 6 patients received 1,760 rets (or less) tumor dose. The initial symptoms attributable to radiation necrosis appeared 4 to 31 months after irradiation and were those of a focal supratentorial mass. Cerebral angiography delineated an avascular frontal or temporal lesion in all 6 patients; in 1 case a magnification study revealed narrowing, irregularity, and occlusion of small cortical vessels. Four of our 6 patients underwent craniotomy with partial or complete surgical extirpation of necrotic brain tissue. Two operated patients are alive and without disabling neurological symptoms 30 and 25 months, respectively, after the operation. The characteristic neuropathological features of delayed radiation necrosis of brain suggest that vascular injury rather than neuronal or glial damage is of primary pathogenetic significance.


Acute promyelocytic leukemia. Management of the coagulopathy during daunorubicin-prednisone remission induction. Seven adults with acute promyelocytic leukemia (APL) and disseminated intravascular coagulation were treated for remission induction with daunorubicin hydrochloride and prednisone. In all patients the coagulopathy was managed with continuous-infusion heparin sodium and vigorous transfusion with platelets, cryoprecipitate, and fresh frozen plasma. Five patients survived induction; they all achieved complete remission (CR). Median duration of CR was 27 + months; two patients presently survive in their initial CR at 28 and 48 months. Recognition of APL as a distinct type of acute leukemia and prompt initiation of treatment aimed at rapid cytoreduction and control of the coagulopathy has resulted in a prolonged disease-free survival for the majority of patients.


Iatrogenic pancreatitis. A fatal complication in the induction therapy for acute lymphocytic leukemia. A patient with acute lymphocytic leukemia developed acute pancreatitis during induction therapy with corticosteroids and asparaginase. Postmortem examination showed changes consistent with hemorrhagic pancreatitis and fat necrosis over the pancreas and omentum. Corticosteroids were thought to be responsible for pancreatitis in this patient since "hemorrhagic pancreatitis" has not been previously described with asparaginase. We recommend careful follow-up of serum and urinary amylase values in patients receiving induction therapy with these agents.


Endoscopic retrograde cholangiopancreatography. Endoscopic retrograde cholangiopancreatography (ERCP) involves cannulation of the papilla of Vater followed by contrast radiology of the biliary and pancreatic ducts. With experience, X-ray films of the desired duct(s) can be obtained in 90% of patients, with minimal patient discomfort and a low frequency of complications. Retrograde cholangiography accurately assesses the site and cause of biliary tract obstruction. Retrograde pancreatography reveals ductal abnormalities in most patients with chronic pancreatitis and pancreatic cancer, and the nature of the abnormality usually permits differentiation of the two diseases. The diagnostic accuracy of ERCP is enhanced by cytological evaluation of pure pancreatic juice, while endoscopic sphincterotomy is a therapeutic option in selected patients with choledocholithiasis and papillary stenosis. Current developments include endoscopic aspiration biopsy of the pancreas and endoscopy of pancreatic and biliary ducts, using a miniature endoscope passed down a channel in the parent instrument.


A surgical approach to diagnostic ultrasound and its relation to other organ imaging techniques. Ultrasound can be of considerable help to the surgeon in the diagnosis of non-bowel abdominal lesions and of peripheral soft tissue masses. Its relationship to established radiological and nuclear medicine technqiues and computed tomography is discussed. The place of ultrasound in an organ imaging department is outlined.


Twenty years' experience with parathyroid exploration. Eighty-four patients have undergone surgical exploration following a clinical diagnosis of hyperpathyroidism over a 20-year period. Urinary tract calculi were the major indication for exploration, and 90% of these patients had recurrent calculi. Osteitis fibrosa was a rare presentation of hyperparathyroidism. Lethargy, sometimes profound, was an important symptom, in some instances the dominant feature. Persistent hypercalcaemia remains the chief diagnostic investigation, with helpful confirmation from estimation of the parathyroid hormone level. Little attempt was made in this series to utilize preoperative localization techniques, reliance being placed on meticulous bloodless surgery to find normal and abnormal parathyroid tissue. Eighty-five explorations were carried out in the 84 patients. Seventy-four of the explorations were successful, converting the patient to a normocalcaemic state. Of these, 63 had a single adenoma (86%).


Hormone receptors and breast cancer.

Hormone receptors and breast cancer. The hormones of reproduction have been implicated in breast cancers of women. A short reproductive life, and a pregnancy prior to the age of 30 years, both reduce the risk of breast cancer (Doll, 1975). In addition, removal of endogenous sources of oestrogens, and administration of anti-oestrogens, cause some breast cancers to regress (Stoll, 1969). Such observations have led to an investigation of the role of the hormones of reproduction, and of oestrogen in particular, in the maintenance of breast cancers.


Computed tomography of abdominal aortic aneurysms. Computed tomography is an excellent non-invasive method for visualization of the size and extent of abdominal aortic aneurysms. It demonstrates the size of the lumen and the amount of thrombus in the aneurysm, and detects complications such as dissection and leakage.


Malignant melanoma: microstages and individualized therapy. In the prognosis of malignant melanoma the clinical stage and the microstage are the most important factors. According to the microstage, malignant melanomas can be divided into low-risk and high-risk melanomas. The subungual-volar melanoma seems to be an exception. Irrespective of the microstage, the prognosis of this type is probably worse than that of other types of melanoma. In patients with clinical Stage I the therapy should be individualized. In a low-risk melanoma, a wide local excision is sufficient; in a high-risk melanoma an additional regional lymph node dissection appears to be indicated; and if the primary tumour is located on an extremity a hyperthermic perfusion is also called for.


Pancreatic ascites and pleural effusions. Two cases of pancreatic ascites are presented and reviewed, together with 92 cases of internal pancreatic fistula reported in the recent literature. Alcohol abuse is the predominant aetiological factor, and chronic pancreatitis with an associated pseudocyst the most common pathological finding. The diagnosis depends on clinical suspicion and can be confirmed by the estimation of amylase and protein levels in the aspirated fluid. Medical treatment includes the aspiration of fluid accumulations, inhibition of pancreatic secretion, and nutritional augmentation. The use of pancreatography is recommended as a guide to the appropriate surgical procedure in patients who do not respond to medical therapy. Overall results indicate a cure rate of 77% and a mortality of 19%.


Chemoimmunotherapy in disseminated melanoma and colorectal carcinoma. Non-specific immunotherapy with monthly intramuscular injection of Corynebacterium parvum has been investigated by randomized clinical trials in patients with advanced cancer. Thirty-six patients with disseminated melanoma were treated with either imidazole carboxamide (DTIC) alone or DTIC plus C.parvum. A 19% objective response rate was observed. The mean survival time was similar for both groups. Thirty-three patients with disseminated colorectal cancer were treated with either 5-fluorouracil (5FU) alone or 5FU plus C.parvum. No objective responses were observed. The mean survival time was similar for both groups. No advantage has been demonstrated in either tumour group by adding C.parvum to standard chemotherapy.


A New Zealand experience of staghorn calculus surgery. Sixty-one patients with staghorn calculi who have undergone surgery at the Auckland Department of Urology since 1972 have been reviewed. Maoris have been shown to have a higher disease incidence than Europeans. In those cases followed longer than one year true stone recurrences was 14%. A significant number of patients have developed obstruction in the pelviureteric region, and the reasons for this and possible preventive measures are discussed.


Bent and broken femoral prostheses following total hip replacement: a case report. The case of a 56-year-old man with a bent heavy, and a broken standard, Charnley femoral prosthesis, following total hip replacement, is presented. Both of these complications are uncommon, and as far as is known this is the first bent Charnley heavy prosthesis recorded. It is suggested that patients in the younger age group following total hip replacement should not expect to be able to lift excessively heavy weights, or to jump from any height.


Congenital duodenal diaphragm in an adult: an unusual case associated with coeliac disease and recurrent peptic ulceration. A case of congenital duodenal diaphragm in an adult is reported. A correct preoperative diagnosis of this rare condition was made. The duodenal diaphragm was associated with both coeliac disease and recurrent peptic ulceration, resulting in a complicated clinical course.


A procedure for the prevention of recurrent saphenofemoral incompetence. Evidence is presented suggesting that recurrent saphenofemoral incompetence may occur after an efficiently performed high legation of the great saphenous vein flush with the femoral vein. A procedure designed to prevent such recurrence, by suturing a flap of pectineus fascia over the femoral vein and ligated saphenous stump to the femoral sheath and margins of the fossa ovalis, is described.


The use of the ureteric stent.

