A survey of airborne pollen and spores in Auckland: its use in the diagnosis of seasonal allergies. A survey of airborne pollen and spores is being undertaken in Auckland. The results for the 15-month period from November 1976 to February 1978 are presented. Even at the height of the flowering seasons meteorological factors greatly influence the concentration of pollen and spores in the atmosphere. Consideration of these factors is therefore essential when assessing the allergic patients' symptoms and treatment. A flowering calendar for Auckland of common anemophilous plants (many of which produce allergenic pollen) is presented.


Smoking during pregnancy.

Smoking during pregnancy. The paper examines smoking amongst a sample of 1248 women giving birth to live-born infants. The findings show: 1. That about 26 percent of women smoked throughout pregnancy and a further 8.0 percent smoked at some time during pregnancy. 2. Smoking during pregnancy was realted to the mother's social background: younger mothers, non-European mothers, mothers with no formal educational qualifications, mothers of low socioeconomic background and mothers of ex-nuptial infants tended to smoke more during pregnancy. 3. Smoking was associated with a decrease in birth weight, a greater risk of low birth weight (less than 2500g) infants and a greater risk of spontaneous abortion. There was no statistically significant relationship between smoking during pregnancy and: the risk of complicated labour, time to the onset of neonatal respiration, the use of active resuscitation or the risk of neonatal infection.


Fluctuating ovarian function in a perimenopausal women. Plasma follicle stimulating hormone (FSH) and luteinising hormone (LH) concentrations, and pregnanediol and oestrogen excretion rates, were measured in a perimenopausal woman from the first appearance of oligomenorrhoea until the onset of severe and persistent hot flushes two years later. Postmenopausal episodes characterised by hot flashes, amenorrhoea, high FSH levels (greater than or equal to 5IU/L) and low urinary oestrogens (less than or equal to 50 nmol/24hr), were followed by menstrual cycles in which the FSH levels were low (less than 5 IU/L) and there was an ovulatory pattern of oestrogen and pregnanediol excretion. An unusual association of high urinary oestrogens (greater than or equal to 50 nmol/24hr) with high gonadotrophin levels was observed on several occasions. The transient postmenopausal episodes were biochemically and symptomatically indistinguishable from the permanent amenorrhoea of postmenopausal women.


Vasculitis in a patient receiving naproxen. A case is described of a 44-years-old woman who developed cutaneous vasculitis, nephritis and paralytic ileus after three years' treatment with naproxen. All these features were thought to be attributable to a naproxen induced vasculitis and all resolved spontaneously after the drug was stopped.


The pseudo-boutonniere deformity.

The pseudo-boutonniere deformity. The pseudo-boutonniere deformity is a boutonneire-like deformity resulting from a hyperextension injury to the proximal interphalangeal joint causing tearing of the volar soft tissues. It is seen almost exclusively in the little and ring fingers. The features, pathomechanics and prophylaxis of the condition are described. The treatment is by dynamic splintage and the importance of distinguishing the deformity from the true boutonniere deformity is emphasised.


Peripheral early stage lung cancer: superiority of six-monthly over random chest films. An analysis of 100 biopsy-proven lung cancers found by chance chest films and treated by resection have been collected over a 20 year period. Data relating to sex of patients, smoking habits, age groups, lung and lobar sites, cell type, treatment and survival are stated and discussed in relation to the findings of a known planned study for detecting early stage lung cancer by chest films. It is concluded that, if a person at lung cancer risk is genuinely interested in having regular checks to catch early, operable disease, then his chances are best with six-monthly chest films.


Frontal lobe abscess of dental origin. Report of a case. A 52-year-old white man came to our hospital with obscure signs of disease. Multiple laboratory tests, radiographs, and examinations ruled out aseptic meningitis, bacterial endocarditis, cerebral artery aneurysm, and other possibilities. A brain abscess was finally diagnosed. The teeth and their surrounding tissues were implicated as the etiologic factors. The importance of odontogenic sources as potential foci of infection is emphasized. This sequel to odontogenic infection is quite rare, but it can be prevented by removal of chronically carious teeth and periapical pathosis.


Cherubism: a study of twenty cases from one family. A study involving twenty cherubs, members of one family, is presented. The autosomal dominance pattern of inheritance is confirmed, while the penetrance is shown to be 80 percent. Clinical presentation and characteristics are discussed, together with histologic findings which reveal the giant-cell nature of the lesions. Conservative management is advocated, with emphasis placed on avoidance of radiotherapy.


Fibrous dysplasia of the jaws. Report of five cases. A brief review of the literature concerning fibrous dysplasia and fibro-osseous lesions of the jaws is presented. Five cases of fibrous dysplasia are described. The manner of presentation, diagnosis, histologic appearance, and treatment of this disease entity are discussed in light of previously published data. Histologically, two cases showed the "classic" features of woven bone in the fibrous stroma. The remaining three cases showed variable amounts of lamellar bone. The presence of lamellar bone is not considered incompatible with a diagnosis of fibrous dysplasia of the jaw, especially in older patients and in those in whom the lesion is of longer duration.


Delayed extraoral hypersensitivity to dental composite material. Despite their similarities to acrylic resins, composite resins have not been reported to cause allergies. This report documents the case of a patient who experienced several delayed hypersensitivity reactions associated with epoxy-based materials, including dental composite resin. Patch testing confirmed her hypersensitivity to the composite materials. Removal of the composite restorations and replacement with acrylic restorations did not trigger further allergic reactions. Dentists using composite resin materials should be aware of both the possibility of delayed extraoral manifestations of hypersensitivity to those materials and the management of these patients.


Oral leiomyomas.

Oral leiomyomas. Oral leiomyomas are considered to be rare neoplasms, but they may be encountered more frequently than generally believed. Three types of leiomyomas are commonly described: solid leiomyomas, angiomyomas, and epithelioid leiomyomas. Three cases of solid leiomyoma are presented, all of which occurred in the anterior mandibular mucobuccal fold. Leiomyomas can be easily confused with other spindle-cell tumors. The necessity of using special stains, especially Mallory's phosphotungstic acid hematoxylin, is discussed.


Squamous odontogenic tumorlike proliferations in odontogenic cysts. Five cases of squamous odontogenic tumorlike proliferations occurring in the walls of odontogenic cysts are presented. These lesions showed no more aggressive potential than the cysts, if taken alone, in which they occurred. The lesions showed no tendency to develop into solid tumors and, on the basis of this limited series of cases, conservative surgery appears to be the treatment of choice.


Arteriovenous shunts demonstrated in the apical circulation of rat incisor teeth by the use of radio-labeled microspheres. The distribution of systemically introduced 85Sr-labeled tracer microspheres to unexposed and previously exposed rat lower incisor tooth pulps was investigated. Fewer tracer microspheres entered the microcirculation of pulps that had been previously exposed as compared to control unexposed pulps. The presence of large numbers of dilated blood vessels in the apical tissues of teeth with exposed pulps was observed, and it is postulated that these vessels may be operating as arteriovenous anastomoses so that the pulpal microcirculation of teeth with inflamed pulps is bypassed by the tracer microspheres. The possible clinical significance of these findings is discussed.


Factors influencing the design of aiming devices for intraoral radiography and their practical application. Intraoral roentgenograms can be made according to the long-tube paralleling technique utilizing aiming devices. These instruments consist of a bite block, an indicator rod, and a collimator plate. For the position of the film in relation to the bite block surface, the following data are decisive and therefore studied: the length of the teeth to be radiographed, the enlargement as a result of the divergence of the x-ray beam, and the periapical area necessary for the interpretation and mounting of the roentgenograms. As a result, the bite blocks of the instruments were provided with three vertical steps to permit different film positions needed for the specific situation in the different regions of the mouth. The use of the correct film positions results in roentgenograms with a high diagnostic value. In order to reduce the patients radiation dose the aiming devices include a collimator plate. A description is given of the data used for the design of the plate.


The appearance of bisporocytic oocysts of Eimeria maxima in drug-treated chicks. A line of Eimeria maxima acquired resistance to Lerbek (a mixture of clopidol and methyl benzoquate) after serial passage against rising drug levels. Abnormal bisporocystic oocysts which appeared throughout this series were picked out individually and these produced infections in further groups of chicks. Serial passages of selected bisporocystic forms raised their proportion in oocyst yields to about 80% after 10-14 passages, but a few normal oocysts were still present.


[Diagnosis and differential diagnosis of osteosarcoma (author's transl)]. A primary malignant bone disease can generally be suspected on the basis of x-ray findings and may be even highly probable if several signs of malignancy are seen on one and the same film. Such changes include bone lesions larger than 6 cm on the first film with blurred outlines, showing patterns of destruction resembling moth-eaten textiles, the covering periosteum revealing spicula or Codman's triangles. Rapidly growing tumours can break cortex components from the continuous layer and shift them outwards. Roentgenological case controls are useless and must be replaced by a sample excision, since x-ray malignancy signs have no absolute value as decisive criteria in view of the fact that they are seen, inter alia, also in osteomyelitis, myositis ossificans and callus formations.


The colony forming cell in the myeloproliferative disorders and aplastic anaemia. Bone marrow colony forming cell (CFC) concentration and the proportion of CFC in DNA synthesis were studied in myeloproliferative disorders and aplastic anaemia. Growth patterns of bone marrow cells in agar cultures were able to supplement traditional morphological and clinical criteria in the diagnosis of these haematological conditions. Bone marrow CFC concentration tended to be increased in chronic myeloid leukaemia (CML) and polycythaemia vera (PV), but decreased in myelofibrosis, erythroleukaemia, paroxysmal nocturnal haemoglobinuria (PNH) and the aplastic phase of aplastic anaemia. The proportion of CFC in DNA synthesis was decreased in CML, myelofibrosis and aplastic anaemia, but increased in blastic transformation, PV, PNH and during regeneration from aplastic anaemia. The proportion of CFC in DNA synthesis in bone marrow from patients with CML in blastic transformation was directly related to the percentage of myeloblasts in the bone marrow. CFC kinetics in blastic transformation have been demonstrated to be different from those in acute leukaemia.


