Prostaglandins and the side effects of anti-inflammatory drugs--the kidney. The most important renal side effect of non-steroidal anti-inflammatory therapy in man is analgesic nephropathy. One possible mechanism for this effect is inhibition of renal prostaglandin synthesis. However, an understanding of the regional biosynthesis of renal prostaglandins, of their pharmacological, physiological and pathological properties in the kidney and an understanding of the consequences of their inhibition by drugs is required in order to assess whether such a mechanism is involved. These aspects are reviewed, using much of the early work of the author as a basis for the discussion. The following conclusions can be drawn form a review of published work. "The consequences of the inhbiition of renal prostaglandin synthesis do not seem to bear much relationship to the renal side effects of anti-inflammatory therapy in man". It is further suggested that impaired renomedullary blood flow arising from decreased renomedullary PGE2 synthesis results in increased accumulation of drug in the renal medulla leading to direct toxic damage. Finally, examples of diseases associated with increased or decreased renal PGE2 synthesis are discussed and some examples of drug interactions are presented.


Plasma levels of immunoreactive 15-keto-13,14-dihydro-thromboxane B2 in guinea pigs during anaphylaxis and after histamine injection. A sensitive radioimmunoassay for 15-keto13,14-dihydro-thromboxane B2 was developed using a monovalent iodinated tracer. The radioimmunoassay was used to determine levels of 15-keto-13, 14-dihydro-thromboxane B2 in guinea pig plasma after injection of histamine and during anaphylactic shock.


Effects of prostaglandins on peripheral nociceptors in acute inflammation. The effects of different prostaglandins were determined on (a) the hyperalgesia produced by subplantar injections of yeast given into the hind paws of weanling rats, and (b) the reflex vasopressor responses to bradykinin (BK) injected dose-arterially into the spleen of anaesthetised cats and dogs. In the rat prostaglandins (E1 greater than E2 greater than F2 alpha = F2 beta=A2=D2=I2O) injected into the same paw either with the yeast or 25 min later reduced the latency to the onset of hyperalgesia. In the cat and dog prostaglandins (E1 greater than E2 greater than F2 alpha greater than or equal to F2 beta greater than A1=A2=O) potentiated vasopressor responses to BK and reversed the inhibition of BK responses by indomethacin. It is likely that prostaglandins sensitize peripheral nociceptors through a specific prostaglandin receptor.


[H.R.P.-System 2000: a new universally applicable ventilation system for single or limited multiple use with high bacteriologic-hygienical safety (author's transl)]. A new bacteriologically safe system for artificial respiration, H.R.P.-System 2000, is presented. Only two different SETS for artificial respiration of prematures, newborns and infants (P.N.J.) and adults, children and todlers (A.T.) are necessary. They can be adapted very easily on different types of respirators. Besides the tubing and expiratory valve the H.R.P.-SETS include a highly efficient electronically controlled humidifier working on the principle of gas bubbling through a heated water bath, a special tracheal tube adapter with an automatic water exhaust and flexible gas-reservoir for manual ventilation as well as C.P.A.P. or I.M.V. therapy. The H.R.P.-SETS are available as steril disposables. Resterilisation with gas on several occasions is possible. In a control study on thirty children, mainly premature infants and newborns a conventional SET, similar to the Bennett respiration system with disposable tubing and the H.R.P.-SETS are compared under the conditions of our intensive care unit. Using the criteria of serial bacteriological examinations of the tracheo-bronchial secretions and clinical criteria, H.R.P.-SETS proved superior. Artificial respiration without bacterial contamination by hospital strains for more than 10--14 days seems to be possible as a routine in newborns and children.


Cell ultrastructure during the development and the transformation of a pig--uterine tube cell line. Observations by electron microscopy disclosed ultrastructural features which were not apparent by light microscopy during the three stages of the development of a pig uterine tube cell line. Ciliated cells without dynein arms were found naturally occurring in the first 100 subcultures (pseudo-diploid stage). They were not observed in the routinely growing cultures after the concomitant detection of the first chromosome marker and expression of a type C virus, unless the cells were treated with estradiol (transformed stage). Gap junctions and increased numbers of lamellar and lysosomic bodies and vacuole-like structures were observed in clusters of tumoral cells in the high subcultures if a new chromosome marker occurred (malignant stage). Type C viruses were found as early as the 106th subculture (transformed stage) in populations of actively dividing cells 3 days after seeding, but not in populations of nondividing cells a week after seeding. Both viruses and viral reverse transcriptase were continuously released in the 300 subsequent subcultures.


[Acute myeloid leukemia with megakaryocytic predominance and malignant megakaryocyte proliferation. Apropos of 3 cases]. Three cases of acute myeloid leukemia with megakaryocyte predominance are reported. In the first case megakaryocytosis was particularly evident in bone marrow, liver and spleen. In the second case high content of megakaryocytes was observed in the bone marrow and spleen, during the preleukemic phase only. Third case exhibited a strong predominance of megakaryocytes exclusively within the bone marrow. The characteristics of such observations and their nosologic position within myeloproliferative disorders group are discussed, with special reference to modern views concerning myeloid leukemia.


Evidence of a mixed population from uterine tube epithelium in a continuous line of pig cells. The pig uterine tube (PFT) cell line is composed of a mixed population which is undifferentiated. However, specific markers indicating the original tissue of the uterine tube were shown if cells differentiated into epithelial cells forming spheroids in the 254th subculture. Ciliated and secretory cells, and cells with a basal lamina and interstitial collagen were observed in the spheroids. Microlumina found in the spheroids appeared morphologically similar to the lumen of the uterine tube. These observations indicate that undifferentiated cells can multiply in vitro and keep their potentiality of differentiation for future expression. It is proposed that the PFT cell line was partly derived from epithelial cells originally harvested from the PFT.


Long-term mortality experience of chrysotile miners and millers in Thetford Mines, Quebec. Among a cohort of 544 men with at least 20 years of employment in chrysotile mining and milling at Thetford Mines, Canada, 16% of the deaths were from lung cancer and 15% from asbestosis. The excess over expected deaths from these causes account for 43 of 178 deaths in the group. The risk of death of asbestosis, at equal times fron onset of exposure, is very similar in miners and millers, factory workmen and insulators. The ratio of observed to expected deaths from lung cancer is similar in the miners and millers and factory workers, but higher in insulators. The risk of death of mesothelioma in miners and millers is decidedly less than the other two groups. The exact causes of the reduced risk in this category are not yet completely clarified.


Asbestos exposure: factors associated with excess cancer and respiratory disease mortality. A cohort of 1075 men who completed their working lifetimes with an asbestos company, worked at a facility in the United States, and retired with a company pension during the period 1941--67 was updated for deaths through 1973. The average length of employment was 25 years, and all had been exposed to asbestos dust. Respiratory cancer and pneumoconiosis-pulmonary fibrosis mortalities were examined in relation to cumulative dust exposure and to other factors after taking into account cumulative dust exposure. Men who worked in the production of asbestos cement pipe exhibited a higher risk of respiratory cancer, as did men with some crocidolite asbestos exposure. Because these two groups overlap, we could not be certain that crocidolite asbestos was responsible for the increased risk. Men working in general plant maintenance displayed a striking lack of deaths due to pneumoconiosis-pulmonary fibrosis, as compared with production workers and with maintenance personnel assigned to specific departments. Five mesothelioma deaths were observed at age 65 and over. Three of these deaths occurred during the period 1970--3.


Asbestos disease in maintenance workers of the chemical industry. In several large groups of workers employed in chemical plants, chest x-ray abnormalities (small irregular opacities and/or pleural changes) of the type known to be induced by asbestos were found in a proportion of those examined. A cross-sectional study of maintenance workers in a large chemical plant was undertaken to evaluate the prevalence of asbestosis; 185 workers were examined. Radiologic evidence of parenchymal interstitial fibrosis was found in 24% of those examined; in 10% of workers, parenchymal fibrosis was the only abnormality. Pleural fibrosis and/or calcification was found in the absence of parenchymal fibrosis in 14% of cases; in another 14% of workers, both parenchymal and pleural abnormalities were detected. The prevalence was significantly higher in those employed 20 or more years. Pleural abnormalities were more prevalent than were parenchymal changes. The increased risk of lung cancer and mesothelioma remains to be studied.