The use of the ureteric stent. The use and placement of ureteric stents either endoscopically or as part of an open procedure are outlined. The ureteric stent can replace the pyelostomy or nephrostomy tube and significantly reduce the postoperative morbidity.


Knowledge and attitudes of gastroenterologists in colorectal cancer. A group of 73 gastroenterological specialists (36 physicians, 25 surgeons, 12 trainees) completed a detailed questionnaire on their knowledge of and attitudes to colorectal cancer. A surprising unawareness of recent developments in colorectal cancer was apparent. Although responses to individual questions varied throughout the three groups, overall knowledge and attitudes on colorectal cancer were not related to age and years since graduation, and were not different in the three groups. This study suggests failure of traditional methods of continuing medical education, and has practical implications for any screening programme designed to detect early colorectal cancer.


[Meaning of pleocytosis in spinal fluid in children with neoplasias]. Thirty-five spinal fluids with leucocytosis belonging to 26 children presenting neoplasia without metastases or CNS infection, were studied. We found that 69% of the cases were receiving some kind of CNS therapy, although leucocytosis could be found at any moment of the evolution and independently of treatment. It is stressed that the criteria for meningeal infiltration in children with neoplasia must be established only if tumoral cells are found in the spinal fluid. Pleocytosis and absence of symptomatology must not be used as the main criteria.


Leiomyosarcoma of the cheek: a case report. Oral leiomyosarcomata have been reported on only 15 occasions in the world literature. An additional case of leiomyosarcoma of the cheek in an 88-year-old male is reported. The relevant features of leiomyosarcomata are reviewed and discussed.


Intravascular angiomatosis of the pharynx (Masson's vegetant intravascular haemangioendothelioma)--a case report. A case of intravascular angiomatosis arising in the pharynx of a 30-year-old man is reported. Gross and microscopic features with differential diagnosis are discussed. The importance of recognition of the lesion as a benign lesion which can arise in the pharynx is stressed.


Benign fibrous xanthoma of the parotid gland: a case report. A fibrous xanthoma of the parotid gland is reported, the literature is reviewed with a discussion of the classification of such tumours. The present case is possibly the first report of a typical benign fibrous xanthoma of the parotid gland.


Mandibulo-facial aspects of the cervical cystic lymphangioma (cystic hygroma). Sixteen cases of cervical cystic lymphangioma are reported; all but two were present at birth. Intra-oral extensions were detected in five and three of these caused macroglossia resulting in partial respiratory obstruction. Mal-development of the jaws and consequent dental malocclusion is a possible complication of the condition. In planning the treatment of such patients, maxillo-facial surgeons and orthodontists should be consulted at an early stage. The treatment of choice is complete excision, but where vital structures are involved repeated sub-total excisions are advocated.


Peripheral facial nerve paralysis of dental origin. The aetiology, diagnosis and treatment of peripheral facial nerve palsy are discussed. Four cases of facial nerve palsy following dental procedures are reported. Following a revision of the world literature during the last 23 years, the 25 cases of facial nerve palsy documented are analysed and divided into four groups on the basis of aetiology, speed of onset and recovery and modes of treatment suggested.


Acute hemiplegia in childhood following a dental abscess. The syndrome of acute hemiplegia in childhood is described and a case following dental infection reported. The possible mechanisms responsible for the development of this condition are considered.


An unusual case of acquired unilateral condylar hypoplasia. A case is described of acquired unilateral condylar hypoplasia, in which the right condyle seemed to have been fractured at an early age. There is evidence to suggest that the unresorbed condylar remnant persisted in the glenoid fossa and that a new condylar head had developed anterior to the articular emminence. This 'new head' showed a carrot-shaped radiolucent wedge suggestive of the condylar growth cartilage and, clinically, exhibited some growth potential. A complex composite odontome present in place of the mandibular right third molar may also have been caused by this early trauma.


The atrophic mandible: aspects of technique in lower labial sulcoplasty. Severe alveolar atrophy is a common sequel to the extraction of teeth from the mandible. This atrophy, coupled with the associated superficiality of adjacent muscle attachments (Fig. 1a) precludes the provision of a stable, retentive prosthesis. This paper discusses some of the operations which have been designed to alleviate this considerable clinical problem and considers three aspects of the sulcoplasty procedure which in the author's opinion are crucial to its success. The paper also introduces the use of lyophilised porcine skin to dress the surface deficit created during surgery, thus obviating the need for skin grafting.


Iron uptake studies on erythroid cells.

Iron uptake studies on erythroid cells. Iron uptake from 55Fe-labelled transferrin, ferric citrate and the two fungal sideramines, ferricrocin and fusigen was studied using four erythroid cell cultures: Friend virus-transformed erythroleukemic cells (mouse), transformed bone marrow cells, Detroit-98 (human), reticulocytes (bovine), bone marrow cells (rabbit). The present comparative study reveals pronounced differences in iron uptake behaviour. Compared to transferrin, ferric citrate and the sideramines are preferred in transformed erythroid cells. In reticulocytes transferrin and ferric citrate showed a better uptake as compared to the two sideramines. Primary bone marrow cells showed nearly equal iron uptake rates using transferrin or ferricrocin.


Use of iron from transferrin and microbial chelates as substrate for heme synthetase in transformed and primary erythroid cell cultures. The enzymatic heme production in cell-free extracts of virus-transformed Friend erythroleukemia cells and primary bone marrow cells from rabbits has been measured by determining the activity of heme synthetase after addition of iron sulfate, transferrin or microbial iron chelates. In transformed cells the amounts of heme formed did not show significant difeerences independent of which substrate was offered. In cell-free extracts of primary bone marrow cells no increase of heme production could be observed.


Adenosine deaminase, terminal deoxynucleotidyl transferase (TdT), and cell surface markers in childhood acute leukemia. The purpose of this report is to compare measurements of enzymatic activities and cell surface markers as methods of distinguishing subtypes of lymphoid leukemias of childhood. Twenty-six children ages 2-15 yr were studied. Terminal deoxynucleotidyl transferase (TdT) activity was high in blasts from all 20 children with either null or T cell acute lymphoblastic leukemia. The activity of adenosine deaminase per cell was higher (P less than 0.005) and that of TdT lower (p less than 0.05) in T than in null cell lymphoblasts, although there was some overlap in values. Blasts from 3 children with acute lymphoid leukemia were positive for surface-associated immunoglobulins. The neoplastic lymphoid cells from these children differed from T and null cell leukemic lymphoblasts by having very low levels of TdT and adenosine deaminase activity. Measurements of adenosine deaminase and TdT may complement measurements of cell surface markers and distinguish biochemical subtypes of acute lymphoid leukemia.


Controlling the production of blood cells. The development since 1966 of a technology for growing stem cells in vitro has provided new insights into the controls of blood cell production. Hematopoietic hormones have been purified and important cellular interactions in hematopoiesis have been defined.


Eradication of the intramedullary Ph1 positive cell line without accompanying improved survival in chronic myelogenous leukemia. A patient with Ph1+ chronic myelogenous leukemia is presented who upon entering the accelerated phase of her disease developed aneuoploidy, including duplication of the Philadelphia chromosome. Intensive chemotherapy resulted in a marrow remission and reversion of the marrow karyotype to normal. Rather than entering an anticipated prolonged remission she relapsed four weeks later with return of her aneuploid clone. Postmortem examination revealed several unsuspected areas of extramedullary leukemia, perhaps serving as the source for repopulation of the marrow. If a desired goal of therapy is to eradicate the Ph1+ cell line, then we recommend that it be undertaken early in the disease when there is the least likelihood of extramedullary leukemia.


Multiple red cell antigen loss in acute granulocytic leukemia. Loss of certain red blood cell antigens has been described in various disease states including acute granulocytic leukemia (AGL). This paper describes the loss of blood group A antigen in three patients, two with AGL and a third with a myeloproliferative disorder similar to AGL which developed following total body irradiation for malignant, well-differentiated lymphocytic lymphoma. In the latter case, the onset of the myeloproliferative disease correlated with the loss of A antigen. In addition to A antigen loss, all three patients' red cells showed the loss of Lewis antigen, a finding previously unreported. Finally, the two patients with AGL also exhibited the loss of I antigen from their red cells.