Study of some erythrocytic enzymes in extracorpuscular hemolytic anemias. Investigations on the activity of three erythrocytic enzymes i.e., glucose-6-phosphate dehydrogenase (G-6-PDH), catalase and lactate dehydrogenase (LDH), in 20 patients with extracorpuscular hemolytic anemias of various origins showed a general tendency to decrease of G-6-PDH and catalase, with a concomitant increase in LDH. These results are interpreted as due to metabolic disturbances induced by hemolysis in the erythroblastic series and/or to possible perturbations specific for each type of anemia.


[Viral hepatitis and dental practice].

[Viral hepatitis and dental practice]. A description of the clinical features and epidemiology of viral hepatitis is followed by a literature survey of the problems concerning the relevance of viral hepatitis to dental practice. Most investigators have found, that in comparison to the general population dentists do have an increased risk of viral hepatitis. The probability of acquiring hepatitis increases linearly with the duration of professional activity, it is highest in dental surgeons. A recent increase of the risks seems to be related to the growing problem of drug abuse and to the increasing carrier rate of hepatitis antigen in certain sections of the population. Isolated epidemics of viral hepatitis in patients of dentists who were hepatitis antigen positive have been described. Careful prospective studies suggest however, that overall hepatitis antigen positive dentists or physicians do not present a serious health hazard to their patients. The prophylactic measures useful in dental practice are discussed.


[Arteriovenous angioma in the maxillofacial region]. Congenital arteriovenous angiomas are seldom observed in the maxillofacial region. Because of their hemodynamic-active Shunt volumina, they tend towards progressive and difforming increase in volume. Clinical differentiation from other angiodysplasias is obtained by serial angiography. Therapy in the facial region consists of either a direct and mostly subtotal interruption of the short circuit by embolization of the AV shunts and selective ligature of the hemodynamically important vessels, or in a total removal of the involved region by extensive plastic-reconstructive measures. The latter particularly applies to hemodynamic shunt volumina with general cardiovascular feedback, grave recidivating bleeding, important defiguration and recidives after selective ligature operation.


[Extended fissure sealing--a review for the dental practitioner]. There is scientific proof that destructive processes of the oral cavity can be avoided through a combination of general prophylaxis with individual preventive care. In children with few or no carious lesions in the deciduous dentition a complete eradication of caries of the permanent teeth should definitely be attempted. Pits and fissures of premolars and molars should therefore be individually sealed within six months after tooth eruption. In cases of incipient occlusal caries preventive resin restorations allow the repair with a minimum of tooth removal, i.e. therapeutic preventive dentistry. The use of the somewhat destructive conventional restorative techniques including prophylactic odontotomy, fissure eradication and extension for prevention that are unfortunately favored by the common dental fee policy should be strictly limited to cases where better alternatives are as yet unpracticable.


[Side effects and late results of the combined radio- and chemotherapy of the brain in children with acute lymphoblastic leukemia (author's transl)]. In case of lymphoblastic leukemia, acute general side effects of the therapy phase II which occured, mostly in the form of gastric troubles, in 42,0% of the 50 children, have to be attributed to the skull irradiation as well as to the intrathecal MTX injections. Irritations of the meninges provoked in the course of phase II appeared in the form of a liquor pleocytosis in 44,7% of 38 children and in the form of an augmentation of the liquor proteins in 23,6%. Considering the success of the meningiosis prophylaxis, alopecia must be tolerated. In 66,0% of the 50 cases, the syndrome of somnolescence was found two to nine weeks after phase II; this syndrome is considered to be reversible, and no late damages are known until now. A therapy control is possible by periodical neurologic examinations and electroencephalography: after phase II, a normal EEG is found in 66,7% of 39 cases; a pathological EEG is found in 28,2% of the cases with preliminary EEG and in 5,1% of the cases without preliminary EEG. The psychic development of the children submitted to a central nervous system prophylaxis can only be judged in a reliable manner if comparative tests are executed. The irradiation dose to the skull during phase II is within the generally accepted tolerable values; seven children were dissected, and the neurohistologic examinations produced no evidence of late irradiation damages.


[Vertification of the age dependence of salivary gland function by means of 99 Tc sialadenoscintigraphy]. The authors describe the salivary gland function diagnostics by means of 99mTc-pertechnetate under the conditions of computer scintigraphy. Parameters suited for numerical evaluation were selected. The age-dependence of the parotid gland function was studied in 49 healthy subjects of different age-groups. The present results permit to exclude such a dependence. The values obtained may be used as basic documentation in evaluating pathological conditions of the parotid gland by means of function diagnostics.


[Improvement of stomatological diagnosis by means of the II operating microscope]. The author verified the possibilities of the in vivo use of the Zeiss Operating Microscope II for stomatological diagnosis and therapy control in conservative stomatology. It was found that this microscope provides better information about morphological details and the efficiency of therapeutical measures (fillings) as the hitherto commonly used tools, mirror and probe.


[The use of vasoconstrictor agents in low concentration as additives to local anesthetics in ambulatory maxillofacial interventions]. The authors studied in several test series the suitability of adrenaline and noradrenaline as vasoconstrictor additives to 2% Xylocitin, in a concentration of 1:100,000. At this concentration, noradrenaline proved well suited in tooth extractions. The vasoconstrictor effect of adrenaline is sufficient in all maxillofacial interventions on an outpatient basis.


[Mandibular refractures].

[Mandibular refractures]. The portion of individuals with mandibular refractures in traumatized patients is but small. During a period of more than 10 years, 16 male patients presented once more with a mandibular fracture. In five of these patients, the mandibular fracture was a true refracture. Apart from problems by which experts are confronted in such cases, special attention is given to the epileptic who is at risk of trauma.


[Incisions for apicoectomy with a limited range of indications]. The author deals with certain incision techniques for the purpose of apicectomy that that are but rarely used due to their relatively limited range of indications. Furthermore, he describes and recommends two new incision techniques. The first is a variant of the V-incision at the labial frenum; the second is a Y-incision to be employed when there is a flat oral vestibule or an interfering frenulum of the cheek.


[Somatic radiation load by radiography of the temporomandibular joint]. 660 exposures were performed on an Alderson phantom to determine the somatic radiation exposure values for standard examinations of the temporomandibular joint. Comparative examinations with the classic contact technique according to Parma served to make clear the results obtained. The lowest amount of surface exposure was observed in contact examinations of the temporomandibular joint. The use of a flat tube leads to a 13-fold reduction in surface exposure compared to contact examinations according to Parma. Furthermore, a heavy gradient of radiation exposure from the area of exposure to the environment was stated in using a tube (flat tube and ear tube).


[A case contribution to the Gardner syndrome]. As to its course the Gardner syndrome is similar to a chronic disease and has the following symptoms: 1. Fibro-epithelial tumours of the skin with first symptoms in early childhood. 2. Osteomes, osteofibromas, desmoids mainly located in the cranial region. 3. Disturbances of the dental development in the form of tooth retentions, persistence of milk teeth and supernumerary tooth germs. 4. Intra- and retroperitoneal or intramesenteric fibromatoses which scarcely become clinically manifest. 5. Intestinal polyposis occurring in most cases only in the third decade of life. The tumours of the skin, of the connective tissue and of the bone are always benign, whereas the intestinal polypi show a considerable tendency toward malignant degeneration. For this reason, the prognosis of the Gardner syndrome must be considered unfavourable. On the basis of a case report, the clinical symptoms and findings in the maxillofacial region are outlined.


[The possible development of non-academic professions in stomatology]. The dental care of the population may be considerably inproved by the further development of non-academic careers in stomatology. Past experience has shown that, in the majority of cases, the dental care of the children is jeopardized if the ratio of dentists to population is low, and the need for care is great. Therefore, the employment of specialized nurses with appropriate duties is of particular importance in paedodontics. The possibilities and variants are discussed in the light of international trends.


[Ambulatory dental care of school children in the Soviet Union]. The great prevalence of dental and periodontal diseases in children and adolescents requires systematical registration and care. The authors describe an organizational system practised in the Soviet Union and demonstrate its efficacy. The necessity for the dental care of children at the earliest possible age is emphasized.


[The posture of the dentist].

[The posture of the dentist]. Using the multi-moment recording technique, the authors examined in 23 dentists from territorial health services the frequency of certain postures and attitudes during working time as related to working procedure. It was stated that in case of the conventional standing dentistry the dentists assume a forced attitude in 37.7% of working time. On contrast, the values found for dentists practising almost exclusively sit-down dentistry were considerably more favourable (4.2% of working time). The results are discussed, and relevant conclusions are drawn.


[Hydantoin hyperplasia--the interesting case]. The author describes a case of excessive gingival hyperplasia in a 9-year-old girl under hydantoin medication. The hyperplasia of the gingivae inhibited the regular uptake of food and the eruption of the permanent teeth.


Herpes simplex kerato-uveitis and glaucoma. We present a retrospective study of fifty patients who developed raised intraocular pressure in association with herpes simplex kerato-uveitis. We consider the incidence, clinical features, management and prognosis, and discuss the mechanisms which may be responsible.


Aphakic glaucoma. Prophylaxis and management. Glaucoma secondary to angle closure is a not infrequent complication of cataract extraction. The incidence may be reduced by preventing or accurately treating those conditions causing shallowing of the anterior chamber in the postoperative period. Once established, however, management follows the principles used in managing chronic simple glaucoma.


Role of cardiovascular disease in the pathogenesis of rhegmatogenous retinal detachments. In 100 patients with fresh rhegmatogenous retinal detachments complete ocular and physical examinations including electrocardiograms were carried out. The incidence of coronary artery disease and systemic hypertension in these patients with retinal detachments was much greater than that found in the general population of similar age and sex. A vascular theory is proposed to explain these findings in light of our current concepts of the pathogenesis of retinal detachments. It is also suggested that retinal detachments may be one element of a generalized vasculopathy that involves the coronary arteries, the pulmonary vasculature, and perhaps the renal circulation in patients with systemic hypertension.