Asbestos risk among full-time workers in an electricity-generating power station. A matched survey of 55 full-time workers probably exposed to asbestos in an electricity-generating power station (exposed group) and of 53 unexposed workers in an automobile plant has been conducted. The asbestos risk in the power station was confirmed by the presence of airborne fibers in the range 0.1--6000 X 10(-9) g/m3 in the air sampled during the survey period and by the presence of FB in the sputa of 32.7% of the workers. The following parameters were significantly related to asbestos exposure in the study group: FB in the sputa, localized rectitude of the diaphragm, pleural thickening, pleural calcification, and the chest pain. Moreover, for all persons studied, gastrointestinal symptoms and recent hoarsening of the voice were significantly related to the number of FB in the sputa.


Clinical measurement in Quebec chrysotile miners: use for future protection of workers. There is a relationship between dust exposure, on the one hand, and serious disease and death, on the other, in chrysotile asbestos mine and mill workers of Quebec. Studies in current working populations indicate that prevalence of abnormality increases with increasing exposure. However, the relationship is weak and offers only a partial explanation of between-subject variability. In addition, there is no certain way to detect or predict change. Because of the relative nonspecificity of the health measurements examined and their poor relationship to exposure, control should be based on environmental monitoring, with biologic monitoring considered in a complementary role. This leaves the clinician with the dilemma of how best to advise the worker in whom questionable changes have been detected. At present, there appears little doubt that the decision must remain essentially clinical, based, on one hand, on all available information about the man, his job, and the plant or mine in which he works, from which an estimate of likely outcome must be made, and, on the other hand, on the social and human factors concerned, including the fact that removal from exposure does not necessarily prevent the appearance of abnormality.


Mesothelioma incidence in a Dutch shipyard. On Walcheren Island (the Netherlands), 25 cases of mesothelioma were diagnosed from 1962 to 1968. In 22 cases, there had been an occupational association with Royal Schelde, the shipyard in Vlissingen. A relationship with exposure to asbestos, frequently used in shipbuilding in the past, could be demonstrated. Further observations showed the expected increase of mesothelioma cases in Royal Schelde workers. In 1974, the number of cases totaled 42; in 1978, the number rose to 57. In addition, five more recent cases have not yet been confirmed histologically, but the clinical symptoms are unmistakable. In seven of 12 mesothelioma cases on Walcheren Island that had no association with Royal Schelde, asbestos exposure in the occupational history could also be traced. Finally, a few facts are mentioned about the recent Dutch Asbestos Act.


Radiographic search for asbestos-related disease in a naval shipyard. The Long Beach Shipyard underwent a chest x-ray survey of 6640 employees, or 88.6% of the total shipyard population, to determine the level of asbestotic changes. For computer classification purposes, the findings were divided into five groups: abnormal findings consistent with inhalation of asbestos fiber; normal; pulmonary fibrosis, nonspecific, questionable; and other findings not related to asbestosis. Asbestos-related abnormal findings, were encountered in 1061 workers, or 16.0%. No change was noted in 4806, or 72.4%. Pulmonary fibrosis was encountered in 140, or 2.1%. Other abnormalities not related to the inhalation of free asbestos fiber were encountered in 624, or 9.4%. The interpretation was questionable in nine individuals, or 0.1%. Of the male employees, 17.2% were positive for asbestos-related chest x-ray changes, and four women, or 0.8%, showed comparable findings. Of the men, 71.5% had normal chest x-rays, and 83.3% of the 402 women demonstrated normal films. Positive x-ray changes for asbestosis were encountered in a linear relationship when viewed by age of the worker. Employees aged 25--29 years exhibited 1.3% positive findings, and this level increased to a maximum of 38.2% positives among workers aged 65 years and over. Normal chest films descended, conversely, in a linear relationship. Similarly, the percentage of positive findings for asbestos-related disease increased in a linear configuration with length of service. Persons with 2--6 years of asbestos contact displayed 12.4% positive findings, while individuals with 22-26 years of work at the shipyard manifested 37.0% positive chest film findings. Although the shipyard was operational between 1943 and 1949, the system of allocation of badge numbers precludes the inclusion of these 7 years of work among persons who had had at least 26 years of service. When studied by work site, dividing the subjects into production and nonproduction personnel, it was found that production workers accounted for 74.5% of the asbestos-positive films. Overall, the 780 production workers manifested 11.8% of the positive findings of all persons studied, while nonproduction employees accounted for 4.1% of the positives out of the population studied. A figure that approximates the total finding of asbestos-related disease is 16.0%.


Risk of asbestosis in crocidolite and amosite mines in South Africa. X-rays of all while and mixed-race men employed in crocidolite and amosite mines and mills were read independently by three experienced readers according to the ILO U/C classification. Abnormality was regarded as present if reported by two or more readers. Parenchymal abnormality, defined as the presence of small irregular opacities of profusion 1/0 or greater, was found in 7.3% of the workers. Pleural thickening was found in 4.5% of the workers, costophrenic angle obliteration in 3.2%, and pleural calcification in 1.7%. The prevalences of both pleural and parenchymal abnormality were strongly related to the duration of exposure to asbestos at work. The overall prevalence of abnormality increase from 4.0% in men with exposure for 1 year or less to 47.9% in men with more than 15 years of exposure. After taking into account the effects of age and duration of asbestos exposure, the prevalence of pleural abnormality was not predicted by fiber concentration. However, white men working with amosite tended to develop a higher prevalence of pleural abnormality than did those working with crocidolite. Compared to whites, men of mixed race, who only work with crocidolite, had a high prevalence of pleural abnormality in each exposure duration category. In contrast to pleural abnormality, the prevalence of parenchymal abnormality, after taking into account the effects of age and duration of exposure, was significantly predicted by fiber concentration but not by race or asbestos type. Our results suggest that parenchymal abnormality in workers in South African asbestos mines could be largely prevented by reducing exposure to fibers visible under the light microscope. However, this may not be the case for pleural abnormality.


Levels of asbestos air pollution in some environmental situations. Asbestos contamination of the outside aid in Paris and suburbs has been monitored in some environmental situations, namely, "typical" urban sites removed from known sources of asbestos emissions, crossroad locations, the vicinity of a freeway, areas with buildings under construction, and areas around asbestos factories. In the same manner, measurements have been performed inside buildings of various types: those sprayed with asbestos-containing materials, those fitted with asbestos products, and control buildings. Air has been sampled by use of 0.45 micrometer pore size Millipore filters. After low-temperature ashing, ultrasonicated ashes were transferred to carbon film on 200-mesh gold grids examined under an analytic transmission electron microscope. Levels of pollution were expressed in terms of gravimetric concentrations. Inside buildings, when the air was in contact with significant amounts of asbestos-containing materials (spray, sheets), the levels were in the range 0.1--1000 10(-9) g m-3. In the vicinities of asbestos plants, the concentrations were higher: 1000--3000 10(-9) g m-3. Under other circumstances, the levels were of the same order of magnitude: 99% of the values were below 7 X 10(-9) g m-3. The Conseil Supérieur d'Hygiène Publique de France proposed a numerical ambient air quality standard of 50 X 10(-9) g m-3 inside buildings sprayed with asbestos.


French mesothelioma register.

French mesothelioma register. A total of 197 definite cases of mesothelioma (mainly of the pleura) have been reported by pathologists to the French Mesothelioma Register for the period 1965--78. A moderate linear increase in the annual incidence of mesothelioma cases since 1965 was noted. In men and women over the ages of 47 and 41 years, respectively, the annual death rate was higher in those with mesothelioma than in those of the general population. The proportions of mesothelioma patients who had experienced occupational, para-occupational, and unknown asbestos exposures were 77%, 3%, and 20% respectively. The number of cases reported to the register is obviously an underestimate of the true number of mesothelima cases in France, because such cases are not reported to the register systematically. Mesothelioma registers cannot provide information about dose-response relationships; however, with good management of the register, such relationships could be obtained, since a good assessment of dose can be accomplished by biologic monitoring.


The contamination of Lake Superior with amphibole gangue minerals. Iron ore called taconite is mined in the Biwabik Iron Formation in the Eastern Mesabi region of the Mesabi Range, in eastern Minnesota. After mining, ore is shipped to Silver Bay, Minnnesota for processing and wet magnetic extraction. Tailings from the process are dumped, as a slurry, into a man-made containment delta constructed in Lake Superior. Submicroscopic amphibole fibers and/or cleavage fragments, a component of the gangue, apparently escape from the delta at Silver Bay, and enter Lake Superior. These particles contaiminate the potable water supplies of municipalities drawing directly from the lake. One of the gangue minerals is the amphibole grunerite, whose asbestiform variety is called amosite. Major emphasis of this study was directed at identification of submicroscopic particle pollutants, based on morphology, structure and chemical composition. Quantitative determination of fibrous amphibole phases, present in a range of water samples, was undertaken. Transmission electron microscopy, selected area electron diffraction, and an electron microprobe technique was used for identification and enumeration and this information was compared with data sets determined from standards. Grunerite fiber and/or acicular cleavage fragments, in some instances indistinguishable from asbestiform grunerite, are present in the tailings, lake water and drinking water of a number of municipalities, a result of contamination of the lake at the Silver Bay milling operation. This amphibole is found in drinking water in concentrations which range from 0.6 to 2.8 X 10(6) fiber/liter. The risk to health, associated with direct ingestion of grunerite fiber is unknown and is extrapolated from the asbestiform grunerite (amosite) data base. The biological activity of other fibrous amphiboles observed, unrelated to any asbestiform silicate variety, is presently unknown and warrants investigation.