Osteosarcoma of the soft tissue of the larynx: report of a case with light and electron microscopic studies. A case of osteosarcoma arising in the soft tissue of the larynx in an elderly man is presented with light and electron microscopic documentation. The patient developed chronic hoarseness and a recurring polypoid laryngeal tumor, causing acute airway obstruction. He was treated by total laryngectomy, but he died with multiple pulmonary metastases within three months of laryngectomy. This is the third (or possibly fourth) recorded case of osteosarcoma arising in the soft tissues of the larynx, and the previous cases were clinically and pathologically similar to this one. The prognosis of sarcoma of the larynx is poor but may be improved with early recognition and adequate surgical excision.


Control of globin gene expression by steroid hormones in differentiating Friend leukemia cells. Low levels of dexamethasone and related glucocorticoid hormones suppress the expression of globin genes during the DMSO-induced differentiation of Friend leukemia cells. In this response, the glucocorticoids appear to act at both the transcriptional and post-transcriptional levels in that 10(-8) M dexamethasone prevents the accumulation of both globin mRNA and globin protein, whereas 10(-9) M dexamethasone allows the accumulation of normal levels of hybridizable globin mRNA but prevents the accumulation of globin protein. This suppressive action of dexamethasone is more effective with DMSO as the inducer of globin gene expression than with hemin as the inducer. In contrast to the situation with glucocorticoids, certain sex steroids (etiocholanolone, testosterone and estradiol) facilitate the expression of globin genes in DMSO-treated Friend leukemia cells. The modulation of globin gene expression by steroid hormones is achieved in DMSO-treated cells without altering the growth and morphological changes which characteristically attend the differentiation of these cells.


Syndromes with cleft lip and cleft palate. A series of tables is presented as a diagnostic aid for the clinician when he confronts a patient who has a cleft lip and/or palate, together with associated anomalies. The tables provide a rapid way of sorting through the recognized syndromes with orofacial clefting in search of a possible overall diagnosis. Today, 154 such syndromes are recognized. This is more than twice as many as were known in 1971. Undoubtedly, many new syndromes with orofacial clefting will be delineated in the future.


Anatomic relationshiphs between the human levator and tensor veli palatini and the eustachian tube. To define the interrelationships of the human levator and tensor veli palatini muscles and the Eustachian tube, fetal heads were serially sectioned and anatomic reconstruction done. Cephalometric points on fetal and adult skulls were compared to evaluate the effect of growth and development on these interrelationships. Based on the results of this study, we propose a mechanism for Eustachian tube function in the normal and in the cleft palate patient. This mechanism offers some explanations for many previously unexplained and paradoxical clinical observations.


The longitudinal fibromuscular component of the soft palate in the fifteen-week human fetus: musculus uvulae and palatine raphe. The structural relationships of the longitudinal fibromuscular component of the soft palate (musculus uvulae and raphe) were studied using histologic sections from 19 early human fetal specimens. Musculus uvulae arises in association with the palatine aponeurosis near the beginning of the second quadrant of the velum, follows a sigmoid course, and terminates near the base of the uvula. In addition, an occasional muscular loop may arise from the bony palate, arch downwards, and then recur into the uvular muscle. A complex relationship exists between the raphe in the velum and several palatal muscles. With regard to musculus uvulae, small muscular bundles arise from the raphe to embrace the muscle near its crest. These branches may aid in contouring the dorsal surface of the velum in the region of the levator eminence to complement the surface of the posterior pharyngeal wall and thus enhance the efficiency of the velopharyngeal seal.


Anatomical characteristics of palatoglossus and the anterior faucial pillar. Palatoglossus and the anterior faucial pillar were studied using three techniques: 1) gross dissection, 2) radiographic filming, and 3) histological sectioning. The total subject sample included 25 normal adult male and female cadavers. Palatoglossus has a flattened belly within the faucial pillar, a fan-shaped termination within the palate, and a vertical tapering termination within the tongue. The region of attachment into the palate differs among individuals which could influence its relative importance in velar versus lingual movement. The pillar contains a large investment of loose connective tissue which also penetrates palatoglossus. The collagenous framework would apparently allow expansion of the pillars but also prevent rupture of the tissue at extreme extension. The anterior portion of the pillar contains a sheath of elastic fibers with a density gradient increasing from the tongue to the soft palate. The elastic fibers, which also intermingle with palatoglossus fascicles, could provide a restorative force in lowering the palate, helping to keep the nasopharyngeal airway patent.


Parents and teachers: differing views of behavior of cleft palate children. This study compared mothers', fathers' and teachers' perceptions of behavior of 136 cleft lip and palate children between the ages of 7 and 12. The comparisons were made on the behavioral dimensions of inhibition and acting out. The results indicate that teachers view cleft males and females as significantly more inhibited in the classroom than parents observe at home. The parents are in agreement and differ from the teachers in that they do not view their cleft children as excessively inhibited. Differential expectations at home and school may contribute to the different perceptions of behavior in those environments.


An unusual case of median cleft lip with orbital hypotelorism--a missing link in the classification. De Myer (1963) classified median-facial anomalies into two groups: 1. Median cleft lip with orbital hypotelorism 2. Median cleft lip with orbital hypertelorism. The first group is characterised by median-cleft lip, absence of premaxilla, nasal skeleton, and crista galli. In addition, there is a holoprosencephaly which may involve the whole forebrain or a smaller part of the brain. In this group, the children die within the first year or during childhood and always suffer from mental retardation. In this report, we present a 12-year-old child with an unusual form of median cleft lip with hypotelorism without brain deformity.


Craniofacial and dental study of mulibrey nanism. Dental and craniofacial features of 17 children and young adults suffering from the recently discovered mulibrey nanism syndrome are described and discussed. The present data do not allow any definite craniofacial typification of the syndrome. However, several findings suggest that we may be dealing with persistence of infantile structural relationships in the craniofacial area.


Vitamin A induction of cleft palate.

Vitamin A induction of cleft palate. Both retinoic acid and retinyl acetate, administered in high doses on days 13--15 of gestation, are capable of causing a 90 per cent incidence of cleft palate in Charles River rats. However, an attempt to develop as in vivo rabbit model system for the induction of clefts via hypervitaminosis A was unsuccessful. In the rat, the retinoic acid form of vitamin A is the more potent teratogen, inducing clefts at less than half the dose required to produce them with retinyl acetate. Histologic examination of fetal rat heads confirmed the biochemical evidence that retinoic acid is the more potent teratogen. Both forms of vitamin A prevented palatal shelf reorientation from occurring at the correct gestational age. The retinyl acetate treatment delayed the rotation for approximately 12 hours, the retinoic acid for at least 48 hours.


Bilateral femoral dysgenesis syndrome: a case report. This paper reports a child with the Bilateral femoral dysgenesis--unusual facies syndrome (BFD-UF). The child has, in addition to previously reported findings, a ventricular septal defect with valvar and infundibular pulmonic stenosis, absence of the labia majora, bilateral syndactyly of the second and third toes, bifid great right toe and a pilonidal sinus. The similarity to cases of Caudal Regression Syndrome (phocomelic diabetic embryopathy) is noted.


Incomplete EEC syndrome in a patient with mosaic monosomy 21. Chromosome anomalies in cases of ectrodactyly, ectodermal dysplasia and cleft of the lip and palate (EEC syndrome) have now been reported. We now report a child with the above syndrome and mosaic monosomy of chromosome 21.


Early maxillary orthopedics in CLP cases: guidelines for surgery. Two samples of complete cleft cases between five and seven years of age are compared (11 UCLP + 9 BCLP versus 21 UCLP + 12 BCLP). The same early orthopedic procedures were applied to all cases, but surgical management differed for the two groups: "classical" surgery (lip 3 months, palate 2--2 1/2 years) versus delayed conservative surgery (lip 6 months, soft palate 18 months, hard palate 6--8 years). It is evident that early maxillary orthopedic treatment is of little consequence for long-term development unless concomitant surgery complies with growth and functional requirements. In contrast to "classical" surgery, palatal closure in two steps is more favourable to skeletal growth and does not interfere to any relevant degree with speech development.


Dental health status and treatment needs of students at a disadvantaged secondary school, Victoria, Australia--1975. The dental health status and treatment needs of 302 secondary school students (182 boys, 120 girls: age range 11-16 years) were surveyed. Restorative, exodontic, periodontic, prosthetic, and orthodontic treatment needs were assessed at the time of examination. The dental health status was poor and the amount of treatment needed was high. Treatment needs increased with age and were dominated by resorative work. The average student required 19.8 relative value units of work, taking 2 3/4 hours and costing A$ 93.00.