Fluorescent infra-red angiography of the fundus oculi using indocyanine green dye. This article describes the infra-red fluorescent angiographic technique to study the choroidal circulation in normal and pathological conditions. The standard Zeiss fundus camera was modified to hold suitable excitation and barrier filters. The dye used was indocyanine green, which has been proved to be free from any untoward reaction and has less tendency to leak from the fenestrated choriocapillaris, unlike fluorescein. Results obtained in pathological conditions like temporal arteritis, choroidal naevus, malignant melanoma, and choroidal angiomas were better shown by this technique than by fluorescein angiography.


Selection of type of operation for rhegmatogenous retinal detachment. Primary success in scleral buckling operations may be enhanced by ophthalmoscopically locating all retinal breaks and accurately localizing the posterior margin of the retinal breaks at the time of operation. A scleral buckle created by either an explant or an implant must be large enough to seal the retinal break completely. In 95 per cent of retinal detachments this may be accomplished by using 7 to 7.5 mm wide buckling material in a 10.5 to 11 mm wide scleral bed which creates a buckle extending from the ora serrata to a point 5 mm posterior to the localized posterior margin of the retinal break. Although in selected cases localized scleral buckles may successfully cure a retinal separation, greater initial success will usually be obtained by a buckle which covers the greater portion of the circumferential extent of the retinal detachment.


Hospitalization for retinal surgery.

Hospitalization for retinal surgery. Recovery from general anaesthetic and ocular discomfort may be the only logical reasons for hospitalization after retinal surgery, and 3 days should be sufficient for this--24 hours in most cases. Some patients, discreetly chosen, could be managed on a day case basis, having surgery under local anaesthetic.


Partial central retinal artery occlusion. The clinical picture of multiple circumpapillary cotton-wool spots and mild ischaemic swelling of the inner retina is attributed to partial occlusion of the central retinal artery. The pathophysiological basis of the fundus signs is discussed and the role of interrupted axoplasmic transport in the development of the cotton-wool spots is emphasized.


Presumed inflammatory maculopathies.

Presumed inflammatory maculopathies. The macular disorders are classified according to the originally affected layer and the probable cause of the disease: presumed inflammatory or traumatic, iatrogenic, toxic, metabolic or trophic, and hereditary. Three young female patients are reported who had presumed inflammatory diseases: CBPE-complex (APMPPE), pigment epithelium (pigment epitheliitis), and neuroretina (acute macular neuroretinopathy). APMPPE is considered to be a choriocapillaritis closely related to a soft photocoagulate. They recommend careful follow-up of acute neuroretinopathy because through "disuse" a disease of one layer may progress to other layers as they are metabolically interdependent.


Long-term follow-up of patients after retinal detachment surgery. The value of long-term follow-up of patients after retinal detachment surgery depends on the number of further detachments prevented. This in turn depends on the frequency with which predisposing lesions are found and treated and also the risk of leaving them untreated. In a retrospective study of 128 patients who had attended the Retina Clinic at Moorfields, High Holborn, for at least 10 years, the frequency with which asymptomatic retinal breaks were detected was less than two per hundred patients per year of follow-up. The risk of such lesions progressing to detachment if left untreated is estimated to be no more than 12 per cent and on this basis it is likely that no more than four or five detachments were prevented in our series. During the same period 66 new or re-detachments occurred, in spite of regular examination and treatment of predisposing lesions found, and it is concluded that long-term follow-up is of doubtful value in the prevention of further detachments.


Intrascleral thermocautery.

Intrascleral thermocautery. Because of failure of trabeculectomy to normalize intraocular pressure in a significant number of patients, intrascleral thermocautery has been preferred since 1972. Over 200 eyes have been operated on and the results so far are satisfactory regarding the control of intraocular pressure and the absence of complications.


Congenital anophthalmos. Problems in management. The management of congenital anophthalmos is difficult under the best of circumstances. Therapy is directed towards enlargement of the sorbet by expansion and/or surgical techniques. Early expansion therapy within the first year of life appears to be warranted in view of the differential orbital growth rates.


Ultrasonic examination of the traumatized eye. Ultrasonic examination may be used to assess ocular damage if the media are opaque after blunt or penetrating injury. In eyes with retained foreign material, ultrasound may also be used to aid localization of the foreign body.


Vitreous morphology after perforating injury treated by primary vitrectomy. Perforating eye injuries result in patterns of damage which vary greatly in extent and severity. In undertaking reconstruction of the injured eye the ophthalmologist requires instruments and materials designed for handling each type of traumatized tissue. Problems associated with injury to the vitreous are logically dealt with by purpose-built vitrectomy instruments with the object of attaining a satisfactory and safe vitreous configuration in a visually useful eye.


Intraocular foreign bodies. Indications for lensectomy and vitrectomy. This review of the outcome of the conventional management of magnetic foreign bodies shows that, with the exception of the severe open-eye injuries associated with large foriegn bodies, where immediate lensectomy and vitrectomy is required, conventional magnetic extraction should be performed as close to the foreign body as is feasible. It is important to assess posterior segment damage both before and after extraction of the foreign body, as the subsequent management will depend on the presence of vitreous haemorrhage and retinal damage.


Repair of corneal wounds and the elimination of astigmatism. The modern management of corneal incisions and lacerations, in addition to their accurate repair, necessarily includes the prevention or subsequent correction of induced astigmatism and axial errors. This is yet another important aspect of the new and burgeoning field of refractive corneal microsurgery.


Closed vitrectomy after trauma.

Closed vitrectomy after trauma. The results of vitrectomy in fifty traumatized eyes were assessed, and six types of pathological change resulting from trauma identified. The anatomical and visual results were good except where surface vitreo-retinal traction was present either at the vitreous base or posteriorly.


Ocular effects of hyperbaric oxygen.

Ocular effects of hyperbaric oxygen. A series of 26 patients undergoing hyperbaric oxygen therapy for more than a month was examined. Eighteen of them showed a definite change in their refraction towards myopia. The amount of myopia varied from 0.5 to 5.5 dioptres. No other ocular effects were observed. It is considered that the change in refraction is due to increased refractive index of the lens.


Investigation and treatment of epiphora due to lid laxity. Many patients with lid laxity, in spite of reasonable punctal and lid-globe apposition, may have tearing because of a "lacrimal pump" dysfunction. Dacryocystography and nuclear lacrimal scanning aid when the diagnosis is not obvious clinically. The punctal stenosis, which is almost always secondary to punctal eversion, is treated by dilatation and a punctal inversion procedure. The lax lids are treated with a modified Bick procedure, and in cases of co-existent medial lid laxity, a medial canthoplasty is performed.


Total transplantation of the superior rectus muscle for ptosis. A new surgical approach. In cases of ptosis 45 per cent are severe in degree with poor levator function, 25 per cent are bilateral, and 60 per cent have good superior rectus function. Ptosis with the jaw-winking phenomenon accounts for 6 per cent of cases of congenital ptosis (Berke, 1949), and in these the levator palpebrae is either poorly functioning or has to be sacrificed. Total transplantation of the superior rectus muscle into the eye lid has been specifically designed for cases of severe ptosis with poor levator function. Embryological, anatomical, and physiological similarities make the superior rectus the most natural substitute for a defunct levator muscle. In the last 2 1/2 years, we have operated upon fifteen severely ptotic lids (four bilateral and seven unilateral) by transplantation of the superior rectus muscle. The results were satisfactory in thirteen cases, with slight undercorrection in two.


Cryosurgery for trichiasis.

Cryosurgery for trichiasis. A series of 41 cases of trichiasis was treated with cryosurgery using a standard retinal cryoprobe. The failure rate was approximately 50 per cent. The results should be improved by using properly designed equipment capable of cooling the lash follicles to -20 degrees C, and ensuring that this temperature is achieved by using a tissue thermocouple. A double freeze-thaw cycle should be used and a long-acting local anaesthetic containing adrenaline. The main complication is depigmentation which is a problem only with heavily pigmented patients. Cryosurgery does have potential for the treatment of trichiasis.


Variable focus spectacles.

Variable focus spectacles. The history of prostheses for presbyopia is reviewed with an account of the development of variable focus spectacles. They have fluid-filled cells, with one flexible wall on the back of the base lens. The curvature of the flexible wall can be varied by operating a bellows in one side-arm. Their use for presbyopia, aphakia, and glaucoma is considered. The spectacles are believed to have reached a stage where they are ready for commercial production.


Pretrabecular filtration for secondary glaucoma. The available drainage procedures in cases of glaucoma cause many early and late postoperative problems, including non-formation of the anterior chamber, excessive hypotony, changes in the lens, and unsafe filtering blebs. New microsurgical techniques involving the area of trabecular meshwork and Schlemm's canal include trabeculotomy, sinusotomy, and trabeculectomy. In a new drainage procedure devised by us a covered filtering track is created, which opens in front of the trabecular meshwork. This procedure, designated "pretrabecular filtration", has been a standard primary procedure in all types of glaucoma in our hospital for the last 3 years.


Peripheral retinal cryotherapy as a treatment for neovascular glaucoma. This treatment does have a place in the management of the established conditions because, when it is successful, some guiding vision is maintained; this is potentially important, as a central retinal vein thrombosis may affect the second eye. Restoring a normotensive eye has other long-term advantages; it is cosmetically better, and is unlikely to lead to a degenerate cornea, which would otherwise occur, and might lead to late endophalmitis.


[Characteristics of the occurrence and development of tumors in rats depending on age and the nature of the strontium-90 exposure]. In chronic strontium-90 administration into rats aged 8--10 months osteosarcomas did not develop, while in animals at the age of 3--4  months osteosarcomas incidence was 6.7%. In single injection of the radionuclide in 8--10 months old animals osteosarcomas developed in 2.2% of observations, whereas in 3--4 months old animals--in 45.7%. The most early appearance of osteosarcomas (at the 193d--316th day) was noted in 3--4 months old animals subjected to a single exposure to strontium-90.