Indoor asbestos pollution: application of hazard criteria. Asbestos contamination of relatively contained environments within structures can occur under many conditions and in association with various activities. Such contamination persists and can potentially expose all structure users. The more significant contamination levels are associated with disturbance of friable asbestos-containing materials, although bonded material is also capable of fiber dissemination under special conditions. Application of occupational government standards for limitation of exposure, both presently in force and proposed or recommended, indicates that levels found in some situations exceed those considered potentially carcinogenic.


Influence of crystallization habit of minerals on in vitro cytotoxicity. Four samples of cummingtonite-grunerite series in various crystallization habits were tested in vitro. The cytotoxicity to Chinese hamster ovary cells and hemolysis to sheep erythrocytes were inversely proportional to the structural faults and surface defects of the minerals. At a comparable surface area, asbestiform grunerite (UICC amosite), semi-asbestiform cummingtonite, acicular cummingtonite, and acicular grunerite were found to be cytotoxic and hemolytic in a decreasing order. The influence of particle size on hemolysis and cytotoxicity was observed with acicular grunerite. Although samples of relatively large particle size were found to be inert, samples of smaller particle size were cytotoxic as well as hemolytic. No apparent relationship between surface charge and hemolysis as well as cytotoxicity was observed.


Fiber dimensions and aspect ratio of crocidolite, chrysotile and amosite particles detected in lung tissue specimens. Chrysotile, amosite and crocidolite fibers detected in autopsy tissue specimens from cases of mesothelioma and controls have been characterized by particle length, diameter and aspect ratio using a transmission electron microscope. The pooled information from such specimens reveals that the fibers of each mineral type detected in biological material have very different physical characteristics although in all samples fibers less than 5 microns in length are predominant by number while fibers over 25 microns in length are found very infrequently. Chrysotile fibers on average appear as the shortest fibers with the most fine diameter distribution, amosite fibers are on average the longest with the most coarse diameter distribution, crocidolite fibers on average have dimensions which are intermediate between both chrysotile and amosite. The percentage number of fibers of chrysotile, amosite and crocidolite detected with an aspect ratio less than or equal to 10 were 31.7%, 24.2% and 18.5% respectively.


Human and experimental data on translocation of asbestos fibers through the respiratory system. The translocation of fibrous dusts through the respiratory system is discussed on the basis of human and experimental data obtained with the transmission electron microscope. Comparison of the characteristics (numerical and mass concentrations, sizes, types) of asbestos fibers retained in different locations of the respiratory system in humans exposed to asbestos has shown that there is no relationship between the numerical concentrations in lung parenchyma and those in parietal pleura. Moreover, almost al fibers encountered in the pleura were ultimate, short fibrils of chrysotile. The animal data are from rats injected intrapleurally with different types of fibers (chrysotile, crocidolite and glass fibers) and sacrificed at different times. There was a progressive increase in the number and mass of fibers translocated into lung parenchyma from the pleural cavity that was particularly obvious after 90 days. After this time, the mean length of fibers, especially chrysotile, increased, indicating that more long fibers are retained in alveolar tissue than short fibers.


Endodontic treatment of primary teeth.

Endodontic treatment of primary teeth. Endodontic treatment of primary teeth is undertaken by indirect pulp capping, direct pulp capping, formocresol pulpotomy and pulpectomy. The same treatment principles apply to both primary and permanent teeth with infected or necrotic pulps. The main differences are the use of formocresol for root canal medication and a resorbably zinc-oxide and eugenol paste for root canal obturation.


Assessing the effectiveness of dental health education in the South Australian School Dental Programme. Approximately 25--30 per cent of operational time in the School Dental Programme is assigned to dental health education, representing a sizeable investment of public resources. If the full potential of dental health education is to be realized, the respective effectiveness of various dental health education activities need to be identified so that the more effective activities can be emphasized and developed further. As an essential prerequisite there is a need to refine the evaluation process by introducing: (1) improved dental indices; (2) improved methods of classifying and maintaining records of the dental health education activities undertaken; (3) better methods of quantifying dental care items and other social and environmental covariables; and (4) more sophisticated forms of multivariate analysis.


Australian aboriginal studies. 1. The effect of socio-economic changes on the prevalence of caries in 6-14 year-old children resident at Bathurst Island and Groote Eylandt in the Northern Territory of Australia, 1971. Investigations carried out on 6--14 year-old Aboriginal children resident at Bathurst Island and Groote Eylandt showed that the Groote Eylandt children had a higher prevalence of dental caries at statistically significant levels. This difference in prevalence was attributed to the greater financial affluence at Groote Eylandt.


Neuropathies and myopathies.

Neuropathies and myopathies. The manner of dealing with this subject is to be strictly clinical and practical. Classifications will not be all-embracing but will include only those conditions likely to be encountered at some time in the career of the ordinary family practitioner. Only occasionally, in the interests of clarity, will an uncommon disorder receive brief mention. The amphasis will be on bedside diagnosis; electrodiagnostic tests will not be described.


Polytetrafluoroethylene (PTFE) grafts for haemodialysis: patency and complications compared with those of saphenous vein grafts. A comparison has been made between polytetrafluoroethylene (PTFE) and saphenous vein as graft material for the construction of arteriovenous fistulas for use in haemodialysis. Fifty patients with PTFE grafts have been examined and compared with 70 patients with saphenous vein grafts. At eighteen months the accumulative patency rate was 69.8% for PTFE grafts and 68.9% for saphenous grafts. Although the PTFE grafts were similar in terms of patency, their complication rate was higher. The infection rate and distal ischaemia rate for PTFE grafts were double those of the vein grafts. Two patients developed median and ulnar nerve paralysis respectively shortly after implantation of PTFE grafts. Because of this it is recommended that their use be restricted to the lower limb. Despite a higher incidence of complications, PTFE grafts are a satisfactory substitute if a suitable saphenous vein is not available.


A comparison of proximal with distal arterial reconstruction in the treatment of advanced lower limb ischaemia. Elective arterial surgery for lower limb ischaemia due to chronic occlusive disease has been performed in 212 patients over a five-year period. Of this group, 93 patients were treated for limb-threatening ischaemia. The remainder were treated for intermittent claudication. The clinical and haemodynamic responses to surgery are analysed in this series of 93 patients. The results of proximal reconstruction, in terms of a living patient with patent graft and functional limb, were significantly better (75%) at one year than in patients undergoing distal segment reconstruction (45%). Successful aortoiliac surgery was associated with a mean increase in the ankle systolic pressure index of 0.36, comparied with 0.46 in the distal reconstruction group.


Microvascular techniques in reconstruction following major resections for cancer of the head and neck. Thirteen microvascular free tissue transfers have been used for reconstruction of defects in the head and neck following cancer ablation. These procedures have produced a more rapid repair than conventional techniques and have allowed use of more appropriate tissues than are available locally.


Another look at keratoacanthoma.

Another look at keratoacanthoma. In a retrospective survey over a three-year period there were found 199 patients with keratoacanthoma among 3,180 patients with malignant skin disease. The clinical features of the series are presented, with particular attention to the diagnostic error. Amongst experienced clinicians there was an 8.5% error in calling an invasive squamous cell lesion a keratoacanthoma. Pertinent features of the clinical nature of keratoacanthoma with particular reference to immunological surveillance are discussed.


Evaluation of an intraoperative test for the completeness of vagotomy. An intraoperative test for the completeness of vagotomy has been evaluated in 103 consecutive operations, including proximal gastric, selective and truncal vagotomies, and truncal vagotomy with antrectomy. At the completion of the vagotomy a pH probe was used to test gastric mucosal response to an intravenous infusion of pentagastrin, aiming to detect undivided vagal fibres by localizing residual areas of acid secretion. Testing was performed in 86 out of 103 vagotomies, and in only 34% was the vagotomy judged complete at the first attempt. Residual areas of acid secretion (usually small) were detected in the remainder, and in early all of these it was possible to abolish these areas by dividing further vagal fibres. It is suggested that intraoperative pH testing improves the likelihood of a complete vagotomy. The test is also useful to plot precisely the antral-body junction when antrectomy is combined with vagotomy.