Influence of social norms on toothbrushing behavior of preschool children. Two hundred and eighty mothers of preschool children were interviewed in order to determine first, their children's toothbrushing habits and secondly, their expectations concerning the brushing behavior of preschool children in general. The influence of social and demographic factors on children's brushing behavior was also investigated. The results showed that the practice of toothbrushing is widespread and mothers play the central role in teaching the brushing routine. However, the social norms concerning oral hygiene were imprecise, indicating that mothers had no social support for teaching their children to brush and no information on how brushing should be carried out. Dental health educators should encourage mothers of young children to develop positive attitudes towards toothbrushing and teach them the correct technique.


Effect of socioeconomic factors on the observed caries reduction after fluoride tablet and fluoride toothpaste consumption. The caries experience of 123 fluoride users (F-tablets and/or F-toothpaste) was compared with that of a group of 226 non-users. Fluoride users appeared to have a 15% lower DFS score (16.2) than non-users (19.0). After a matching procedure had been used to correct for some intervening variables (socioeconomic status, toothbrushing habit, sweet consumption) no difference was found between the groups of F-tablet and F-toothpaste users and the respective groups of matched non-users. The difference in caries experience of 15% between users and non-users remained in only one group after the matching procedure, that in which the children used both F-tablets and F-toothpaste.


Periodontal treatment need in a Finnish industrial population. A periodontal study was conducted in a paper mill in Finland. To adapt the Periodontal Treatment Need System (PTNS) to a Finnish adult population the estimates of Finnish periodontologists were used. The mean estimate of periodontal treatment need was 97 +/- 58 (s.d.) min per person and 32 +/- 18 min per jaw segment. Periodontal treatment need increased with age. No significant differences in periodontal treatment need by sex, education, type of employment, regularity of working hours or frequency of dental visits were observed. Adjusted family income and toothbrushing frequency did not produce significant differences in periodontal treatment need, except in the group having four dentulous jaw segments. The groups using sugar, other sweetening agents or neither of these, mainly in coffee or tea, differed significantly: the non-users of sugar had lowest treatment time and those who used other sweetening agents than sugar had highest treatment time.


A comparison of WHO periodontal status index with the periodontal and oral hygiene indices. Examination of 2,138 subjects, aged 15-65+ years, was carried out by calibrated examiners using mirrors and fibre optic illumination. Each subject was scored by the Periodontal Status Index, PSI (WHO Oral Health Surveys), Periodontal Index, PI (Russell) and the Oral Hygiene Index, OHI (Greene & Vermillion). For the PSI, PI and OHI all scores were age-dependent with the exception of soft deposits in PSI and OHI, which were age-independent. The advantages of the PSI system were considered to be the ease of scoring and the opportunity to assess treatment requirements, in terms of time, at the public health service level. Disadvantages were lack of quantitation, difficulties of diagnosis of intense gingivitis, and localized and general conditions. The PI and OHI systems provided a more objective, quantitative and sensitive basis of scoring than the PSI. Statistical tests showed the respective indices are associated and measuring the same kind of criteria. Examiner calibration and consistency were similar for both scoring systems.


Examiner variability in the assessment of dental restorations. A series of examiner variability studies were carried out in the assessment of restorations in adults made by extended duty ancillaries (E.D.A.s). While there were some differences between the two supervising team dentists these were smaller than those found when dentists who did not work in the project were examined. The use of indirect evaluation by examining bitewing radiographs for the presence of overhangs was no improvement over the clinical examination in terms of examiner agreement, and moreover only identified half of the restorations scheduled for replacement clinically. Using the results of these experiments, it is suggested that quality control should take into account examiner variability and consequently a 3-4% sample would be sufficient to maintain standards.


A longitudinal study of oral health in immigrant children in Sweden. Children immigrating into Sweden from Finland and Southern Europe (Greece, Yugoslavia and Turkey) were subjected to a longitudinal study on caries activity and gingival condition. For each immigrant child a Swedish "twin" of the same sex and age was used as a control. Out of 124 pairs originally examined, 75 were reexamined after a 2 1/2-year stay in Sweden. The study showed that on arrival in Sweden the Finnish children had more caries and a higher Gingival Index (GI) than the controls and that they acquired more carious lesions during their stay in this country. Their GI, however, did not develop less favorably than that of the Swedish controls. The South-European children did not seem to have more carious lesions than the Swedish controls on arriving, nor did they seem to acquire more carious lesions during the period of observation. Their GI was higher at the first examination but the change in this index ran parallel with that of the controls. It was concluded that the children immigrating from Finland should be considered a risk group with regard to oral health.


The cerebral function monitor during open-heart surgery. Open-heart surgery has entered the third decade of its existence. The period has demonstrated increased patient safety during and after open-heart surgery due to the employment of simple and reliable monitoring techniques. The monitoring of the function of the brain has not kept pace with these advances. Electroencephalographic (EEG) method is impractical for routine use in the operating room and in the intensive care unit. The cerebral function monitor (CFM) offers simplified continuous monitoring and interpretation of cerebral electrical activity (integrated EEG) in the clinical situation. The unit displays a two channel tracing, one representing cerebral activity and a second indicating electrode impedance artefacts. The early changes seen in addition to other conventional monitoring of the electrocardiogram, blood pressures, pulse rate, etc. offers information especially pertinent to open-heart surgery. It would appear that there is a place in anesthetic practice during and after cardiopulmonary bypass for the routine use of the CFM to supplement existing monitoring for the safer conduct of open-heart surgery. This study analyzes the value of a cerebral function monitor in 112 patients undergoing open-heart surgery.


Regression pattern of amplitude of electrocardiographic waves during intravenous infusion in intact, buffer nerve denervated and spinal dogs. Electrocardiographic (ECG) amplitude changes during clinically feasible rate of infusion of normal saline (NS), Ringer-Locke (RL) solution and tender coconut water (TCW) upto a dose of 100 ml/kg in paraldehyde (PLD) and chloralose and urethane (C&U) anaesthetised dogs were studied. The infusion caused a net decrease in P and QRS amplitudes but had varied effect on T wave amplitude in intact PLD and C&U anaesthetised dogs. Infusion of RL in vagotomised and/or carotid sinus (CS) denervated dogs and in spinal dogs indicated that these neural pathways had a significant effect on basal amplitude of ECG waves but their influence on infusion induced ECG changes was only marginal; in this the vagi seem to have a greater influence than the other pathways. The T wave changes during infusion were independent of simultaneous P and QRS changes and appeared to depend on the ionic composition of the infusion fluid. TCW infusion was very well tolerated, particularly by the C&U anaesthetised dogs. It would seem that the evaluation of ECG from patients on parenteral fluid be done in the context of the present observation that infusion per se decreases the amplitude of ECG.


Periodontal bone loss in English secondary school children. A longitudinal radiological study. The prevalence and incidence of periodontal bone loss during a 3-year period was investigated in 373 English secondary school children aged initially 11--12 years. Bone loss was diagnosed from standard radiographs obtained at the baseline and third year examinations of a caries prophylactic clinical trial in which the children were participating. The interproximal spaces mesial and distal to the first permanent molar teeth were examined: 18.5% of subjects had evidence of bone loss at these sites at baseline and 44.0% at third year. In 60 subjects who had all second premolars and first and second permanent molars fully erupted and present at both examinations, the prevalence of bone loss was 36.7% at baseline and 68.3% at third year. Those children who had bone loss recorded at both the initial and final examinations had evidence of significantly more bone destruction at the conclusion of the study than those in whom bone loss was recorded only at the final examination (P less than 0.001).


Prevalence of chronic periodontitis in 13-15-year-old children. A radiographic study. The bitewing radiographs of 1,731 English and Danish schoolchildren aged 13--15 years were examined to assess the prevalence of chronic periodontitis. Only one child (0.06%) was found to be affected in comparison with the high prevalence of 51.5% reported by Hull et al. (1975). Minute qualitative changes in the radiographic appearance of the alveolar crest, or changes in the visual representation of the width of the periodontal ligament space are not reliable or valid criteria for assessing chronic periodontitis. Horizontal bone loss observed on radiographs, which can be accurately measured using the cemento-enamel junction as a reference point, is a useful diagnostic criterion for the measurement of chronic periodontitis.


Cellular regulation of the metabolism of androgens in rat oral mucosa: I. Effect of medroxyprogesterone acetate (MPA) on the soluble supernatant (cytosol) activating microsomal delta4-3-ketosteroid-5alpha-reductase and 17beta-hydroxysteroid oxidoreductase enzyme systems. Soluble supernatant (cytosol) of rat oral mucosa was found to contain a factor accelerating the activity of microsomal delta4-3-ketosteroid-5alpha-reductase and 17beta-hydroxysteroid oxidoreductase enzymes metabolizing testosterone. Systemic administration of medroxyprogesterone acetate further increased this cytosolic activity.