[Clinical cytological characteristics of osteogenic sarcoma]. The authors report the data on the disease clinical course being dependent on the peculiarities of tumor differentiation. The work is based on the findings of treatment and dynamic follow-up of 156 patients with osteogenic sarcoma of extremity bones. Distant gammatherapy, as the principal method of treatment, was employed in all patients. A cytological test was used to determine the morphological character of the tumor. It was shown that clinico-cytological correlations sometimes help to reveal significant differences in development of the disease. In groups of patients with signs of primary tumor anaplasia male individuals showing acute pains, prompt tumor growth and marked general intoxication phenomena were predominating. In radiotherapy of this group of patients a positive response, which may allow a continuous dynamic observation, is more rarely gained.


[Diagnostic value of alkaline leucocyte phosphatase in hematology (author's transl)]. The diagnostic value of the Alkaline Leucocyte Phosphatase (ALP) was checked on the basis of the patients of a hematologic department. Reliable data can only be obtained for the differential diagnosis of polycythemia vera and secondary polycythemia, not however for the differential diagnosis of chronic myeloid leukemia (CML) and myelofibrosis. In CML the ALP is an aid for evaluating the course of the disease and its remissions. In Hodgkin's disease it is an objective parameter for actiivty of the disease. The leucocyte concentration method can be used for evaluation of the ALP.


Absence of prognostic features in the cytology of effusions due to mammary cancer. Malignant effusions from 150 patients with breast carcinoma were examined to determine whether cytologic features could be related to prognosis. Four features were studied: tumor cellularity and frequency of mitoses in tumor cells as an indication of their proliferative activity, leukocytic (lymphocytic) background as a possible measure of host reaction and tumor cell cluster formation as an indication of the tumor growth pattern. The clinical outlook was poor in all the patients with effusions due to breast cancer, and we found no good relationship between any of these four cytologic features and prognosis.


Carcinoma in situ and invasive squamous cell carcinoma associated with schistosomiasis of the uterine cervix a report of three cases. As part of a mass cytologic screening program, cervical scrapings and endocervical/endometrial aspirations were taken from 1,250 women with systemic schistosomiasis. Ova of S. mansoni were found associated with two cases of carcinoma in situ and one case of invasive squamous cell carcinoma of the uterine cervix. In a fourth case, the ova were associated with a benign cervical lesion.


Occurrence and identification of intracellular calcium crystals in pulmonary specimens. Scanning electron microscopy, x-ray analysis studies and histochemical techniques have identified unusual birefringent intracellular calcium carbonate crystals seen in the sputum specimens of a 68-year-old man with cavitary pulmonary lesions. He was clinically diagnosed and treated for pulmonary tuberculosis. Although other etiologies are possible, we contend that the calcium salt crystals identified in the sputum in this patient represent a peripheral manifestation of tuberculosis which is rarely noticed in the sputum specimens.


Eosinophilic pleural effusions.

Eosinophilic pleural effusions. Forty-three pleural fluids from 30 patients with eosinophilic pleural effusion (EPE) were examined and correlated with biochemical and clinical findings. The percentage of eosinophiles ranged from 12% to 83%, averaged 38% and was accompanied by a high lymphocyte count, averaging 34%. The fluids were shown to be exudates. A history of allergy or immune disorders was elicited from seven patients and allergy to drug from one patient. Eight patients gave a history of thoracic trauma unrelated in time to the effusion. Three patients received transvenous pacemakers. In the remaining 11 patients the presence of the eosinophilic pleural effusion could not be correlated with any clinical data. Regardless of clinical setting, which in six patients included a past history of cancer, EPE proved to be a self-limiting disease with a favorable outcome. Thus, this diagnosis by cytologic examination of the sediment is of considerable prognostic significance even in patients with a history of other disorders that may give rise to effusions. Possibly the most significant observation recorded was the presence of a large population of lymphocytes in EPE. The role of these cells in the mechanism of EPE is discussed.


Diagnostic value of calcium oxalate crystals in respiratory and pleural fluid cytology. A case report. A 56-year-old man presented with massive, left-sided pleural empyema. Sputa, pleural fluids, a bronchial washing and a bronchial biopsy revealed acute inflammatory exudate and numerous birefringent calcium oxalate crystals. One pleural fluid also showed occasional mycelia and rare conidiophores of Aspergillus niger. The fungus was abundantly cultured from all cytology specimens. Other oxalosis-related conditions were not identified in this patient. The finding of calcium oxalate crystals associated with a background of acute inflammatory cells in cellular samples of respiratory secretions and pleural fluid should be regarded as a clue to the diagnosis of infection with Aspergillus niger.


Choriocarcinoma of the esophagus: histologic and cytologic findings. A case report. The present report is that of a 40-year-old woman admitted with hematemesis and epigastric pain. Endoscopy revealed a fungating mass in the lower esophagus. Esophageal brushing revealed clustered and single malignant cells with ample cytoplasm, large bizarre nuclei and prominent, irregular nucleoli; the chromatin was irregular with clumping at the nuclear borders. Giant multinucleated malignant cells were numerous. These cells had nuclear molding and abundant acidophilic cytoplasm. Autopsy findings included a large tumor in the lower esophagus and metastases to lung, liver and kidneys. Microscopically, the fungating esophageal tumor and metastases were composed of cyto- and syncytiotrophoblastic elements. Choriocarcinoma of the esophagus is a rarity, and only two cases were found in the literature. The diagnosis, however, can be achieved by brush biopsy since the characteristic cyto- and syncytiotrophoblastic cells can be readily identified, provided that the possibility of this ectopic occurrence is recognized.


The relation of prognosis to the nuclear diameter of breast cancer cells obtained by cytologic aspiration. Nuclear diameters of breast cancer cells obtained by aspiration cytology from 245 patients were measured by ocular micrometry. The nuclei of 50 benign lesions were also measured. Cancers with 80% or more of their nuclei larger than 12 mu were classified as "large nuclear type" (LN). Those with nuclei of 12 mu or less were considered "small nuclear type" (SN). One hundred forty-nine cases of the former and 96 of the latter were evaluated. There was significant overlap in nuclear diameter of benign lesions and SN cancers but minimal overlap between SN and LN cancers. Thirty-eight percent of SN cancers were staged as T1 as compared to only 20% of LN tumors. Survival, free of disease, at five years was 90% for the SN cancers and 58% for the LN cancers (p less than 0.001). Intervals between completion of treatment, appearance of metastases and death were longer for patients with SN cancers. Measurement of nuclear diameters of cells obtained by aspiration cytology may, therefore, be useful in determining the prognosis.


Endocrinology of reproduction in the female beagle dog and its significance in mammary gland tumorigenesis. On the basis of the results of investigations from systemic tolerance tests (and carcinogenicity studies), an attempt is made to evaluate the effects of various progestagens, oestrogens and progestagen-oestrogen combinations on the mammary gland of the dog. The interpretation of such effects in the dog and its relevance in predicting a tumorigenic effect of contraceptive steroids in man is discussed in the light of comparative endocrinology of reproduction. The induction of mammary gland tumours in dogs by certain progestagens or progestagen-oestrogen combinations must be considered as being a species-specific effect, related to the high hormonal potency (progestational activity) of these compounds in the dog and their stimulatory effect on canine growth hormone. Based on the present state of our knowledge and because of the marked interspecies differences of action of contraceptive steroids in dog and man, the steroid-related canine mammary tumours, especially with regard to the doses necessary for contraception, are unlikely to be indicative of a potential hazard to the human female.


Ultrastruct of oral cells with bar-shaped nuclear chromatin. Scrapings were taken from the frenulum of the lower lip to obtain cells with bar-shaped nuclear chromatin. They were subjected to routine electron microscope processing, sectioning and visualization. Specimens from the lower frenulum of autopsy patients were prepared for light microscope identification of the bar-chromatin cell in tissue. The ultrastructure of the bar-chromatin cell cytoplasm resembled that of normal squamous intermediate cells, but the nuclear chromatin was composed of pleomorphic masses which formed an irregular band on the long axis of the nucleus. In the normal intermediate cell the clumps of chromatin were dispersed randomly. Cells with bar chromatin were found in the stratum spinosum of the oral squamous epithelium.


The normal exfoliative cytology of menstrual blood. The exfoliative cytology of menstrual blood obtained from 10 women by the use of a new vaginal tampon device is described. Endometrial, squamous metaplastic, parabasal, and superficial and intermediate squamous epithelial cells were observed. The quality and quantity of the exfoliated cells of the female genital tract seen in menstrual blood preparations are comparable with the results obtained by the conventionally used cellular collection methods. Furthermore, the vaginal tampon technique has certain advantages over the conventionally used cellular collection methods, since it is noninvasive, convenient and reliable and allows direct delivery of the sample from the patient to the laboratory.


[Phagocytic ability of blast cells in acute leukemia]. In 31 cases of acute leukaemia in adults the ability of leukaemic cells to phagocytize latex was investigated. This ability was confirmed in nearly all cases of monocytic and myelomonocytic leukaemia, in over 1/3 of cases of myeloblastic leukaemia and in one out of 9 cases of lymphoblastic leukaemia.


On the pathogenetic role of prostaglandins in Bartter's syndrome. Two patients, one with Bartter's syndrome and one with severe abuse of diuretics, were investigated before and after indomethacin treatment. Before indomethacin the two patients showed a similar pattern of hypokalaemic alcalosis, secondary hyperaldosteronism, and increased urinary excretion of PGE2 and kallikrein. After a few days on peroral indomethacin medication the hypokalaemia was significantly improved, the plasma renin activity, and the urinary excretion of aldosterone, PGE2 and kallikrein were normalized in both patients. It is concluded that the beneficial effect of indomethacin cannot be used as a proof of prostaglandin overproduction as the primary defect in Bartter's syndrome.


Increased leukocyte alkaline phosphatase activity following transfusion of leukocytes from a patient with chronic myelogenous leukemia. Neutrophils from a patient with chronic myelogenous leukemia and typically low leukocyte alkaline phosphatase (LAP) activity markedly increased in LAP content following transfusion to and circulation in an infected neutropenic recipient. Incubation of the recipient's serum and plasma with normal neutrophils failed to alter their LAP activity. This observation suggests that LAP activity is inducible by as yet unknown "environmental" factors, and possible mechanisms for this are discussed.