A pattern of local recurrence following resection of colorectal cancer. Twenty patients (10%) developed a local recurrence following 200 consecutive curative resections for colorectal carcinoma. Analysis of the pathology of the primary tumours suggests that invasion of adjacent tissues, and lymph node involvement, were more important presection on the mucosa. The average time interval between resection and diagnosis of local recurrence was 17 months. The average survival time following diagnosis was 10 months. Nineteen out of 20 of these patients developed evidence of disseminated disease subsequent to the diagnosis of local recurrence. The most effective palliation occurred in patients in whom the local recurrence could be resected.


Primary sarcomas of the jaw.

Primary sarcomas of the jaw. Nine cases of primary sarcoma of the jaw seen over a period of 14 years are presented. They consisted of four osteosarcomas, three fibrosarcomas, one myxosarcoma and one Ewing's sarcoma. The treatment of choice for osteosarcomas of the mandible is hemimandibulectomy with disarticulation at the temporomandibular joint. Bone graft reconstruction from the iliac crest should be done at a second stage. Palliative maxillectomy for extensive fibrosarcoma of the maxilla served to relieve one patient of local symptoms for more than a year. Myxosarcoma, a variant of fibrosarcoma, and Ewing's sarcoma of the jaw, are very rare conditions, and since these lesions are usually very extensive radiotherapy is the treatment of choice.


Cerebral metastatic melanoma presenting as spastic paraparesis. A case of bilateral deposits from melanoma in the posterior frontal parasagittal region of the brain is recorded. A mechanism to explain the mode of spread is suggested. C.T. head scanning in patients with disseminated malignancy should be considered prior to invasive investigations or major surgical procedures.


Interhemispheric subdural haematoma following head injury. A case of interhemispheric subdural haematoma following head injury is reported. The clinical and computerized axial tomographic (CT) features of this unusual complication are described together with the surgical management.


A method for the operative treatment of chronic ischaemia of the gut. A method of revascularizing the coeliac axis or its branches, and the superior mesenteric artery, is described. A saphenous vein graft is brought from the lumbar aorta behind the pancreas to the recipient host artery. Two illustrative patients' histories are presented.


The development of the circle technique for determining the optimum line of tumour excision. The healing of skin wounds is markedly influenced by their relationship to the tensional forces in the skin. Directional variations in skin extensibility which give rise to the cleavage line phenomenon and the skin tension lines are easily visualized by a recently developed skin marking technique. This technique makes it possible to plan accurately the optimum line of excision of skin tumours, including malignant melanomata, so as to allow primary linear wound closure without the necessity of undermining or grafting. The technique is particularly applicable to the excision of tumours of the back and limbs, and in addition, provides a warning if the local skin tensional state makes primary closure hazardous.


Transplantation of organ cultured rat parathyroids. The hypothesis that tissue culture alters the immunogenicity of grafts by removal or inactivation of passenger leucocytes has been investigated in an inbred rat parathyroid allograft model. DA rat (Ag-B4) parathyroid glands cultured for up to three weeks in Eagle's minimal essential medium (MEM) alone, or MEM with added donor-specific antilymphocyte serum, did not survive longer than fresh glands when allografted into Lewis rat (Ag-B1) recipients. Subsequent in vitro comparisons of three different culture media established that RPMI 1640 was superior to MEM and Medium 199 for rat parathyroids. However, further series of transplants after culture in RPMI 1640 alone also failed to produce prolongation of allograft survival.


Coronary haemodynamics and myocardial metabolism during cardiopulmonary bypass. An experimental animal preparation is described which has allowed us to determine coronary haemodynamics and the overall myocardial metabolic rate of the disease-free, beating, normothermic heart during total cardiopulmonary bypass. We have confirmed that under these conditions the required coronary blood flow is about 50ml/min/100g myocardium, which can be achieved at a low perfusion pressure (60 mm Hg or 8 kPa), and that overall myocardial metabolism is represented by an oxygen utilization of just over 2 ml/min/100g. We have also defined the associated dynamic parameters which characterize oxygen transport in the coronary circulation during bypass. By controlling coronary perfusion, analogous in a clinical setting to selective coronary perfusion, we have demonstrated a simple linear correlation between perfusion pressure and coronary flow, indicating a "fixed" coronary vascular resistance. Under these conditions the myocardial oxygen uptake rises towards a maximum of 4ml/min/100g with the expected associated changes in the parameters characterizing oxygen transport in the coronary circulation. These trends are postulated as being a reflection of alterations in regional myocardial perfusion. By extrapolating to the clinical situation, these data have appeared to give valid information concerning the adequacy of coronary perfusion.


Isolated liver perfusion: the choice of anaesthetic. Perfused livers isolated from rats under halothane anaesthesia produced greater amounts of bile, released smaller amounts of aspartate aminotransferase, and had a much greater ability to maintain a constant concentration of glucose in perfusates than those obtained with ether or pentobarbitone. Little or no effect was shown on the ability of the liver to synthesize urea and to retain potassium within the organ. It appears, therefore,that halothane is the anaesthetic of choice when removing the liver from the laboratory rat.


Changes in liver blood flow with development of biliary obstruction in the rat. As well as causing retention of biliary secretory products, bile duct obstruction is associated with other hepatic and systemic effects which are poorly understood. These latter changes contribute to the increased morbidity and mortality associated with surgery for biliary obstruction. This study examines the changes in liver blood flow occurring after common bile duct (CBD) ligation in the belief that relative hepatic ischaemia may contribute to dysfunction. A new method for measuring liver blood flow (LBF) based on the clearance of 133Xe from the liver following injection into the portal vein is described. With this new development, serial measurements of LBF can be performed in the conscious, unfasted rat. With the development of jaundice, a highly significant reduction in LBF is seen which is first evident 36 hours after CBD ligation. By the third day after ligation, LBF is only 54% of the control value. No fall in LBF is seen in rats subjected to sham ligation. The mechanism for the reduction in LBF is uncertain, but the delayed onset makes any relfex autonomic reaction unlikely.


Intraoperative and postoperative changes in peripheral white blood cell counts: the contribution of stress. The effect of major surgery, blood loss and psychological stress on the peripheral white blood cell (WBC) populations of human patients and healthy volunteers was examined. During, and in the hours immediately after, major surgery, there was a highly significant fall in the numbers of circulating lymphocytes (mean congruent to 30%-60%) and a highly significant decrease in polymorphs (mean congruent to 160%-350%). Blood loss and psychological stress are not major factors contributing to this fall in peripheral blood lymphocytes in the human, as blood donors and invididuals under temporary stress (anxiety about an imminent dental procedure or an important examination) showed no change in their peripheral blood lymphocyte levels in the hours immediately after these experiences. Significant increases in circulating polymorph numbers, however, accompanied procedures involving even slight tissue trauma, e.g. following blood donation and tooth extraction, but did not occur after psychological  stress alone, and were much smaller (congruent to 20%-55%) than those occurring after major surgery. Thus, apart from the complex question of anaesthesia, the nature of the surgical procedure, probably, that is, the degree of tissue trauma involved, is the most important trigger determining changes in the circulating WBC counts after operation.


Retardation of healing of large-bowel anastomoses by 5-fluorouracil. Experiments were performed to test the hypothesis that 5-Fluorouracil (5-FU) would delay or prevent healing of large-bowel anastomoses. The caecums of 120 specific-pathogen-free rats were transected and reanastomosed at once. Daily intravenous injections of 5-FU were given to half the rats, the other half being controls and receiving an equal volume of saline. At Days 5, 7 and 10, standard-sized sections of sutire line were pulled apart, and the  force required to do this was recorded. At five days the strengths of the anastomoses in the 5-FU treated animals were only 25% of that of the controls, but by ten days they were over 60% of the strength of the controls. It was concluded that 5-FU delayed, but did not prevent, healing, and that it would be safe to use it in the early postoperative period, but not until several days after operation.