Dentin permeability: a comparison of functional versus anatomical tubular radii. Two independent techniques (filtration and surface tension) were developed to measure the functional tubular radii of 11 dentin and 2 glass discs. Anatomic radii were determined using SEM for comparative purposes. The functional radii of the dentin discs ranged from 5 to 40% of the anatomic radii. This differences was due to the fact that SEM visualizes only the surface while the functional techniques measure the radii within dentin tubules. It is concluded that the functional methods are preferred whenever the dynamics of fluid flow through dentin are under consideration.


Non-specific induction of mineralization of incisor pulp in the rat. Mineralized intrapulpal lesions were readily formed in the rat incisor after a single intrapulpal injection of the calcergen potassium permanganate, as well as after saline. Besides that there occurred irregular secondary dentin apposition and hard tissue overbridging at the injection site. The mechanism of topical calcinosis in relation to pulp tissue was discussed.


Purification and some properties of alpha-L-fucosidase isolated from Streptococcus sanguis. alpha-L-Fucosidase acting on naturally occurring substrates was highly purified from the growth culture of Streptococcus sanguis ATCC 10557. The molecular weight of the enzyme was approximately 120,000 and the optimal pH was at 5.5. The purified enzyme showed specificity toward the linkage of alpha-(1 leads to 2) fucosides in oligosaccharides and glycoproteins. The enzyme released L-fucose from glycoprotein in human parotid saliva.


Effect of salivary pellicle formation time on in vitro attachment and demineralization by Streptococcus mutans. Enamel subsurface demineralization induced by Streptococcus mutans was significantly reduced by seven-day saliva pre-treatments conducive to the formation of enamel pellicles. A two-hour saliva pre-treatment was ineffective. Results suggest that the protection provided by long-term pellicles may relate to changes in ionic transport rates rather than cell attachment.


The effect of eugenol on oral mucous membranes. Eugenol, in the 100 percent concentration in commercial use, was applied to a circumscribed area, 3 mm in diameter, of rat labial mucosa for 1 minute. Reaction periods of 15 minutes, 1, 2, 4 and 6 hours were then permitted. Using routine histological procedures for processing the experimental tissues, it was observed that eugenol caused denaturation of cytoplasmic proteins and loss of staining capacity of epithelium, loss of cell boundaries, swelling and cell necrosis. In addition, vesicle formation, edema in the corium, and striated muscle dissolution were observed.


Use of the Munsell system to compute color differences in composite resins. Color changes resulting from immersion of four composite resins in hot distilled water, coffee and tea were measured by a tristimulus colorimeter. Changes are shown as CIE deltaE values and converted to Munsell deltaH, deltaV and deltaC values.


Color stability of restorative resins under accelerated aging. The color stability of seven commercial composite resins, an unfilled resin, and three glazes was studied under conditions of accelerated aging by reflection spectrophotometry and visually with Munsell color tabs. After aging for 900 hours, most of the resins had lower values of luminous reflectance and excitation purity and higher values of dominant wavelength and contrast ratio compared to values at baseline.


Luminescence spectra of dental porcelains. The luminescence spectra were obtained for a series of porcelain teeth and powders currently used in this country. Comparison was made between the spectra of these materials and the spectra of plastic teeth and natural tooth structures. It was found that many of the porcelain teeth and powders have strikingly different luminescence characteristics than those of natural teeth.


Clinical performance and physical properties of twelve amalgam alloys. An assessment of the marginal failure rate of 1,041 restorations of twelve alloys was made at one year. In addition, physical property tests were conducted. A correlation was found between the clinical performance and creep (.79), flow (.62) and 24-hour compressive strength (.60).


The colorimetric analysis of sialic acid in human saliva and bovine salivary mucin. Three colorimetric methods were compared for their suitability for the analysis of sialic acid in human mixed saliva and bovine submaxillary gland mucin. The thiobarbituric acid method was most precise with human saliva, appeared to be subject to the least interference and is therefore the method of choice for these samples. However, it is not possible to use this method for the analysis of bovine mucins. With these samples the resorcinol method was most suitable, being subject to the least interference and relatively precise. The direct Ehrlich method was least precise overall and gave high values with human whole saliva.


A study of high copper amalgams. I. A comparison of amalgamation on high copper alloy tablets. Two types of high copper alloy powder have been amalgamated by plating tablets of compacted powder with Hg. Gamma1 Ag-Hg crystals form on both types of tablet. On one type, zeta Cu-Sn crystals are also formed. An amalgamation mechanism for this latter type of high copper amalgam is discussed.


Effect of temperature of SnF2 solution on tin and fluoride uptake by bovine enamel. The tin and fluoride concentrations in surface layers of intact enamel specimens were analytically determined after treatment with 8% SnF2 solutions at temperatures of 25, 45, 65, and 85 C. Significant increases in fluoride uptake and particularly tin uptake in enamel correlated directly with the temperature of the SnF2 treatment.


A study of high copper amalgams. II. Amalgamation on a Hg-plated high copper alloy containing 30 wt% Cu. The amalgamation reaction of a low silver, high copper alloy powder has been investigated by plating tablets of compacted powder with Hg. Both gamma1 Ag-Hg and micro Cu-Sn crystals form on the tablets. In spite of large differences in composition, these tablets amalgamated similarly to the T tablets studied and reported in Part I.


The effect of metal/fluoride complexes on fluoride uptake and caries-like lesion formation in enamel. Pretreatment of enamel with TiCl3 and ZrOCL2-8H2O solutions prior to APF application was shown to increase fluoride uptake and reduce caries-like lesion formation to a greater extent than APF alone. The increase in fluoride uptake by enamel was not solely due to the low pH of the pretreatment solutions.


The metal oxide/eugenol cements. I. The chelating power of the eugenol type molecule. The chelating power of the orthomethoxy phenolic (guaiacyl) group is fundamental to the accepted setting reaction of the metal oxide/eugenol cements. In this report, the chelating power is quantitatively described by the sequence of beta2 for the chelates of the relevant metal ions.


Sintered hydroxyapatite ceramic for wear studies. A sintered hydroxyapatite (HAP) ceramic for use in wear studies was prepared from a commercial tricalcium phosphate. The sintered HAP had physical properties close to those of human enamel. The coefficient of friction and wear of the sintered HAP ceramic as characterized by tangential force, track width, and surface failure data, approximated those of human enamel.


The metal oxide/eugenol cements. II. A diffuse reflectance spectrophotometric study of the setting of zinc oxide and magnesium oxide cements. In a continuing study, spectrophotometry has been used to study the diffuse reflectance of the setting of ZnO and MgO cements.


A micropuncture study of the handling of calcium by the rat parotid. The handling of Ca by the rat parotid gland was investigated using micropuncture, microperfusion, and microanalytical techniques. Concentrations of Ca were measured in salivary fluid from intercalated, lobular and main ducts, and net transductal fluxes of Ca and water were calculated during stimulation of secretion with acetylcholine, pilocarpine, and DL-isoproterenol.


Observations on dental caries in primary teeth after frequent fluoride toplications in a program involving other preventives. The anticaries effect of repeated toplications with APF gel was assessed in the primary dentition of 2-6-year-olds after 8, 18 and 28 months. Frequent, but less than daily, topical fluoride therapy appeared to have little effect in pre-school children consuming water-borne fluoride and receiving other traditionally recommended modalities of prevention.


Micropuncture study of postnatal functional maturation of the rat parotid. The postnatal function maturation of the rat parotid was investigated using micropuncture and microanalytical techniques. The cationic composition of the luminal fluid at different levels of the duct system, the net transductal fluxes of Na, K, and H2O and the salivary excretion of protein and amylase in immature and mature rats were determined.


A comparative in vitro study of GK-101 and GK-101E in caries removal. (1) This study indicated that both GK-101 and GK-101E exerted a statistically significant chemical action in the removal of carious material, in addition to any mechanical effects of the delivery system and applicator tip. (2) The superiority of GK-101E over saline in caries removal was noted, regardless of lesion consistency. (3) GK-101 was statistically superior to saline in caries removal in medium-hard lesions; it was not statistically superior to saline in lesions of medium consistency.


Color stability of elastomers for maxillofacial appliances. The color stability of polyvinyl chloride, polyurethane, and silicone polymers for maxillofacial applications was determined after accelerated aging using reflectance spectrophotometry. On the basis of color stability after accelerated aging, and ease of processing, several silicone materials were the most promising.