Effect of metabolic alteration of periodontal fibers on orthodontic tooth movement. An experimental study. In the present study orthodontic force was applied to the molars of rats treated with the lathyrogen beta-aminopropionitrile (BAPN). New bone formation was measured at two alveolar locations after 9 days of force application. Observation resulted in the following conclusions: 1. New alveolar bone formation in response to orthodontic force in BAPN-treated rats statistically exceeded corresponding bone formation in control animals when measured at two tension sites in the periodontal ligament. 2. BAPN administration produced disorganization of the collagenous fibers of the periodontium of experimental animals. Multiple eosinophilic cell-free areas were found distributed throughout the radicular portions of affected periodontal ligaments. Normal ligament function architecture was disrupted in treated animals. The areas of periodontium surrounding orthodontically treated teeth exhibited relatively normal organization under these conditions, while the periodontium of adjacent nonorthodontically treated teeth was markedly disorganized. Orthodontic stimulation of the periodontium of BAPN-treated rats may have disrupted the formation of eosinophilic cell-free areas characteristically seen in the periodontium of the experimental group. 3. The present results suggest that the typical histologic response to orthodontic force application can occur in the presence of a chemically and physically altered periodontium. The quantitative data collected infer that fiber tension on the alveolus may not be absolutely necessary to stimulate bone formation. Distortion of the alveolus related to force application may be a more important factor initiating bone response. However, the fibers of the periodontium may play a passive role in transferring orthodontic force to the alveolus.


The Michigan School Study cephalometric norms expressed in template form. User-calibrated cephalometric templates have been presented for boys and girls at the ages of 6, 8, 10, 12, 14, and 16 years. The templates were derived by geometric triangulation from normative data published in An Atlas of Craniofacial Growth. A technique for using the templates diagnostically has also been presented.


Soft-tissue change as a result of maxillary surgery. A preliminary study. A retrospective investigation of soft-tissue changes following two types of maxillary surgical procedure (anterior alveolar segmental, LeForte I) in nineteen adult patients was undertaken. Several hard-tissue coordinates were correlated to each coordinate of eleven soft-tissue points by multivariate regression analysis. This new method was compared to a previously derived nonsurgical prediction method (Ricketts). The following results were observed: 1. For eight horizontal and vertical coordinates (Glh, Glv, Nah, Av, Nch, Ncv, Pnh, and Pnv), neither method was accurate. 2. For ten horizontal and vertical coordinates (Snh, Snv, Ah, Av, ULh, ULv, Stv, LLh, Bv, and Pogv), the mean prediction residuals for the multivariate method were significantly smaller than those for the modified nonsurgical method. 3. For three horizontal and vertical coordinates (LLv, Bh, and Pogh), there were no significant differences between the mean prediction residuals of both methods. Two additional cases were used to test the new method for general applicability. Visual examination reveals that the predictions for these cases are clinicallly acceptable. Only further testing can establish the true validity of the new method.


A key to the understanding of extraoral forces. By following certain basic principles, the effects, advantages, and disadvantages of the wide assortment of extraoral assemblies marketed are easily understood. The key to this understanding is the appreciation of the relationship of the line of action of the force application to the center of resistance of the tooth. These principles are discussed in three planes of space: sagittal, coronal, and transverse. Because of the many variables and complexity of mathematically computing the force effects of unilateral or asymmetric extraoral assemblies on molar teeth, a mechanical testing apparatus was designed to accommodate the various face-bows. Not all the designs proved effective, and many of the clinical side effects of the respective face-bow designs became manifest on mechanical testing.


A comparison of four methods of predicting arch length. 1. Four arch length prediction equations (Nance, Johnston-Tanaka, Moyers, and Hixon-Oldfather) were compared by examining pretreatment casts, pretreatment intraoral radiographs, and posttreatment casts of forty-one patients of mixed-dentition age. 2. A comparison of correlation coefficients and slopes of the predicted arch length versus the actual arch lengths revealed that the Hixon-Oldfather method conformed closest to the ideal. 3. No combination of the four methods produced a more accurate equation than the single most accurate method. 4. Neither the sex of the patient nor the type of occlusion affected the prediction accuracy of any of the four equations. 5. All methods tend to overpredict the arch length size by 1 to 3 mm., with the exception of the Hixon-Oldfather equation, which underpredicted by approximately 0.5 mm. 6. An analysis of the intrainvestigator error showed a very low standard error of estimate for individual tooth measurements and for the prediction values. 7. A variance analysis showed that most of the variation was due to arch length (85%), a slight amount was due to the prediction method (8%), and 6% of the variation was due to the rater. 8. A low correlation was found between space available versus actual discrepancy and space available versus actual arch length. 9. High correlation coefficients were found for the predicted arch lengths when compared with the actual arch lengths. As expected, the correlation coefficients for the predicted widths of only the canines and premolars compared with the actual widths were not quite as high.


Maxillary diastema: indications for treatment. 1. In comparing characteristics associated with the presence or absence of diastema at the age of 16 years, generalized spacing was the only significant factor. 2. In the 230 children who had a diastema of 0.5 mm. or greater at age 9, there was a significant association between the diastema and the amounts of crowding or spacing at age 16. 3. A clinician must analyze the individual case in order to determine whether the diastema is to close through normal development or if there exists a likelihood of its persistence.


Adhesion of mesh-base direct-bonding brackets. The bond strength of mesh-base and metal-base brackets to human enamel was investigated for different adhesive systems. The bond strengths were determined by means of tension, shear, and torsion tests. The data were statistically analyzed and the following conclusions were drawn: 1. An adhesive system (bracket base and adhesive) cannot be selected on the basis of one test (tension, shear, or torque) alone. The various systems generally ranked differently, depending upon the test method utilized. 2. Mesh-base brackets were more retentive than the metal-base brackets in tension, while metal-base brackets were more retentive in shear. 3. For the metal-base brackets, Bond-Eze was the most retentive material, Adaptic and Orthomite followed narrowly behind, and Genie was the least retentive. 4. For the mesh-base bracket in tension and shear, Bond-Eze, Adaptic, and Solo-Tach were the most retentive materials when used with the 60-mesh base, and Genie was the least retentive. Torsion values  were not useful because of a large number of bracket wing failures.


Standardization for serial intraoral photography. A recently developed system of mirror holders which makes the taking of standardized intraoral photographs less time consuming and more precise has been described. By fixing the relationship of the intraoral mirror to the camera, all that is necessary is to consistently orient the mirror to the teeth being photographed. Because the operator no longer has to position the mirror with one hand while holding the camera in the other hand, the whole operation of intraoral photography is greatly simplified. By producing serial slides of the progress of orthodontic treatment, a visual sequence of treatment can be prepared for viewing by patients, for educational purposes, and for showing at meetings and study clubs.


Developing an effective oral hygiene program for the orthodontic patient: review, rationale, and recommendations. This article demonstrates the importance of good oral hygiene during and after orthodontic treatment. The attitude of all parties involved toward oral hygiene contributes to the dentition's future. Several means of assisting the patient to maintain good oral hygiene are discussed. It has been emphasized throughout the article that correcting malocclusions is important, but if the result of this effort is lost in a few years because of periodontal disease or caries the patient has not been helped. However, if the patient learns to practice effective plaque control, he may keep his teeth for a lifetime.


[H.R.P.-J.M.V.-200. A device for the simple adoption of modern ventilation techniques with various, even old, mechanical ventilators (author's transl)]. A new constructed device (H.R.P.-I.M.V.-2000) is presented. New techniques of artificial respiration such as E.S.-I.M.V., I.D.V., I.P.P.B. + P.E.E.P. compl., C.P.A.P. ect. can now be used with different types of respirators (pressure-, pressure-flow- and volume-time cycled) even older models. No constructional modifications, are necessary. To perform these techniques manipulation of only two control elements are necessary. Additionally hand ventilation is possible without any further device by the use of the H.R.P.-Respiration-Sets. The significance of E.S.-I.M.V. compared with I.M.V. and I.D.V. has between demonstrated. E.S.-I.M.V. has proved very valuable, because a basic mandatory respiratory is combined with the possibility of a patient-triggered expiration phase. Therefore fighting against the respirator is avoided. In addition the I.M.V.-device is the universal adapter for a new developed respiratory system (H.R.P.-System 2000) for different types of respirators. These sets (including a heated humidifier) are available as disposables or reusables and guarantee optimum hygiene during artificial respiration.


Induction of general anesthesia with diazepam or thiopental: a comparison of the cardiorespiratory effects. Detailed cardiorespiratory studies were performed in 10 volunteers in whom general anesthesia was induced with thiopental 3 mg/kg and diazepam 0.4 mg/kg.Minimal changes in blood pressure were noted with both agents. Depression of total peripheral resistance lasted in excess of 20 minutes with diazepam but had returned to control levels with thiopental, elevations in cardiac rate and output were most evident and lasted longer with diazepam. In the healthy volunteer induction of anesthesia with diazepam causes alterations in cardiovascular parameters which are more profound than with thiopental. The data presented is in contrast to that obtained when patients with cariovascular disease are studied.With diazepam, considerable individual variation and long recovery times were confirmed.Following extensive clinical use, a detailed study demonstrated minimal cardiovascular depression following intravenous induction of sedation with diazepam, in patients who had prior cardiovascular disease. Subsequent studies suggested that diazepam would be a more suitable alternative for induction of general anesthesia in patients with cardiovascular disease. This was confirmed by Ikram and Rubin. It has been used extensively for sedative techniques in dentistry, and therefore it was logical to extend this concept to the induction of general anesthesia by intravenous diazepam. It was decided to evaluate the use of intravenous diazepam for induction of general anesthesia and to compare the detailed cardiovascular and respiratory effects of this drug with thiopental.


[Diagnostic and prognostic value of the assay of lysozyme in acute leukemia (author's transl)]. The diagnostic and prognostic value of the assay of lysozyme in serum and urine was appreciated in 184 cases of acute leukemia. The levels were decreased in the lymphoblastic, mainly of the non B-non T type, and undifferenciated varieties, markedly raised in the monoblastic and myelo-monocytic varieties, while in the myeloblastic ones they were found normal, decreased or slightly increased, and, on the average, significantly higher in the well differenciated than in the poorly differenciated types. For a given cytological type, the level of lysozyme is not correlated with the frequency of the induction of complete remission. However, in the acute myeloblastic leukemia, a significantly higher frequency of infection during or after the induction treatment was observed in the cases presenting initially without a raised serum lysozyme level.