Marrow relapse on maintenance chemotherapy in childhood acute lymphoblastic leukaemia. A retrospective study on 190 children with acute lymphoblastic leukaemia and marrow relapse on therapy demonstrated a universally poor prognosis with a high risk of extramedullary leukaemia. 49.1% of children achieved a second remission, the median duration of haematological remission being 97 days. The median duration of survival was 157 days, with no survivors beyond 2 years 3 months from relapse. Children with high white blood counts at diagnosis, those relapsing early and older children had a particularly poor prognosis. Children who achieved a first remission with difficulty and those receiving regular vincristine and prednisolone in their remission were less likely to achieve a second remission. Those who failed to go back into remission with the more commonly used drugs were not usually responsive to other drugs.


Induction of myeloid leukaemia by whole-body single exposure of CBA male mice to x-rays. A curvilinear dose response of myeloid leukaemia induction in the CBA male mouse was obtained after single whole-body X-irradiation at about 3 months of age. This strain has a very low spontaneous incidence of the disease and no cases were found in the unirradiated controls. The incidence was independent of dose rate over the range used (4.2-552 rad/min). Diagnosis required histopathological examination of various body tissues, the gross anatomical changes being easily confused with other haemopoietic disorders, but a few cases were recognized in life from blood samples. Curve-fitting to various models based on theories of radiocarcinogenic mechanism is described.


Ultrastructural localization of peroxidases in 'undifferentiated' blasts during the blast crisis of chronic granulocytic leukaemia. Twelve cases of Philadelphia chromosome positive chronic granulocytic leukaemia (CGL) in blast transformation have been investigated using ultrastructural peroxidase detection. In all cases, the leukaemic blasts were negative for myeloperoxidase on the basis of standard cytochemistry. In nine cases a variable proportion of blasts contained peroxidase activity detectable only by electron microscopy, permitting definition of their myeloid nature. By their distinct characteristics and localization, different peroxidase activities were recognized. Thus, several types of blasts were identified: megakaryoblasts (MKB), basophil promyelocytes (BPM), myeloid blasts with small granules containing peroxidase (MyB), and proerythroblasts (ProE). MKB were predominant in two cases and present in four cases, mixed with other myeloid blasts. BPM were abundant in one case and present in seven cases. MyB were identified as a majority in four cases. Three cases remained without any peroxidase. It is concluded that ultrastructural detection of peroxidases is of value for the identification of early myeloid blasts. Their high incidence and the simultaneous presence of several myeloid precursors suggest that during the blast crisis the target cell is frequently a pluripotent myeloid stem cell.


Leucine incorporation into leukaemic blast cells. The incorporation of 3H-leucine as an indicator of protein synthesis has been studied of blast cells in acute leukaemia and of proliferative normal bone marrow cells. The results demonstrate a significantly higher 3H-leucine incorporation into normal immature cells as compared to leukaemic myeloblasts, also 3H-leucine labelling of lymphoblasts was significantly lower than both the values found in acute leukaemia and normals. Higher protein synthesis was found correlated to the degree of cell immaturity. No significant correlation between 3H-leucine labelled and 3H-thymidine labelled leukaemic blast cells was achieved. A marked decrease in 3H-leucine incorporation by puromycin was demonstrated in three patients with acute myeloid leukaemia.


A new nitrogen-fixing Clostridium species from a high Arctic ecosystem. A hitherto undescribed species of yellow-pigmented, Gram-negative Clostridium sp., possessing nitrogenase activity, has been isolated from a number of sampling sites on the Truelove Lowland of Devon Island in the Canadian high Arctic. This bacterium, tentatively designated Clostridium arcticum sp. nov., accounted for 19% of all isolates recovered which were capable of anaerobic nitrogen fixation.


Phase II study of VP-16-213 in childhood malignant disease: a Children's Cancer Study Group Report. VP-16-213, a semisynthetic podophyliotoxin, was tested for antitumor and clinical toxicity in 126 children. The drug was administered iv daily x 5 days every 2 weeks at a starting dose of 75 mg/m2/day. The dose was increased by 25 mg/m2/day/course until clinical response or significant toxicity occurred. The only major toxicity was hematologic, with neutropenia as the most predominant feature. There was one local allergic reaction at the site of injection. No systemic allergic responses were reported. The drug demonstrated significant activity in acute myelomonocytic leukemia with four responses among 19 patients, less activity in acute myelocytic leukemia with two responses among 44 patients, and little activity in acute lymphocytic leukemia with only one partial response among 12 patients. Objective partial responses occurred in ten of 48 patients with solid tumors: two each with Wilms' tumor, lymphoma, and histiocytosis X, and one each with rhabdomyosarcoma, neuroblastoma, Ewing's sarcoma, and undifferentiated carcinoma. The inclusion of VP-16-213 in combination chemotherapy for childhood acute myelomonocytic leukemia and acute myelocytic leukemia appears indicated in patients relapsing after initial therapy. For solid tumors this is an interim report, with further patient accrual required before specific comments can be made.


Phase II trial of vindesine in patients with acute leukemia. Vindesine was administered to 18 patients with acute leukemia who had failed conventional chemotherapy. Each course of therapy consisted of an iv bolus infusion at a dose of 1-2 mg/m2 given daily x 5-10 days. Of 13 patients with acute lymphoblastic leukemia, two had partial remissions which lasted 2 and 3 months and five had minor responses. One of three patients with acute nonlymphoblastic leukemia and one of two patients with blastic crisis of chronic myelogenous leukemia each had a minor response. The data suggest that vindesine has activity in the treatment of acute leukemia.


Treatment of blast cell crisis of chronic myeloid leukemia with ICRF-159 (razoxane). Eleven patients with myeloid blast cell crisis and two patients with lymphoid blast cell crisis of chronic myeloid leukemia were treated with ICRF-159. Two of the patients with myeloid blast cell crisis achieved partial bone marrow remission and survived for 8+ and 18 months. One of the patients with lymphoid blast cell crisis reverted to the chronic phase of chronic myeloid leukemia after therapy with ICRF-159 in combination with prednisolone. The only significant toxic effect was myelosuppression.


Hereditary angioedema: lack of close linkage with markers on chromosome 6, with data on other markers. Members of two Australian families with type A Hereditary Angioedema (HAE), having affected individuals in three generations, were typed for a large number of genetic marker systems in a search for close linkage with the locus controlling C1 inhibitor (C1 inh). The evidence from both families indicated lack of close linkage with HLA or with the loci for Bf and GLO on chromosome 6. Very close linkage was also excluded between the locus for C1 inh and the loci for 6PGD, PGM1 and MNSs. The other markers were not informative, but data on all systems showing variation are reported. The publication of similar data for other kindreds will help to determine lod scores for the probability of linkage between the C1 inh locus and loci controlling common protein polymorphisms. Linkage studies of this kind could establish whether the loci controlling type A and B HAE are identical or separate.


[Histocompatibility of porous ceramics in the jaw bones of Cavia cobaya]. Porous ceramic basically fuses hard in osseous connective tissue of the jaw if closed implantation has been successful. The date were derived from ground serial sections in different postoperative intervals. Light, fluorescence (after intravital staining), and scanning electron microscopy were used for the evaluation. The positive results obtained with this test series do not imply that porous ceramic material used as root replacements persists under normal masticatory stress and in the same type of tissue.


[Expertise in prosthetics--expert testimony in the courts]. Expert opinions are usually requested by the courts when the dentist is the plaintiff. The patient must provide the dentist with an opportunity to rectify possible defects. The assessment is based on whether or not the prerequisites necessary for successful treatment were present at the time of insertion. The number of lawsuits involving bridgework is increasing.


[Stress on cast dowel constructions dependent on various means of preparation]. Comparative tests of stress exerted on dowel constructions with secondarily attached crowns were carried out in 60 plastic roots. With one half of the roots, the final preparation was first determined after the dowel construction was inserted; a circular shoulder was uniformly sunk. The margin of the crown and the dowel construction therefore were not at the same level. The remaining half was not reprepared; the margin of the crown and dowel construction were at the same level. The test teeth were loaded palatally as far as the fracture. Most fractures were characteristic oblique fractures in the region of the gingiva. The differences between the two groups were impressive. The load capacity for constructions with level crown margins and dowel constructions as far as the fracture was 6 kp less in the middle than those not at the same level.


[Comparative studies on the reconstruction of the intermaxillary distance after loss of temporary crowns]. If temporary crowns are lost following preparation in the supporting areas, the condyles may be displaced. It however was established that the normal position of the condyles can be approximately reproduced with a central bearing device. On the basis of the results, it was determined that the support pin method is superior to the procedure using central wax registration.