Parameters that affect the color of direct restorative resins. The effects of thickness, background color, specular reflection, and surface roughness on the color of five commercial restorative resins were studied by reflection spectrophotometry. As thickness increased, values of luminous reflectance and excitation purity increased for a black background but decreased for a white background. Opacity increased dramatically as thickness increased from 1.3 to 3.9 mm.


Optimizing creep and corrosion properties in a dispersant amalgam using manganese. It is shown that the creep behavior of a commercial dispersant-amalgam containing copper is improved by the addition of a manganese-containing alloy. This improvement is apparently obtained without any serious changes in corrosion resistance, provided that no more than 20% of the Mn alloy is added.


Influence of fluoride upon plaque and gingivitis in the beagle dog. Two studies were conducted to explore the effects of twice daily topical applications of NaF, SnF2, and an amine fluoride at equivalent fluoride concentrations (0.1%) upon plaque and gingivitis in the dog. Although some trends toward modest benefits were noted in certain instances, none of the agents exerted a significant effect upon either parameter.


Adsorption of Streptococcus mutans on chemically treated hydroxyapatite. Adsorption of Streptococcus mutans on hydroxyapatite and chemically treated hydroxyapatite was studied. Zeta potentials of the surfaces were measured. Chemically treated hydroxyapatite gave higher zeta potentials and lower S mutans adsorption.


Fluoride uptake and dissolution behavior of a synthetic dental enamel-like substrate. A new ceramic form of hydroxylapatite and enamel were found to behave similarly in regard to their acid dissolution behavior in the presence and absence of topically applied fluoride. Discrepancies between the two materials can be explained by morphological differences between the rough enamel and smooth ceramic particles.


Inhibition and killing of oral bacteria by silver ions generated with low intensity direct current. Silver cations generated by passing low intensity direct current through pure silver electrodes were found to be sufficiently antibacterial to cause sterilization of samples of infected dentin. The optimal procedure involved a 5 microA current applied for 20 minutes with the anode then left in contact with the sample. Minimal inhibitory concentrations of electrically generated silver ions for representative oral bacteria were essentially equal to those for silver ions added as nitrate or fluoride salts, and medium constituents, including sodium thioglycolate, antagonized antibacterial action. A major advantage to the use of the electrode method is that it allows for continuous, focal application of antibacterial silver cations.


The effect of NaF on the bacterial production of polysaccharide and subsequent adsorption on hydroxyapatite. The affinity of some bacterial polysaccharides for hydroxyapatite was investigated. Water insoluble polysaccharide production by bacteria was inhibited by the presence of NaF in the growth medium, while the water soluble fraction was unaffected. The adsorption of the bacterial polysaccharide on hydroxyapatite decreased with decreasing levels of the water insoluble fraction. It is suggested that NaF can inhibit bacterial attachment and caries by interfering with bacterial attachment through reducing the production of water insoluble polysaccharide.


Reflections on the three-year program.

Reflections on the three-year program. Dental education has twice altered curriculum length from four- to three-year programs. The first switch from four to three years came during World War II to meet the need for additional dentists, but schools rapidly returned to four-year programs after the war. During the early 1970s, 14 dental schools converted to three-year programs; however, by 1976 several of these schools had returned to the four-year programs. At the New Jersey Dental School, one of the first schools to adopt a three-year program in 1970, a return to a four-year program in 1977 was the result of poor acceptance of the program by the faculty, a lack of flexibility in the schedule, and an undiminishing negative attitude by the profession toward the graduates. The experience derived from the three-year curriculum has reenforced the need for designing variable length programs, because a significant number of students can successfully complete the traditional program in three years.


Fermentation characteristics of strains of Streptococcus mutans. Realization of the important role of Streptococcus mutans in the initiation of dental caries has resulted in extensive studies of all its biologic characteristics. The ultimate goal is to control or eliminate it from the oral cavity. One means of accomplishing this is to reduce or eliminate its carbohydrate source. This study reports those carbohydrates which Streptococcus mutans cannot metabolize.


Faculty practice: advantages and disadvantages. In considering the advantages and disadvantages of full-time dental faculty members involved in private practice, some suggestions for coping with problems represented by the disadvantages have been cited. Faculty members may find a more satisfactory climate for the patient service aspect of their professional activity in a system where several options are made available from which a teacher may select his preferred office environment and practice style.


The reaction of stannous fluoride and hydroxyapatite. Systematic investigation of the chemical reaction of a slurry of SnF2, Ca10(OH)2(PO4)6, and H2O shows that products other than CaF2 are determined by the relative concentrations of the reactants. In addition to Sn2OHPO4, and Sn3F3PO4, a previously unreported compound, Ca(SnF3)2, has been observed as a product of the reaction.


Longitudinal evaluation of a teacher education course presented to dental faculty. A three-day course on teaching methods was held for dental educators who were at various stages of their careers. The course was presented by the staff of the Academic Instructor and Allied Officer School of the Department of the Air Force. The purpose of the course was to aid in acquiring new knowledge of teaching methods and to produce behavioral changes in the participants' teaching techniques. A longitudinal evaluation demonstrated that participants changed teaching behaviors related to the courses' goals, and acquired and retained a significant amount of factual information presented in the course.


Effect of fluoride topical solutions on enamel demineralization by lactate buffers and Streptococcus mutans in vitro. Applications of APF and NaF solutions to extracted human teeth reduced the extent of enamel subsurface demineralization induced by colonization of S. mutans but were ineffective against demineralization by acid lactate buffers. It is concluded that the CaF2 formed on the tooth surface during the treatment is responsible for the protection observed.


Implications of technology assessment and diffusion for dental research. The possible implications of the assessment and diffusion of technology for dental research are explored in two areas: prevention of dental caries and prevention of periodontal disease. Future concepts and their potential alternatives for the profession, the public, and government agencies are examined in terms of the social, economic, and political aspects of dental health care delivery. Consideration is given to their impact on industry and education.


An international comparison: American and Swedish dental students. It is interesting and often useful to compare and contrast individuals from different countries who decide on careers in dentistry. Such data can help provide a broadened perspective from which inferences about future patterns of specialization and distribution of manpower in America may be made. This study compares the backgrounds and plans for dental practice of dental students in the United States and Sweden. The similarities that American and Swedish dental students share relate to strong parental influence, time of decision to attend dental school, origins in urbanized areas, interest in direct patient care, uncertainty about specialty training, and a lack of prior health-related experience among males in both countries. The differences in the dental students of the two nations are more pervasive and may be explained in part by the ways the two countries have organized and financed dental education and dental care.


Faculty qualifications and teaching responsibilities of community college dental hygiene faculty. The purpose of this survey was to assess the current status of community college dental hygiene faculty qualifications in relationship to assigned teaching responsibilities. Data were collected on 508 full-time and part-time faculty from 92 of the 101 community college dental hygiene programs active in the spring of 1977. The majority of faculty degrees were in nondental hygiene disciplines, particularly at the graduate level. The predominant degree was in education. Teaching assignments were generally independent of degree levels and dental hygienists had major teaching assignments in all biomedical, dental, and clinical science areas. Of the dental hygienists serving as program directors, 71% had degrees at or above the master's level. The hypothesis that newer programs tend to have less qualified faculty was not supported. These findings should be of assistance to academic programs preparing dental hygienists for teaching careers by delineating the nature of current teaching assignments in community college settings.


Contract grading in community dentistry. Dental educators are constantly searching for ways to improve the affective environment within dental education. To enhance dental student independence and motivation while reducing anxiety, the authors implemented a contract grading teaching and evaluation technique within their community dentistry courses. This paper reports on faculty and student experiences with the contract grading system. The findings suggest that style of teaching and evaluation may enhance a more personalized understanding of course material and reduce student anxiety during the learning process.


Summary of workshop on recurrent aphthous stomatitis and Behcet syndrome. The various forms of aphthous stomatitis and Behcet syndrome share common signs that were discussed during a conference workshop. Four markers should be considered in determining the presence of these diseases: hematologic abnormalities, HLA, antibody responses, and immune complexes.


Direct pulp capping treatment: a long-term follow-up. In reviewing 356 instances of pulp capping during the past 25 years, 149 cases were recalled with posttreatment intervals greater than five years. One hundred thirty teeth (87.3%) were still vital and functioning with an average posttreatment interval of 11.7 years. The criteria for pulp capping procedures are in need of revision. Restrictions based on tooth size and age of the patient are unfounded.