[Osteogenic cranial sarcoma in Paget's disease (author's transl)]. Sarcomatous changes in Paget's disease are known to occur, but cranial localization with invasion of cerebral parenchyma is rarely seen. A case is reported of osteogenic sarcoma occurring during Paget's disease, which was diagnosed from neurological signs, and on which a complete anatomical study was made.


The study of phagocytic activity of granulocytes during the treatment of acute lymphoblastic leukemia. The phagocytic function of granulocytes from peripheral blood of 14 children with ALL before and during therapy was studied. The children were treated according Pinkel's Protocol VIII. Peripheral blood granulocytes were evaluated for their phagocytic activity by tube phagocytosis test with Staphylococcus aureus. The transient decrease of phagocytic activity after cranial irradiation was noted. This impairment was coupled with increased incidence of infections.


Eye injuries and the dentist.

Eye injuries and the dentist. The risk of damage to the eyes of the patient, the dentist and his assistant should be recognized. Protection can be achieved by the wearing of specially designed spectacles using CR 39 plastic tinted lenses. Contact lenses should be removed by patients who are to undergo general anaesthesia.


Surgical access: the access-line concept. Adequacy of surgical access is determined by the position of the access line and not by the size of the flap as commonly believed. The case for small flaps in surgery is strongly argued for.


Ten years of fluoridation in Perth, Western Australia. The caries experience of children aged six, eight, and ten years, examined in Perth after ten years of fluoridation was less than half that of children examined before fluoridation. In a concurrent survey, the caries experience of children examined in two unfluoridated towns was double that of the Perth children.


Analysis of the effects of treatment on some reflexes of human jaw elevator muscles. Electromyographic analysis was carried out prior to occlusal equilibration for patients who had some form of TMJ dysfunction and again after treatment. The results were compared with similar analyses for patients without any symptoms of dysfunction (controls) and for patients who had been wearing some kind of occlusal appliance as treatment for dysfunction. The parameters measured were the period of minimal activity (inactive phase of jaw elevators sometimes referred to as the inactive phase), the duration of muscle contraction before tooth contact (DMC), the period of muscle activity after tooth contact (latency), the inhibitory response, and the duration of the clench phase of the temporal and masseter muscles. In general the pathological series had longer cycles, longer DMC, longer clench phases and less significant correlation coefficients than the controls. The results indicated a dominance of the closing muscles in the pathological groups over the other parameters of the cycle during metronome monitoring. Also, the controls and the POST equilibration group yielded readily to cortical command. The parameters of the cycle in the POST-equilibration group were facilitated as compared to the other groups.


The effect of aluminium on the metallography of a nickel base removable partial denture casting alloy. Three special nickel-chromium alloys were prepared in which the aluminum levels were adjusted both above and below that of a commercial nickel base dental casting alloy. Tensile and metallographic evaluation of representative samples of the alloys were made and the changes in the properties of the alloys are reported.


Hypnotherapy in the treatment of oro-facial pain. A continuing study at the Oro-Facial Pain Clinic. The Royal Dental Hospital of Melbourne has demonstrated that hypnotherapy is a useful tool in the management of previously resistant, chronic facial pain disorders, discomfort conditions and dental phobic illness.


Intermittent atrioventricular block: procainamide administration as a provocative test. Twelve patients with clinical features suggesting possible intermittent high degree atrioventricular block were studied. All 12 patients had basic 1:1 atrioventricular conduction but nine had an electrocardiographic pattern of bifascicular distal conduction disease (right bundle branch block with left anterior or posterior hemiblock, or left bundle branch block). Intracardiac conduction was assessed by recording of the His bundle electrocardiogram and atrial pacing techniques, before and 20 minutes after intravenous administration of procainamide, in a dose of up to 10 mg/kg. Before procainamide administration, seven of the 12 patients had a prolonged H-V interval (greater than 55 ms). Procainamide administration lengthened the H-V interval in all 12 patients by 5--40 ms. In five patients, procainamide induced second or third degree AV block below the level of the bundle of His. It was concluded that the administration of procainamide may be a useful provocative test of distal conduction in patients with possible intermittent AV block.


Ultrasound tomography of the liver: Non-invasive method of choice for the differential diagnosis of jaundice. Grey-scale ultrasound tomography was used to examine the liver and biliary tree of 100 consecutive unselected jaundiced patients in a prospective study. It was successful in differentiating between hepato-cellular and obstructive jaundice in 94%. It precisely localised the site of obstruction in 75% of those patients with enlargement of the head of the pancreas from either carcinoma or gall-stones impacted in the Ampulla of Vater. This figure was reduced to 60% when all cases of obstruction were considered. Cirrhosis and chronic active hepatitis were found to be associated with an abnormal pattern of echoes within the liver. These echoes were stronger and more numerous than normal. This association was not apparent with drug-induced cholestasis or acute viral hepatitis. Grey-scale ultrasound tomography is quick, safe and completely non-invasive. It should be the initial investigation of choice in the differential diagnosis of jaundice. When precise localisation of an obstruction is not possible after a repeat attempt, then percutaneous transhepatic cholangiography should be considered.


Some observations on the immunological status in scleroderma (progressive systemic sclerosis). A variety of tests were performed to determine the immune status of a group of patients with scleroderma (progressive systemic sclerosis). Sera of 11 of 35 patients showed autoantibodies by an immunofluorescent technique. There was no significant difference between the C3 and C4 components of complement in 12 patients tested and laboratory controls. IgM levels were raised in 24 of 34 sera. Four of ten patients showed some deficiency of phagocytic function in the leucocyte iodination test. B cell and T cell numbers were normal in the eight patients tested. Reactivity to mitogens was usually normal in ten patients tested with a deficient response to one of the three mitogens in two patients. In skin reactivity tests in 23 patients, only one was anergic to all of the four antigens tested. It is concluded that although some immune abnormalities are common in scleroderma there is no consistent abnormality in any of the tests used. This does not exclude the possibility that immune factors may be involved in systemic manifestations of the disease, or that there may be some subtle specific abnormality not revealed by the tests performed.


Progesterone and oestrogen receptors in human breast cancer. Receptors for progesterone were found in 27% of 98 human breast tumours, and for oestrogen in 57% of 191 tumours. With one exception, progesterone receptors were found only in tumours which also contained oestrogen receptors. Levels of oestrogen receptor in positive tumours rose significantly with patient age whereas progesterone receptors were unchanged. Progesterone receptor levels were lower in lymph node metastases than in primary tumours, and oestrogen receptor levels were lower in large tumours (greater than 5 cm diameter) compared to small lesions. Receptor levels were not significantly correlated with circulating concentrations of either oestrogen or prolactin. The implications of receptor measurements in assessing hormone responsiveness of breast tumours are discussed.


Carpal tunnel syndrome, diabetes and pyridoxal. Serum pyridoxal concentrations were estimated in 13 patients who had both diabetes and carpal tunnel syndrome. The clinical features and response to treatment in these patients did not differ from that seen in non-diabetic patients with this syndrome. No significant difference in mean serum pyridoxal concentrations was noted between diabetics with carpal tunnel syndrome, diabetics without neuropathy, and normal subjects. These results indicate that carpal tunnel syndrome in diabetics is distinct from polyneuropathy in that it is not associated with a reduction in serum pyridoxal levels which is a feature of diabetic polyneuropathy.


Migraine attacks and increased platelet aggregability induced by oral contraceptives. A case where common and complicated migraine attacks appeared during the course of oral contraception is reported. The attacks of complicated migraine also continued to appear after the contraceptives were stopped. Increased platelet aggregability was found at the time when the complicated migraine attacks were frequent and, therefore, treatment with dipyridamole and aspirin was given. At the time when a gradual reduction of the platelet aggregability was observed, a decrease in the frequency, and eventual disappearance of the complicated migraine attacks was simultaneously seen. Causal relationship between increased platelet aggregability and complicated migraine attacks is suggested.


Surgical division of an accessory atrioventricular connection in the posterior septal region following ventricular fibrillation in the Wolff-Parkinson-White syndrome. A young man presented with atrial fibrillation and a rapid ventricular response which degenerated into ventricular fibrillation. Electrophysiological study demonstrated an accessory atrioventricular connection in the posterior septal region. This was sectioned to prevent recurrence of his arrhythmia. Post-operative electrophysiological study demonstrated that the surgical section was successful.


The association of chronic active hepatitis with pyoderma gangrenosum. This report deals with a 25-year-old man with chronic active hepatitis and cirrhosis who developed the rare complication of pyoderma gangrenosum which improved rapidly following the commencement of prednisolone.


The non-operative management of gallstones. During the last decade the non-surgical management of gallbladder stones has become possible. Oral chenodeoxycholic acid (CDCA) and more recently, ursodeoxycholic acid (UDCA), have proved to be safe and effective. For the treatment of bile duct stones, various methods including flushing, chemical dissolution and mechanical procedures are now available. A combination of these techniques can be used in a logical sequence and should enable the successful treatment of most patients with bile ducts stones.


Planning for better standards in the care of the neurological sequelae of trauma. Injuries of the nervous system are common, and cause many deaths and much permanent disability. They inflict an enormous financial burden on the national economy; in Australia, adequate data are at present lacking, but a simple extrapolation from Canadian statistic suggests an estimate of more than $500,000,000 annually for the injuries resulting from road traffic accidents alone; if other causes of injury are included, the figure may reach one billion dollars. The neurosurgeon is specifically trained to undertake the management of all forms of neurological trauma; however, in Australia, and in many other countries, only a small minority of such injuries receive neurosurgical care. This is chiefly because the number of neurosurgeons at present available is small in relation to the tasks. Many cases must therefore be in the care of general or orthopaedic surgeons, especially in country centres, and it is important that these surgeons should have some basic neurosurgical training. The Neurosurgical Society of Australasia wishes to formulate a programme to ensure that opportunities for such training are available throughout Australia. This programme should also embody a national plan for research into the treatment and prevention of neurological trauma.