[The polymerization temperature of Scutan, Palavit 55 and Trim]. Synchronous temperature measurements with thermocouples in the coronal pulp and in temporary plastic crowns were undertaken in "in vitro" tests which were very similar to "in vivo" conditions. 1. The plastics Scutan and Palavit 55 used in connection with Frasaco strip crowns irreversibly damaged the coronal pulp during the polymerization process because the polymerization temperature was as high as 46C. 2. The plastic Trim used in connection with Frasaco strip crowns produced temperatures as high as 39 C in the coronal pulp. 3. The temperature in the coronal pulp dropped to 35 C when Palavit 55 was used together with an alginate cast.


[The necessity of registration measurements in the construction of masticatory surfaces]. Model studies of denture forms with group contact and front canine guidance showed that a procedure for the reconstruction of grinding surfaces not directly involved in movement guidance, based on the mean values, can be accurate. The standard measures of registration for transference to a semiadjustable articulator are adequate for satisfactorily reducing vertical deviations to a clinically tolerable minimum in reconstruction guide planes.


[The problem of prosthesis stomatitis--allergic reaction to the prosthesis lacquer "D/22 Meton"]. The gloss on die-cast prostheses is sometimes achieved by coating the surface with enamel. A case was reported in which the prosthesis enamel D/22 Meton produced an allergic reaction in the mucosa.


[Electronic studies on the biological tolerance of the mandibular movement limits]. Three-dimensional synchronized position-limits of the mandible were electronically derived and evaluated in 10 adult subjects with normal mastication. It was shown that the respective positions could not be identically reproduced. To define this physiologic distribution, parameters were introduced with which the biologic tolerance and the reproducibility of the position-limits of the mandible can be described in the first approach.


[Multiple osteosarcoma in spontaneously hypertensive rats (author's transl)]. For period from 1971 to 1975, 18 cases of osteosarcoma were experienced among 9132 spontaneously hypertensive rats. The onset was at 72 to 145 days of age and death occurred before 423 days of age. The tumors were multiple being distributed in the skull (11 of 14 cases), caudal vertebrae (8 of 14 cases), and fore- and hind-limb. All the tumors were mainly composed of sarcomatous tissue with some osteoid and cartilage. Metastasis was never observed. Serum A1-P levels of tumor bearing animals were 2 times higher than those without tumor. Bronchiectasis and abscess formation of submaxillary lymph nodes were noted in most affected animals.


[A new artificial respirator suited for perfusion fixation of tissues in small laboratory animals (author's transl)]. A new, simple and inexpensive instrument, that proved to be useful for perfusion fixation of small laboratory animals, was devised.


Differential diagnosis of periapical radiolucent lesions. When a clinician is confronted with an apical radiolucent lesion he must follow an organized thought process and diagnostic technique prior to therapy. This technique employs the collection of data, called the diagnostic data base, and radiographic data. The diagnostic data base and radiographic data combined with the results of the vitality tests will provide the clinician with an appropriate working diagnosis. If the data support a diagnosis of radiolucent lesion associated with a nonvital tooth then endodontic therapy should be provided and the patient should be seen on a routine follow-up basis. Dr. H. M. Worth has most elequently summarized the responsibilities of the clinician as follows: "The endodontist cannot content himself with sufficient knowledge to deal with apical infections only, for he encounters a great number of diseases; it is necessary for him to be reasonably well informed on the radiographic appearances of most of the abnormalities and diseases that occur in the jaws."


Root canal anatomy. Road map to successful endodontics. Every tooth in the distal arch presents occasional aberrations from normal canal anatomy. The alert practitioner, aware of these anomalies, will avoid a frequent source of endodontic failure.


Instrumentation of finely curved canals. The conclusion to be reached should not be that one method of enlargement is better than another in finely curved canals, or that one filling material is better than another but rather that all materials and methods have strong points and weak points which should be taken into consideration when endodontic therapy is performed. The stepback enlargement technique is probably the best technique for enlarging finely curved canals, but problems may be experienced with it also if careful procedures of instrumentation and cleansing are not followed. If these factors are kept in mind it will help us to provide the highest possible quality of endodontics.


Differential diagnosis in endodontic failure. Research in education has demonstrated the usefulness of verbal mediators as memory aides. The mediator or mnemonic POOR PAST can be of use to the dentist in recalling the list of alternatives in the differential diagnos of endodontic failures: P--perforation; O--obturation; O--overfill; R--root canal missed; P--periodontal disease; A--another tooth; S--split; T--trauma. With a comprehensive list of diagnoses, recall of the appropriate questions and tests in examining for each possibility is simplified. The diagnostician then proceeds to look for a specific symptom or symptoms that would confirm a particular diagnosis or that would limit the alternatives to two or three possibilities. Questioning about the nature and duration of the symptoms is useful in ruling out some diagnoses. Pulp tests, periodontal probing, radiographs from different angles, percussion, palpation, and sinus tract exploration each have special application to one or more of the possibilities on the list. The wise clinician also evaluates access preparations, occlusion, and those etiologic factors that could cause pulp or periodontal disease. Variations in the root canal, requirements of treatment, the nature of the healing process, expected results, and surgical principles are considered along with the foregoing in problem solving. After a case has been thoroughly investigated and if the POOR PAST alternatives have been ruled out the dentist may then conclude that for some as yet undetermined reason the lesion exceeds the recuperative powers of the host and that further consultation or surgical intervention will be necessary.


The perio-endo question: differential diagnosis. Clinical diagnostic criteria used to distinguish between diseased states of periodontal origin and those resulting from pulpal ncrosis are based on the physical characteristics of the presenting lesion. Strict attention to minute detail and development of acute tactile discrimination are required to make accurate diagnoses.


Office sterilization and asepsis procedures in endodontics. Available evidence that there has been an epidemic of hepatitis B in the population since the 1960s and of the vulnerability of clinical dental and endodontic personnel has indicated a need to improve general asepsis procedures to guard against the spread of infection, and to improve screening for possible carriers. Specific improvements in personal protection, surface disinfectants and procedures, and control of bacterial populations in dental water units as well as broader use of instrument sterilization can provide safer conditions of treatment for patients and personnel alike. Monitoring of asepsis can increase awareness and guide improvements of skills in aseptic treatment, and improved methods of transporting samples can improve recovery of anaerobic pathogens for determinations of antibiotic susceptibility.


The general practitioner and the endodontist. One of the rewards of specialty practice is the opportunity to work with a great many referring dentists. The camaraderie is good, the friendships that develop are satisfying and long lasting. The specialist's goals are the same as those of the general practitioner: to provide the highest level of care possible in the best interest of their shared patient. This is best accomplished by open and effective communication between the general practitioner, the endodontist, and their mutual patient.


Effects of murine erythroleukemia inducers on mouse erythroid colony formation in culture. The effect of various agents which are known to increase the differentiation of Friend erythroleukemia cells was investigated in cultures of mouse bone marrow cells. N,N-dimethylacetamide (5 and 15 mM) and acetamide (60 mM) significantly increased the number of erythroid colonies observed. Tetramethylurea, dimethylformamide, pyridine N-oxide, and butyric acid were ineffective. Dimethylsulfoxide at a concentration of 1% significantly increased colony number in cultures of marrow cells obtained from male mice, but had no effect in cultures of female bone marrow cells.


Acetylene reduction (dinitrogen fixation) and nitrification in soil as affected by the structural aggregate size. The effect of size of structural aggregates on the intensity of nitrification and nitrogenase (nitrogen: acetylene oxidoreductase) activity was investigated in three soils. In two of them the nitrogenase activity was limited by addition of glucose. Aggregates of a larger diameter (2-4 mm) exhibited a considerably higher nitrogenase activity than those with a diameter smaller than 2 mm. This effect was even more pronounced when the soil samples were repeatedly intensively aerated. On the contrary, smaller aggregates (0.5-2 mm) exhibited more intensive nitrification.


[Clinical and experimental studies on aldolase and its isoenzymes in leukemia and allied hematological disorders (author's transl)]. Relations between clinical course and change in aldolase (ALD) isoenzyme pattern were investigated on the peripheral and bone marrow blood of normal subjects and patients suffering from leukemia, multiple myeloma, hypoplastic anemia and other hematological disorders. Similar examination was performed on human leukemia cells and on sera and leukocytes from Donryu rats inoculated with rat leukemia cells (DBLA-6), induced by NBU. In addition to the enzyme activity, isoenzyme pattern was analyzed electrophoretically. The results obtained were as follows: 1) FDP/F1P ratios of the peripheral and marrow blood were high in untreated leukemia. After the induction therapy, the ratio in the marrow blood was high, but decreased in peripheral blood. 2) In complete remission, both ratios were decreased to normal level. 3) In the early relapse of leukemia, the marrow blood showed a high ratio in spite of normal value in the peripheral blood. During full relapse or reinduction therapy, FDP/F1P ratio remained high in both the peripheral and marrow blood. 4) Atypical hypoplastic leukemia showed a significantly high ratio in the marrow, but a low ratio in the periphery. No difference in either ratio was detected between hypoplastic anemia and normal subjects. 5) Zymogram of leukemia cells from leukemia patients showed that ALD-A was predominant more clearly than in normal leukocytes. ALD in normal leukocytes was composed mainly of ALD-A and its hybrids with ALD-B and ALD-C. 6) The ratio in sera and leukocytes from rats inoculated with DBLA-6 cells was increased with exacerbation of leukemia. ALD-A was predominant in rat leukemia cells on the zymogram. It is concluded that aldolase isoenzymes, especially the FDP/F1P ratio, are useful in estimating clinical course of leukemia, particularly in deciding early relapse of leukemia in bone marrow. These laboratory findings are also useful in differentiating atypical leukemia from hypoplastic anemia.