Evaluation of student performance in the four-year study of expanded functions for dental hygienists at the University of Iowa. A comparison was made of the quality of selected operative and periodontal procedures completed by expanded-function dental hygiene and senior dental students. Each student group included 48 students selected from all academic quartiles of their respective classes. The evaluated operative procedures included a Class II preparation and amalgam restoration and a Class III preparation and composite restoration. Both operative procedures were completed twice, once on a patient and once on a Dentoform. The periodontal procedures were completed on patients and included a periodontal examination, a periodontal treatment plan, and one quadrant of root planing and soft tissue curettage. Three examiners independently rated each student's performance in an examiner-blind situation. Examiners judged numerous criteria for each procedure as satisfactory or unsatisfactory. In addition, an overall rating of excellent, clinically acceptable, or unacceptable was given to each procedure. Comparisons between student groups of the time required to complete procedures showed that dental students completed cavity preparations of all operative procedures and quadrants of root planing and curettage in significantly less time than did dental hygiene students. For restorations, periodontal examinations, and treatment plans, there was no significant difference between student groups in the time required to complete procedures. In general, the results of the study showed that the dental hygiene students were able to perform selected operative and periodontal procedures at a comparable level to that of senior dental students.


A state-supported incentive program and distribution of dental manpower. To encourage dental health practitioners to practice in areas of low dentist/population ratios, an Educational Loan Program has been set up in North Carolina. Through practicing in areas of designated shortage, graduates can fulfill their loan obligations.


Coordination of the goals of orthodontic, surgical, and prosthetic dentistry: anterior maxillary osteotomy. This paper demonstrates the necessity of a team approach in complicated cases; introduces an inexpensive yet stable appliance for postsurgical intra-arch fixation; and warns of the dangers of rehabilitation before total temporomandibular joint resolution.


Discussion of sensitivity to preservatives in anesthetics. A 23-year-old woman with reported sensitivities to several drugs, including anesthetics, requested dental care. Because of the lack of evidence of allergic reactions to lidocaine, it was used in a dental emergency procedure. The patient had an allergic response. In an evaluation by an allergist, an allergy to methyl paraben was detected. The dental practitioner should be aware of possible allergies to preservative agents when a patient has a history of sensitivity to anesthetics. The practitioner's choice of anesthetics and OTC drugs for this type of patient is crucial.


Peripheral ameloblastoma.

Peripheral ameloblastoma. A peripheral ameloblastoma in a 58-year-old man has been reported. No evidence as to the origin was shown, although the tumor was in apposition with the basal layer.


The missing orthodontic elastic band, a periodontic-orthodontic dilemma. A review of the literature and a case report are presented, documenting and illustrating the effect that gingivally retained orthodontic elastic bands have on the periodontal tissues. Until a harmless radiopaque medium can be safely incorporated into elastic bands, extreme caution in their use should be observed. Not only should all attempts be made to anchor the elastic bands to the clinical crown, but the patient should receive thorough instructions in their placement and removal. The dentist should include frequent examinations as part of his treatment regimen.


Supervised weekly rinsing with a 0.2% neutral NaF solution: results from a demonstration program after two school years. The implementation of a school-based mouth-rinsing program in a Long Island, NY, community was described. In this program, children rinse once a week with a neutral 0.2% sodium fluoride solution under the supervision of homeroom teachers. Although the children reside in a fluoride-deficient community (F less than or equal to 0.1 ppm), the baseline dental caries prevalence of a subsample of the group (11 to 13 years old) was similar to that of comparably aged children who were residents of a fluoridated community and from approximately a third to a half lower than that of other fluoride-deficient communities. Despite the initially low caries activity in the study population, there was a 19.9% difference in mean DMFT prevalence scores between the baseline and two-year examination and a 20.3% difference in DMFS scores after two years of rinsing (average of 49 rinses). The greatest difference, 40.0%, was found between proximal surfaces; differences for occlusal and buccolingual surfaces were 19.6% and 15.6%, respectively.


Treatment rationale of fractured posterior teeth. The four types of fractures most frequently encountered in posterior teeth--obliquely directed complete fractures, vertically directed complete fractures, obliquely directed incomplete fractures, and vertically directed incomplete fractures--have been described. A detailed treatment approach for each type has been presented.


Follow-up evaluation of 105 patients with myofascial pain-dysfunction syndrome. A follow-up study of 118 patients was performed to determine the effect of various conservative treatments for MPD after six months to 12 years. Of the patients, 82% were females; 62 were females younger than 40 years old. During treatment, patients were made aware of muscle spasm, and consciousness of the role of muscles in MPD was raised. Of 105 patients who were contacted, 65 had no further problems, 26 thought the problem was improved and under control, and 14 had not improved or had sought treatment elsewhere. Musculature and psychological factors play major roles in the MPD syndrome.


Loss of tooth structure associated with chronic regurgitation and vomiting. In summary, a teenaged patient had generalized loss of tooth structure. As the patient previously had a normal dental history and as his family history was negative, many causative factors were quickly ruled out. Finally, after obtaining full cooperation of the patient and reviewing the complete medical records, it was concluded that the loss of tooth structure resulted from demineralization by acidic gastric contents, due to chronic regurgitation and vomiting.


Magnetic determination of occlusal vertical dimension. The determination of the edentulous interridge dimension is at best an inexact process. During the past seven years, the use of 1 mm thick minimagnets has been a simple, rapid, and accurate method of verifying or ascertaining interridge dimension.


Preservation of occlusal vertical dimension in overdentures. The preextraction record is used to reestablish the occlusal vertical dimension in immediate and in later overdentures. A colored dot on the denture can be used to verify the occlusal vertical dimension after the dentures have been inserted.


Surgical management of microstomia in the dental office. Scarring of the oral stoma is usually a consequence of burns of the circumoral region. The subsequent contractural decrease in the width and general size of the opening is deforming, interferes with eating, makes dental treatment extremely difficult, prevents access for oral hygiene, and makes general anesthesia hazardous. A case report demonstrates the relative ease and safety of performing a commissurotomy in the dental office with local anesthesia alone so that access is facilitated and the dentition of these patients can be rehabilitated.


Juvenile periodontitis (periodontosis): current concepts. The clinical signs and symptoms of periodontosis have been described. Although initially described as a degenerative, noninflammatory disease, recent evidence suggests that periodontosis is inflammatory, with virulent gram-negative microorganisms, selective immune deficiencies, dysfunction of polymorphonuclear leukocytes, genetic predisposition, or any combination of these as possible etiologic factors. Several authors have, therefore, advocated replacing the term periodontosis, which implies a degenerative disease, with destructive or idiopathic juvenile periodontitis. Although various treatments have been proposed, a definitive therapy for the disease depends on the future elucidation of the specific causative factors.


Some variables affecting dentists' desire to use expanded duty dental auxiliaries. A survey of all active practitioners in Rhode Island was conducted to determine which demographic or practice variables or knowledge or attitude variables, or both, might be associated with a desire to use EDDAs. A total of 355 (74.6%) dentists responded to the questionnaire. Of these, 33.4% indicated a desire to use EDDAs, 36.1% were undecided, and another 30.5% did not wish to use EDDAs. A desire to use EDDAs was associated with the following variables: demographic background, continuing education profile, indicators of how busy the practice is, number of hours auxiliaries were employed, practice efficiency indicators, and knowledge and attitude indicators.


Renal adenocarcinoma of the kidney with metastasis to the tongue. A rare metastatic cancer in the soft tissues of the oral cavity has been discussed. The importance of a good clinical examination and the interrelationship between medicine and dentistry have been emphasized.


Planning the treatment of the complex prosthodontic case. An approach to planning the treatment of a complete maxillary denture opposing an imperfect mandibular dentition has been described. Maxillary supporting tissues under complete dentures that oppose natural dentitions are often overstressed during function. Generally, as the damage to dentition increases, so do the forces causing thrusting and rotation of the denture. Every effort should be made to develop an occlusal table at the optimal level and in harmony with the patient's condylar guidance and a minimal incisal guidance in the attempt to enhance the stability and retention of the denture and the preservation of the dentition and supporting tissues that remain.


Multiple antibiotic allergies.

Multiple antibiotic allergies. A case of an 18-year-old woman with postoperative infectious complications and multiple antibiotic allergies is discussed. The case poses several problems: the selection of an appropriate antibiotic to combat the infection, the persistence of the infection, and the treatment of multiple allergic responses to each of the antibiotic agents chosen.


Design of a practical dental chair made of corrugated cardboard. Directions for the construction of a corrugated cardboard dental chair, useful for mobile clinics and community dentistry programs, are presented. The designers of the cardboard dental chair and I hope that it will be as useful to other members of our profession as it has been to the USC Mobile Dental Clinic.