The diagnosis and treatment of functional disorders of the biliary tract. An approach to the diagnosis and treatment of patients with presumed functional disorders of the biliary tract (biliary dyskinesia) is described. The current diagnostic criteria are pain compatible with biliary pain in the absence of gallstones and other organic gastrointestinal disease, or other disorders which might produce abdominal pain, together with reproduction of the patient's symptoms by cholecystokinin, or morphine, or both. Other diagnostic methods are described together with their limitations. The results of operation in 38 of 45 patients seen in this Unit during the past six years are presented. The results were poor in 20% of patients, but two-thirds of the group have had good results in the short term.


Operative liver biopsy abnormalities in patients with functional disorders of the biliary tract. The group of conditions variously termed biliary dyskinesia, acalculous cholecystitis, biliary pain without stones, or functional disorders of the biliary tract, is poorly defined clinically, and no consistent pathological abnormalities have been previously described in patients with this diagnosis. In this paper we report histological abnormalities encountered in operative live biopsies in such patients. The criteria for the diagnosis of a functional biliary tract disorders were: pain typical of biliary pain, negative results of investigations for organic biliary tract or other gastrointestinal disease, and reproduction of the patient's symptoms by cholecystokinin, or morphine, or both. Twenty of 45 patients with a presumptive diagnosis satisfied these criteria, and had a wedge liver biopsy at the time of operation. The 20 liver biopsy specimens were compared in a blind fashion with similar ones taken from patients having diagnostic laparotomies; patients with stones confined to the gallbladder; patients with gallstone pancreatitis; and patients with proven common bile duct stones. The biopsy findings were found to be similar to those in the latter two groups. Thus the abnormalities were similar to those found in partial or intermittent biliary obstruction, and it is suggested that they may be due to intermittent increases in biliary pressure.


Recurrent biliary calculi due to non-absorbable cystic duct ligatures. A non-absorbable cystic duct ligature may migrate into the common bile duct and act as a nidus for recurrent stone formation. Four case histories are presented and the problem is discussed. This sequel may be prevented by the use of absorbable sutures to ligate the cystic duct, thereby reducing the number of patients facing the hazards of recurrent biliary surgery.


Choledochal cyst: a review of seven cases from Auckland. This is a short review of the operative experience during the last decade with seven patients who presented with a choledochal cyst. A choledochal cyst is reported for the first time in a Polynesian. The relevant literature is briefly reviewed, with particular attention to operative management, which was found to carry a 10% mortality.


Posttraumatic vascular malformations of the orbit. The close association of the external and internal carotid circulations in the orbital cavity is well recognized. Two cases are presented in which local trauma to the orbit apparently resulted in the formation of an arteriovenous fistula. These lesions progressively expanded, producing classical features of proptosis, chemosis, and bruit. The investigation by selective angiograms and the surgical management of these malformations are discussed. A further case is presented in which an early lesion was noted in angiography after a head injury, with subsequent disappearance of the lesion some weeks later.


Supraclavicular traction injuries of the brachial plexus. Thirty supraclavicular traction injuries of the brachial plexus are reported. Young motor cyclists are frequently involved. Recovery is slow and often incomplete. Myelography remains the most useful investigation for prognostic purposes. The management of intractable pain is discussed. An early assessment of prognosis is an important fact in planning and supervising the long-term management of these patients.


Traumatic haemobilia treated by hepatic artery ligation. A 22-year-old woman developed haemobilia following suture of an apparently superficial liver injury. The diagnosis was made on the basis of the clinical features, duodenoscopy, and liver function test. Selective hepatic angiography and liver scintiscan demonstrated a cavity in the right lobe on the liver, with the bleeding arising from a branch of the right hepatic artery. She was treated by cholescystectomy, exploration of the common bile duct with removal of clots, and ligation of the right hepatic artery. Subsequent T tube cholangiography and liver scintiscans demonstrated complete resolution of the cavity, and there was no further bleeding. Experience with this patient suggests that contrary to previous recommendations, haemobilia associated with an intrahepatic cavity may be successfully treated by hepatic artery ligation.


Spontaneous perforation of the common bile duct: report of a case. A case is reported of spontaneous perforation of the common bile duct in a 59-year-old woman. Recurrent episodes of epigastric and right hypochondriac pain over one year culminated in the onset of obstructive jaundice. There were not signs of peritonitis, and laparotomy revealed an abscess surrounding a perforation in the common bile duct just distal to the cystic duct. A cholesterol gallstone was present at the site of perforation. A paracolon bacterium, providence alcalifaciens, was isolated from the abscess. The patient made an uncomplicated recovery after cholecystectomy and drainage of the bile duct.


Bronchobiliary fistula due to hydatid disease: a case report. A case of bronchobiliary fistula due to transdiaphragmatic rupture of hepatic echinococcal cyst is described. The importance of excluding associated extrahepatic biliary obstruction is emphasized. Successful treatment involves relief of this obstruction as well as management of both the pleural space and pulmonary complications.


Avulsion of the ampulla of Vater: an isolated injury following blunt abdominal trauma. A case of avulsion of the ampulla of Vater from the duodenum due to blunt trauma is presented. In patients in whom leakage is confined to the extra peritoneal tissues, the condition can be insidious, making diagnosis difficult.


Instrumental removal of retained stones after choledochotomy. Despite the widespread use of operative cholangiography and choledoschoscopy, stones are still left behind after exploration of the common bile duct. Reoperation is associated with a significant morbidity and mortality. The use of a steerable catheter-basket technique has enabled stones to be removed from the biliary tract in the vast majority of cases without significant complications and has practically eliminated the need for further surgery.


Some specific anatomical features of the atlas and axis: dens, epitransverse process and articular facets. Metrical and morphological findings, based on 107 human vertebral columns, related to the variations of the dens are given, and differences in the depth of the superior articular facets of the atlas and specific pertinent details related to the os odontoideum and epitransverse process are also provided and their possible clinical relevance indicated. Findings reveal considerable variation in the height of the dens (11 to 18 mm), but remarkably little in its anteroposterior and transverse diameters at the root. The use of the term "hypoplasia" with reference to the dens is discussed, and a need for more rigid criterian in the use of this term stressed. It is also suggested that there may be sufficient radiological evidence in a lateral radiography to lead one to suspect the presence of an os odontoideum or a separate dens caused by trauma in the distant past.


The effect of insulin and hydrocortisone on the isolated rat liver. Isolated rat livers were perfused at 35 degrees C with bovine serum albumin (40 g/l) in Krebs Ringer bicarbonate buffer, or with the same solution containing insulin (0.22 x 10(-6) mol/l), hydrocortisone (0.068 x 10(-3) mol/l), or both hormones together. Observations on the synthesis of bile and on perfusate levels of potassium, aspartate aminotransferase, urea and glucose showed that the presence of insulin and/or hydrocortisone had no beneficial effect on the perfused rat liver in vitro. There is little justification of the isolated liver.


The experimental assessment of techniques of measuring biliary pressure. A variety of different methods have been used for the measurement of pressures during operations on the biliary tract. However, there are few data on the experimental evaluation of the methods, and there has been no controlled comparative evaluation of the most commonly used techniques. In these experiments, we have compared the manometric technique of Caroli, the syringe barrel method of Daniel and White et alii, and the constant infusion apparatus of Cushieri. The experiments were performed in pigs because of the similarity of their biliary tract to that of man. Resting and opening pressures were recorded, and flow into the duodenum via the ampulla was measured simultaneously. The manometric and syringe barrel techniques gave highly reproducible measurements of resting and opening pressure, and valid measurements of opening pressure. The constant infusion apparatus gave reproducible measurements of resting pressure, but did not measure opening pressure. The manometric technique was shown to measure changes in the resistance of the choledochoduodenal junction in response to morphine and atropine.


A paediatric ventilator with a fluidic control system. A paediatric ventilator has been designed basically as a fluidic-logic controlled T-piece occluder. Inspiratory and expiratory time, inflation pressure limit, positive end-expiratory pressure (PEEP), continuous positive airway pressure (CPAP) and inspiratory flow-rate are controlled independently and intermittent mandatory ventilation (IMV) is available. Warning systems are provided for failure of the driving as, low airway pressure and inspiratory pressure limit. The breathing circuit is isolated from the control and warning systems for ease of sterilization.


Studies on the subcellular organelles of neutrophils in chronic granulocytic leukaemia with special reference to alkaline phosphatase. The organelle pathology of neutrophils in chronic granulocytic leukaemia (CGL) was investigated by analytical subcellular fractionation. There were minor reductions in activity of some granule enzymes with an abnormal distribution in sucrose density gradients of the specific granules. There was a marked reduction of 5'-nucleotidase activity but this is probably related to the relative reduction of the mononuclear cell contamination of the neutrophils isolated from leukaemic patients compared with controls. Another plasma membrane enzyme, NADH-nitroblue tetrazolium reductase, which has a microbicidal role, had increased activity. Neutrophils from patients with CGL had 13% the alkaline phosphatase activity of controls and were compared with neutrophils from women in the third trimester of pregnancy when the activity was increased to 8 times the control level. The latent activity, per cent inhibition by Levamisole, kinetic constants and subcellular distribution of alkaline phosphatase were similar in the three groups. It is suggested that the properties and intracellular localization of alkaline phosphatase are normal in CGL and that there is a quantitative lack of enzyme.


The use of proplast in oral and maxillo-facial surgery. The use of Proplast in the restoration of contour defects and for reconstruction of alveolar ridges is described. An evaluation of the results of treatment suggests it is a useful material for the restoration of facial contour, but that there is a significant risk of infection when the intra-oral approach is adopted.


Florid focal epithelial hyperplasia in Fanconi's syndrome. Florid focal epithelial hyperplasia of at least 5 years' duration in a Cape Coloured boy aged 12 years and suffering from Fanconi's syndrome is reported.