Time-studies of the changes in the sex-dependent activities of enzymes of hepatic steroid metabolism in the rat following gonadectomy. The activities of cytoplasmic 3 alpha- and 17 beta-hydroxysteroid dehydrogenase, microsomal 3 alpha- and 3 beta-hydroxysteroid dehydrogenase and microsomal 5 alpha-reductase of rat liver were determined at different time points after gonadectomy on day 75 of life. Following testectomy the activities in male rats assume female values. However this change is relatively slow, 10--14 days being necessary for significant trends in individual activities to develop, and 40--60 days before the final level of activity is reached. The changes in enzyme activities after ovariectomy are only slight. The change in microsomal 5 alpha-reductase activity following gonadectomy of male rats is biphasic, the activity increasing initially to the normal female level before falling to the intermediate "neonatally androgen-imprinted" level. The reaction of 17 beta-hydroxysteroid dehydrogenase activity to testectomy and ovariectomy indicates that in the course of several years, during which we have investigated the behaviour of this enzyme in Chbb/THOM rats, the regulation of its activity has changed from one of oestrogen dependency to one of androgen dependency.


Time-studies of the changes in the sex-dependent activities of enzymes of hepatic steroid metabolism in the rat during oestrogen administration. This investigation was undertaken to elucidate the amount of oestradiol and duration of its administration necessary to cause complete feminization of the activities of cytoplasmic 3 alpha- and 17 beta-hydroxysteroid dehydrogenase, microsomal 3 alpha- and 3 beta-hydroxysteroid dehydrogenase and microsomal 5 alpha-reductase in male rat liver. With the exception of cytoplasmic 3 alpha-hydroxysteroid dehydrogenase, 5 microgram oestradiol/d for 8 days and less was sufficient to cause complete feminization. The order of oestrogen sensitivity was cytoplasmic 3 alpha-hydroxysteroid dehydrogenase greater than microsomal 3 beta-hydroxysteroid dehydrogenase greater than microsomal 3 alpha-hydroxysteroid dehydrogenase greater than microsomal 5 alpha-reductase greater than cytoplasmic 17 beta-hydroxysteroid dehydrogenase. Although the changes occurring after oestradiol administration are qualitatively the same as after testectomy, they occur more rapidly. This rules out the possibility that oestradiol exerts its effect via androgen deprivation. Diethylstilboestrol administration causes the same changes in cytoplasmic 17 beta- and microsomal 3 beta-hydroxysteroid dehydrogenase activity as oestradiol, although the dosage must be increased 100 fold. The effect of diethylstilboestrol on 5 alpha-reductase activity changes with the dose applied. Doses up to 100 microgram/d partially feminize the activity, but at higher doses the enzyme activity is repressed.


Transposition of 9q34 and 22 (q11toqter) regions has a specific role in chronic myelocytic leukemia. Six cases are reported of variant Ph' translocations found among 240 patients with Ph'-positive CML. Five cases had a three-chromosome rearrangement involving, in addition to chromosomes 9 and 22, chromosomes 7, 4, 2(two), and 3, respectively, and one case had a two-chromosome rearrangement 22/5. A review of the literature revealed that three- and two-chromosome variant Ph' translocations are observed with equal frequency. It is postulated that all variant translocations are indeed three-chromosome rearrangements, that the specific event for the formation of the Ph' chromosome is the reciprocal translocation 9/22, and that the transposition of regions 9q34 and 22 (q11toqter), plays a major role in the development of CML.


[Characterization of Mycoplasma salivarium in periodontal diseases]. Research for oral mycoplasms has been conducted on individuals affected with periodontal disease. In 66 out of 100 samplings taken from lesions distinctive or gingivitis, it has been possible to identify Mycoplasma salivarium, by means of specific culture medium and serological reactions. A good correlation has been established between the oral hygiene index and the presence of Mycoplasma salivarium. 80% of the samplings taken from the periodontal pockets of patients affected with chronic periodontitis have revealed the presence of Mycoplasma salivarium. There is a close connection between the stage of the infection and the depth of the pockets. The deeper periodontal tissues of 63 out of the same 100 subjects bear evidence of Mycoplasma salivarium, which, besides the processes already described in relation to bacteria, would come to imply a direct action of mycoplasms on the cell metabolism.


SDH activity in the developing incisors or irradiated mouse fetuses. Pregnant CD1 Swiss albino mice were irradiated with 400 rads of whole body X-irradiation on the twelfth gestational day. The animals were then sacrificed beginning on day 14 through 20 of gestation by chloroform inhalation. The fetuses were extirpated via laparotomy and decapitated. The severed heads were rapidly frozen and sectioned in a cryostat. The sections were affixed to glass slides and incubated for succinic dehydrogenase activity according to the method of Nachlas et al. (1957) and counterstained in Safranin 0, routinely dehydrated and mounted. Data from observations indicated that siccinic dehydrogenase activity appeared normal in the tissue layers of the developing tooth germ when compared to control animals. When the experimental procedure had invoked damage to the developing tooth, succinic dehydrogenase activity was lessened relative to the degree of damage. Presumably the X-irradiation had affected the cellular maturation process thereby reducing the functional competency of the cells as illustrated by the reduced enzyme activity.


Qualitative and quantitative changes in the histology of the human submandibular salivary gland during post natal growth. One submandibular gland from each of 33 necropsies on children aged between birth and 14 years was examined histologically. A simple point-counting method established the volume fractions of various component tissues of the glands and these were compared between five age groups. Below 30 days of age acini and ducts were often immature and widely separated by abundant, vascular, connective tissue. After six months of age glandular structure was more compact with little intralobular connective tissue. Lymphocytic foci were numerous in many of the glands from children aged over six months with a prevalence higher than that previously established for young adults. Consolidated intraductal deposits were found in just under half the glands, mostly after the age of six months. The mean volume proportion of acinar tissue was 43% in the age group 0-30 days but had increased to 64% in the 6 month -- 2 year age group. Over the same period there were reductions in the mean proportional volumes of ducts, vascular and connective tissues. After the age of two years changes in the volume proportions of component tissues were not significant. The developmental and growth-associated changes of the present investigation were opposite in direction to the ageing changes which previous studies have shown occur over the whole of adult life. Moreover, the point at which reversal occurs seems to be in early adult life rather than in childhood.


[Late development of human dental enamel]. Planes of longitudinal fractures of human dental enamel observed in scanning electron microscopy showed morphological variations related to age. This late maturation was observed along the enamel sheaths which disappeared in the subsurface and decreased in the rest of the structure. The destructions produced by demineralizing substances (phosphoric acid, citric acid, EDTA) were always more severe in enamel of older teeth when compared to younger samples. A pretreatment of the fragments with a urea solution increased the acid effects only in young enamel. It is suggested that the late maturation of enamel consists in a reduction of matrix components.


[Dental apatites by electron diffraction study and its impact on the level of piezo-electricity of teeth]. A study of the structure of human normal dental enamel has been performed by single crystal electron diffractionand by reconstitution of the configuration of the unit cell of the hydroxyapatite crystal by computer.


[Autoradiographic study of the activity of odontoblasts and secretory ameloblasts in the rat incisor: changes induced by vinblastine]. An autoradiographic study conducted on the rat incisor showed the presence 4 hours after (3H) proline injection, of 25-30% of the grains on the secreting cells and 70 to 75% on the extracellular matrics. The simultaneous injection of vinblastine sulphate reversed these percentages to 75-80% on the cellular level and 25-25% on the matrics. The vinblastine therefore inhibited the secretory processes of these cell types. On the other hand, due to the alkaloid, the number of grains present increased over the ameloblasts and principally over the intercellular spaces. The effects of these secretion and permeability variations suggested that a flow of precursor rich material reached the epithelial layer whatever the state of ameloblast activity.