Antibody-induced loss of Friend virus leukemia cell surface antigens occurs during progression of erythroleukemia in F1 mice. Friend virus (FV)-induced leukemic spleen cells from (B10.A X A)F1 mice were found to lose sensitivity to antibody-mediated lysis during progression of erythroleukemia. This was correlated with a 78% loss of FV-induced cell surface antigens as determined by quantitative absorption of cytotoxic antibodies and with a decreased percentage of leukemic spleen cells showing membrane immunofluorescence with anti-FV antibody. Antigen loss was observed only with virus-induced antigens, and was limited to antigens expressed on the cell surface. FV-induced antigens were regained when low-antigen leukemia cells from late stages of the leukemia were transferred to lethally irradiated nonimmune recipients, but not when these cells were transferred to hyperimmune lethally irradiated recipients. Conversely, when high-antigen leukemic spleen cells from early stages of the erythroleukemia were transferred to hyperimmune irradiated recipients, antigen loss was induced. The immune response to virus-induced antigens appeared to be involved in causing the antigenic changes observed on leukemia cells in this system.


Gilles de la Tourette syndrome: a 20-month study of the effects of stressful life events and haloperidol on symptom frequency. The frequency of tics in a 10-year-old boy suffering from Gilles de la Tourette syndrome was investigated in the laboratory and at home using counts of tics made by the parents. The study spanned 20 months during which time the patient was treated with haloperidol. Parents' counts were reliable and valid. Stressful life events overcame positive medication effects, and symptom level varied markedly with the activities in which the child engaged. Such situational variability may explain the previously reported waxing and waning of symptoms. Findings also suggested that specific counseling be given when haloperidol is prescribed in order to prepare parents and patients for any apparent worsening of the disorder that may actually be due to the presence of stressful life events.


Healing of continuous-wave and rapid superpulsed, carbon dioxide, laser-induced bone defects. With rabbits as the experimental model, a comparative study was done to assess the healing of bone in response to osteotomy by rapid superpulsed and continuous-wave carbon dioxide lasers. The laser was capable of easily incising bone; the rapid superpulsed mode required less energy to do so than did the continuous-wave mode. When the narrow zone of tissue necrosis adjacent to the laser osteotomy was debrided, it was found that healing was similar for each laser mode. Healing occurred in orderly progression from deposition of trabecular bone to formation of lamellar bone.


Arthroscopy of the temporomandibular joint of the rabbit. A technique for arthroscopic examination of the temporomandibular joint (TMJ) of the rabbit is reported. Rabbits were selected because of the accessibility of the joint and its relative morphologic similarity to the human TMJ. The clinical findings and postoperative sequelae of the procedure are discussed. The results indicate that the technique safely and accurately demonstrates the internal anatomy of the TMJ, and suggest its future application in studies in humans.


Mucosal grafting over Proplast-augmented edentulous ridges: a pilot study. Full-thickness mucosal grafts were placed over Proplast-augmented alveolar ridges in six mongrel dogs. Five of the six grafts were successful, indicating that properly prepared recipient sites over Proplast provide adequate blood supply to support free grafts. A thicker keratinizing graft such as palatal mucosa may provide greater protection for the implant under the stress of a prosthesis.


Pigmented lesions of the oral cavity.

Pigmented lesions of the oral cavity. The factors that produce dark pigmentation of the oral soft tissues are described. Examples are given of aberrations of the melanin-forming cells in the oral cavity and a new case of oral blue nevus is added to the literature. A unique case of localized melanosis of the tongue is described clinically and histopathologically.


Juvenile fibromatosis with invasion of the mandible: report of two cases. Two cases of juvenile fibromatosis involving the mandible were found in children aged 1 1/2 and 2 1/2 years. The tumors, while histologically benign, were clinically aggressive, causing bone erosion and destruction and invading adjacent normal soft tissue structures with firm fibrous tumor extensions. In each instance, the lesion was completely removed by radical local surgery with no recurrence after a seven-year follow-up. The pertinent literature, consisting of six previously reported cases, has been reviewed.


Malignant lymphomas of the oral soft tissues. Two cases have been presented in which a malignant lymphocytic tumor was found in the oral soft tissues. The first was a "histiocytic lymphoma" that appeared as a rapidly growing, ulcerative lesion. This tumor was the initial presentation of disease and may be considered a primary lesion. The second was a "poorly differentiated lymphocytic lymphoma" which formed a mass in the mental area. In that case, the tumor was associated with widespread disease. Both of these lesions had previously been diagnosed by physicians as inflammatory processes.


Respiratory epithelium within a mandibular dentigerous cyst. A case report of a dentigerous cyst of the mandible with respiratory epithelium has been described. A review of the literature shows this to be only the fourth case reported. The three most current theories to explain this phenomenon have been presented.


Use of a metallic nasal tube protector during maxillary osteotomy. A technique is described for use of a metallic nasal tube protector to guard against accidental cutting into the endotracheal tube, its pilot tube, or an esophageal stethoscope when performing maxillary osteotomy.


A histological study of cartilage autografts and allografts placed in dental sockets of rats. Seventy-two albino rats were used in order to analyze what occurs when fresh cartilage autografts and allografts are placed into dental extraction sockets. The rats were killed from 1 to 120 days, and the following conclusions were made: autografts were better accepted; there was a tendency to eliminate graft material as healing took place (this was more pronounced in the allograft group); there was appositional growth of the grafts in both graft groups, although this was more pronounced in the autogenous group; the bone trabeculae near the graft in the dental sockets were not formed from the perichondrium; the rate of the alveolar bone healing was retarded, especially in animals that received allografts; with respect to the alveolar socket healing process, there is no advantage in the use of cartilage grafts.


Stability of the mandible after surgical correction of skeletal class III malocclusion in 50 patients. Fifty cases of skeletal Class III malocclusion were analyzed by the tracings of presurgical and postsurgical cephalograms to evaluate the stability of the mandible a year after surgery. In 33 patients, the curved oblique osteotomy in the ascending ramus was used; the correction was made in the mandibular body for 17 patients by either the rectangular osteotomy or the sliding osteotomy. Minimal relapse was observed in all three procedures, with the least amount occurring after mandibular body ostectomy or osteotomy. The results were considered to be due to careful determination of the correct time for surgery in each patient to avoid skeletal relapse resulting in continued mandibular growth, prompt osseous healing at the surgical sites by providing close and tight bony contact between the segments, elimination of the effect of the major muscles of mastication, minimum alteration in the position of the posterior segment and trimming of the margin of the anterior segment to form a proper gonial angle, and a stable occlusion with maximum intercuspation and an adequate overbite. In addition, preoperative orthodontic treatment and extraoral traction of the mandible by chin cups were considered effective means to stabilize the post-operative occlusion.


Use of the mandibular staple bone plate in the deformed mandible. Seven cases have been presented to demonstrate the reconstructive potential and the longevity of the mandibular staple in a variety of unusual cases. The use of the staple provides a surgical method to rehabilitate various types of mandibular deformities. Functional success without major complications has occurred in 90% of cases recently reported.


Rhinolith: unusual appearance on panoramic radiograph. This case report describes an unusual radiopaque lesion that was an incidental finding on a routine panoramic radiograph. The location of the rhinolith gave it the appearance of being within the maxillary sinus. The position of any lesion seen on a panoramic radiograph should be confirmed by other radiologic studies.


Arteriovenous fistula of the upper lip: report of case. A case of arteriovenous malformation is presented. Complete excision is important to avoid recurrence and formation of a new fistula. The pathophysiology and treatment of the lesion are discussed.


Speciation studies with Eimeria acervulina and Eimeria mivati. Eimeria mivati was described as a new species of chicken coccidia in 1964 by Edgar and Seibold, but recently some British workers have relegated its status to that of a variety of Eimeria acervulina. Using strains supplied by Dr. Edgar, we have prepared lines of E. acervulina resistant to methyl benzoquate, sulfaquinoxaline and robenidine and a line of E. mivati resistant to methyl benzoquate. Genetic transfer of resistance between the various lines of E. acervulina to produce doubly-resistant coccidia has been demonstrated, but no such transfer could be obtained between E. mivati resistant to methyl benzoquate and the resistant lines of E. acervulina. Although some immunological relationship between E. acervulina and E. mivati has been demonstrated, we conclude that this failure of the 2 organisms to interbreed lends support to the status of E. mivati as a distinct species.