Atypical odontalgia.

Atypical odontalgia. Forty-four cases of odontalgia are described which are considered to be a painful migraine-like disturbance of the blood vessels of the dental pulp and periodontal membrane. The condition appears to be a manifestation of depression and other personality disorders and responds well to antidepressant drug therapy (75 per cent of the patients). The recognition and proper management of this atypical ondontalgia is of crucial importance in preventing unnecessary surgery.


Disseminated histoplasmosis presenting with oral lesions - report of a case. A case of disseminated histoplasmosis is presented in which the initial diagnosis was made on the histology from oral lesions. The clinical and microscopical differential diagnoses are discussed. Including the present case, 12 of the 13 subjects with disseminated histoplasmosis initially diagnosed in Great Britain have given a history of residence in an area where the disease is endemic. Many years of good health may intervene between the original infection and its subsequent reactivation. A diminished cellular immune response may precipitate this reactivation but could also facilitate the possibility of exogenous reinfection. The literature is reviewed.


Maxillary African histoplasmosis mimicking malignant jaw tumour. An account is given of an unusual presentation of solitary Histoplasmosis duboisii of the jaw simulating a malignant neoplasm. This report is of interest for two reasons; firstly, the rarity of such a presentation and secondly, the extensive search of the literature which has failed to produce another case. The rationale for our treatment is also briefly discussed.


Aneurysmal bone cysts of the jaws.

Aneurysmal bone cysts of the jaws. Two cases of aneurysmal bone cyst are recorded. In the first there is clinical evidence to suggest that the lesion had been present for an unusually long period while incomplete clinical records of the other also indicate an unusual history. Histologically both lesions show a paucity of giant cells. It is not possible to make significant observations on aetiology other than support the theory that the lesion arises as a result of altered haemodynamics.


Aneurysmal bone cysts of the jaws: a case report and review of the literature. A case of aneurysmal bone cyst of the mandible in a 21-year-old female has been presented, and the pertinent literature reviewed. Conservative surgery in the treatment of this type of jaw lesion is recommended.


Two atypical solitary bone cysts.

Two atypical solitary bone cysts. Two atypical solitary bone cysts occurring posterior to the angle of the mandible, and in each case showing delayed healing, are reported. Some speculations are made on the possible aetiology of these lesions in general.


Bilateral haemorrhagic bone cysts of the mandible: a case report. A case report is presented of a patient found to have bilateral haemorrhagic bone cysts. There have only been two previous reports of such an occurrence.


Interrelationship of immunologic characteristics, proliferation pattern, and prednisone sensitivity in acute lymphoblastic leukemia of childhood. In children with acute lymphoblastic leukemia (ALL) the effect of prednisone therapy on the cell-cycle phase distribution of leukemic bone marrow cells was determined with pulse cytophotometry at the time of diagnosis. Also, the interrelationship with the presence of the sheep erythrocyte receptor as a marker for T cells was investigated. In 17 or 21 patients prednisone treatment caused a decrease in the percentage of cells in the S+G2+M phases. In 11 of 12 adult patients with ALL the same result was obtained. In a group of 31 children with ALL, 6 cases of T-cell ALL occurred in combination with intermediate or high WBC counts. The 3 patients with the highest E-rosetting percentages had rather high proportions of bone marrow cells in the S+G2+M phases. No correlation could be established between the WBC count or the E-rosetting percentage and the chance for complete remission.


Clonal identification in acute lymphoblastic leukemia. In a case of acute lymphoblastic leukemia, two distinct types of leukemia blast cells could be identified throughout the course of the disease. The initially dominant type of blast cell was sensitive to chemotherapy; the other was drug-resistant, gradually becoming dominant as the disease progressed. The cell types could be clearly separated by their morphologic and surface membrane marker characteristics. The same chromosomal constitution was present in both types of blast cells, indicating a common clonal origin. Additional chromosomal abnormalities were present in the later stages of the disease, demonstrating that a distinct subclone had proliferated. This study illustrates that in some cases of acute leukemia, disease relapse is caused by growth of drug-resistant subclones that may be clearly identified by changes in morphology and surface membrane marker characteristics.


Case report: osteolytic osteosarcoma in a German Shepherd bitch. Necropsy of a six year old female German Shepherd revealed the presence of a large oval mass in the thoracic cavity originating from the thickened proximal portion of the right fourth rib. Osteolytic osteosarcoma was diagnosed on the basis of gross appearance, presence of many pleomorphic spindle cells, containing pink stained intracytoplasmic granules in cytological preparations of impression smears of the tumor and histopathology. The tumor was considered highly malignant and was characterized by an abundant osteoblastic and connective tissue stroma with extreme cellular pleomorphism including giant cells, atypical mitoses and occasional trabeculae of tumor bone and osteoid. Metastases were found in the lung and spleen. Electron microscopy was carried out to support the diagnosis.


Tumour-promoting phorbol diester induces substrate-adhesion and growth inhibition in lymphoblastoid cells. The treatment of human lymphoblastoid cell cultures with the phorbol diester, 12-O-tetradecanoyl-phorbol-13-acetate, a tumour promoter, caused at nM concentration surface structural changes associated with altered adhesion properties. The effect was observed in several cell lines from normal or leukaemic origin. In addition, the tumour promoter induced an early and transitory growth inhibition which was observed in all tested B-characteristic cells. The phorbol diester, 4-O-methyl-phorbol-12,13-didecanoate, which is devoid of tumour-promoting activity, was much less effective in altering cell adhesion properties and cell growth than the active derivative. These observations suggest that lymphoblastoid cells may be a useful model for studying the molecular alterations at the membrane level resulting from the action of tumour-promoting phorbol diesters.


The relevance of cell kinetics for optimal scheduling of 1-beta-D-arabinofuranosyl cytosine and methotrexate in a slow growing acute myeloid leukemia (BNML). 1-beta-D-Arabinosyl cytosine and methotrexate were studied for their antitumor activity in acute myeloid leukemia of the BN rat (BNML), which is characterized by a slow growth rate due to the presence of a high proportion of nonproliferating cells. It was found that the two drugs showed the maximal cytotoxic action when given separately. The effect was highly dependent on the interval between the administration of each drug. The variation of the cell kinetic parameters produced by the recruitment into cycle of the resting population, as determined by labeling indices, correlates well with the antileukemic action of the drug combination.


An improved thin-layer chromatographic method for urinary oligosaccharide screening. A modified thin-layer chromatographic screening method is presented for the rapid diagnosis of glycoprotein storage disorders based upon excess oligosaccharide excretion. The system has been used successfully in the diagnosis of mannosidosis, GM1 gangliosidosis, mucolipidoses types I and III, aspartyl-glycosaminuria and fucosidosis.


Trisomy 13 in bone marrow cells in acute myelocytic leukemia and myelofibrosis. We have identified trisomy 13 in two additional patients with hematologic malignancies involving the hematopoietic stem cell: a 75-year-old female with acute myelocytic leukemia and a 64-year-old female with agnogenic myelofibrosis and myeloid metaplasia. Chromosome analysis of the direct bone-marrow preparation showed 100% of cells with trisomy 13 in the first and 10% of cells in the second. We also previously reported a patient with Ph1 negative chronic myelogenous leukemia in whom 100% of the marrow cells showed an identical trisomy. The probability of finding three such patients in our case material was calculated to be 0.05--0.08, implying that trisomy 13 may be another nonrandom chromosomal aberration associated with malignancies of hematopoietic pluri-potent stem cell.


Organ distribution of natural cytotoxicity in the rat. The natural (spontaneous) cytotoxicity (NC) of cell populations from different lymphoid organs of the rat were examined using a human myeloid cell line (K562) and a rat fibrosarcoma cell line (Mc40) as target cells. Rat blood and spleen lymphoid cell populations gave high cytotoxicity against K562, while lymph node cells and bone-marrow cells gave low levels of cytotoxicity and thymus cells virtually no activity. Addition of thymus or lymph node cells to spleen effector cells did not suppress the high cytotoxicity of spleen cells. A similar organ distribution of reactivity was observed against Mc40 cells, but the levels of cytotoxicity were much lower than for K562. A strain difference was monitored in the levels of natural cytotoxicity and cell populations from inbred Wistar rats consistently gave higher activity on a cell-to-cell basis than the corresponding population from PVG/c rats. Natural cytotoxicity was not removed when spleen cell populations were depleted of cells adhering to nylon-fibre columns or plastic surfaces, or depleted of cells ingesting carbonyl iron. In agreement with other studies using human and animal lymphoid cells, the natural killer cell in this system was found to be non-adherent and non-phagocytic and its distribution did not correspond to the established organ distribution of T or B lymphocytes.


Pneumatosis coli in adult acute myeloid leukaemia. Three cases of pneumatosis coli (PC) in adult patients with acute myeloid leukaemia seen over the last five years in Hammersmith Hospital are reported. Although definite conclusions are impossible, we suggest that that pneumatosis could be due to damage to the bowel mucosa as a result of the disease or the treatment. The literature is reviewed and discussed in an inconclusive attempt to discover the source of the gas.


[A comparison of light-hardened and UV-polymerizable sealants and composites]. Ultraviolet irradiation has been used for the photopolymerization of composites and sealers. As new initiators were developed, the effectivity of this system was extended into the visible spectral region. Photo-sensitivity probably only limits the processing period slightly, at least under these conditions relevant for the dental practice. One important advantage is the extension of the maximal tempering depth (2 to 3 times, compared to ultraviolet polymerization). The improved penetrability of the dental substance with increasing wave lengths also reduces the risk of portions of the undercuts not being polymerized.


[Mandibular movements during sleep].

[Mandibular movements during sleep]. Measurement methods using digital evaluation are suitable for determining spacing. Important parameters, such as distribution of spacing during the night, frequency and duration of grinding movements, mean and most frequent spacing, were calculated. We also used the same method to measure pressure exerted on the headgear and the activator as well as to evaluate the interocclusal spacing in subjects wearing orthodontic apparatuses. Additional studies are planned in regard to teeth grinding, individuals with unusual habits, distinctive sleeping positions, and obstructed occlusion.