The effect of metronidazole on the development of plaque and gingivitis in the beagle dog. The present investigation was performed in order to assess if the administration of metronidazole changed the composition of developing plaque in dogs, which at the start of the study were free from signs of gingivitis. Five beagle dogs were used. Throughout the observation period the animals were fed a diet which favored plaque accumulation. A baseline examination involved assessments of plaque, gingivitis and gingival exudate. Gingival biopsies were sampled and the tissue examined by a point counting procedure. The composition of the subgingival bacterial flora was assessed by dark-field microscopy. The bacteria were characterized into the following types: coccoid cells, straight rods, filaments, fusiforms, motile and curved rods and spirochetes. Following the baseline examination the teeth of the right jaws were allowed to accumulate plaque. A careful tooth cleaning program was maintained in the left jaw quadrants. Plaque and gingivitis assessments were repeated and biopsies sampled in the right jaws after 7, 14 and 28 days of no tooth cleaning. On experimental day 28 the second part of the study was initiated. A baseline examination was performed in the left jaws, after which the tooth cleaning program also in this part of the dentition was terminated. During the subsequent 28-day period each animal was given a dosage of 20 mg metronidazole/kilogram bodyweight/day. Clinical examinations and biopsies were repeated after 7, 14 and 28 days. The results demonstrated that metronidazole administered via the systemic route during a 28-day period can effectively decrease plaque and gingivitis development in dogs. The bacterial flora from subgingival sites of healthy gingiva was dominated by coccoid cells and straight rods. During the phase of developing gingivitis the percentage of coccoid cells and rods tended to decrease, while motile rods and spirochetes increased. During the 28 days of metronidazole treatment the subgingival plaque flora maintained its "healthy" composition, i.e. a gradual influx of motile rods and spirochetes was prevented.


Subgingival microflora of periodontal patients on tetracycline therapy. Samples of subgingival plaque were collected from periodontal patients receiving two different tetracycline treatment regimens following conventional periodontal therapy. Four patients had received an oral dose of 1000 mg/day for 2 weeks and nine had received 1000 mg/day for 1 week followed by 250 mg/day for extended time periods. The latter regimen is similar so that commonly prescribed for the chronic skin disease, acne vulgaris. Taxonomic characterization of plaque isolates indicated that the predominant organisms cultured from both treatment groups were species of Streptococcus and the branching, filamentous Gram-positive rods, Actinomyces and Rothia. A much greater microbial complexity was observed among the flora isolated from patients taking 250 mg/day. The latter group harbored many of the fastidious Gram-negative organisms presently implicated in the etiology of periodontal disease. All bacterial strains isolated were tested for resistance to tetracycline by replica-plating cultures on an agar medium containing two-fold dilutions of the antibiotic. Streptococcus, Veillonella and Neisseria were the bacterial genera found to be consistently resistant to tetracycline, with minimum inhibitory concentrations as high as 128 micrograms/ml. Among the Actinomyces, selection for antibiotic resistance was common only within a single species, A. odontolyticus. However, A viscosus strains isolated at 54% of the subgingival flora from one patient did demonstrate an intermediate resistance level, growing on concentrations up to 8 micrograms/ml. Tetracycline resistance was shown by a variety of Gram-negative rods isolated from the low dosage group. Although a minimum number of patients were studied, extensive microbial analyses of the predominating subgingival bacteria indicated that the goal of tetracycline therapy was achieved during the 2-week therapy period at 1000 mg/day.


A 3-year longitudinal study of the position of the gingival margin in man. The position of the gingival margin of the incisor and canine teeth, indicated by clinical crown height, was measured using a standardised photographic technique, in 30 dental students over a 3-year period. There was a progressive increase in mean clinical crown height during this period, suggesting that continual passive eruption of the teeth was occurring. There was a significant slowing in the rate of change over the period 1975-1977 for tooth 33, the reason for which is unknown.


Gingival inflammation and bone loss in periodontal disease. Fifty subjects between 27 and 43 years of age were studied to determine the relationship between the severity of gingival inflammation, the amount of bone loss and the plaque score in interproximal sites. The results indicate moderately good correlations between Gingival Index or Plaque Index and percentage bone loss. However a low correlation was found between the amount of crevicular fluid and percentage loss. Gingival Index and Plaque Index were well correlated. It was also found that when patients were divided into two age groups, younger and older than 35 years, the older individuals studied had more bone loss interproximally compared with the younger despite comparable amounts of plaque or gingival inflammation. The data suggest that both severity and longevity of the inflammation may play a role in determining the rate of alveolar bone resorption.


A study of the bacteria associated with advancing periodontitis in man. Samples of apical plaque were taken by means of an anaerobic gas-flushed syringe from 21 sites in eight patients. The samples were anaerobically dispersed, diluted and plated and incubated in an atmosphere of 80% N2, 10% H2 and 10% CO2 for 7-21 days. All colonies on plates containing 20-50 isolates were picked, repeatedly restreaked, characterized and identified where possible by a probabilistic computer identification program. The sites were divided into four groups on the basis of clinical features. The significance of differences between bacterial populations in the groups was determined by the Kruskal Wallis and Mann-Whitney U tests, while the Spearman rank correlation coefficient was used to determine the rank correlation of clinical features of diseases and microbial species. The subgingival microbiota in advanced destructive sites was predominated by Gram-negative rods. The microbiota of two young adult patients with generalized extensive bone loss, extensive clinical inflammation and suppuration was dominated by Bacteroides asaccharolyticus and an organism with characteristics consistent with Actinobacillus actinomycetemcomitans. The predominant cultivable microbiota in two patients with extensive bone loss but minimal clinical inflammation was predominated by Bacteroides melaninogenicus ss intermedius and Eikenella corrodens in one patient and E. corrodens and a slow growing fusiform-shaped Bacteroides in a second patient. A third group of four patients demonstrated moderate levels of clinical inflammation and evidence of continued bone loss in the last year. Predominant organisms in this group were more heterogeneous and included B. asaccharolyticus, Fusobacterium nucleatum, the "fusiform" Bacteroides and anaerobic vibrios. Sites with minimal disease in the patients revealed higher proportions of Gram-positive organisms including Rothia dentocariosa, Actinomyces naeslundii and Actinomyces viscosus. A positive rank correlation could be detected between clinical inflammation including suppuration and B. asaccharolyticus and a negative rank correlation between inflammation and E. corrodens.


The effect of splinting on tooth mobility. (2) After osseous surgery. The purpose of this study was to determine if fixed splinting of teeth with intraoral wire and acrylic splints had advantages with respect to tooth mobility, bone level and attachment level over unsplinted teeth following osseous surgery. Ten patients were chosen who exhibited bilaterally similar chronic destructive periodontitis and mobile teeth. One maxillary sextant was splinted, while the other was unsplinted. Both sextants functioned against an unsplinted mandibular arch. Following initial therapy, osseous surgery was performed in both maxillary sextants on the same day. Tooth mobility data was collected 1 week before and at 3, 6, 12, and 24 weeks following surgery. Levels of gingival attachment and bone were recorded before and 24 weeks after surgery. Splints were removed before measurements, then replaced, and the occlusion refined. Prophylaxes and oral hygiene instruction were repeated every 3 weeks throughout the study. For all categories of teeth and mobility examined, tooth mobility increased initially after surgery and subsequently decreased by 24 weeks to about presurgical values. The splinted and unsplinted segments reacted similarly throughout the study; splinting did not significantly reduce the mobility of individual teeth. Pre- and postsurgical bone and gingival attachment levels were also similar for the splinted and unsplinted segments.


Histologic characteristics of experimental gingivitis in the juvenile and adult beagle dog. An earlier study (Matsson & Attström 1979) revealed an unexplained difference between juvenile and adult dogs in the propensity to develop clinical signs of gingivitis. The aims of the present investigation were to depict the structural composition of clinically normal gingiva and to analyze the histologic changes in the gingiva during plaque development in juvenile and adult dogs. Six beagle dogs were used. Two periods of discontinued oral hygiene were studied, the first at 3 and the second at 12 months of age. Biopsies were sampled on days 0, 4, 7, 14, 21 and 28 of each period. Sections from the biopsies were analyzed at two levels of magnification. Compared to adult dog gingiva, juvenile gingiva seemed to display: 1) a thicker keratinized layer of the oral epithelium, 2) a junctional epithelium that structurally resembles the oral epithelium, 3) a cuticular structure at the surface of the junctional epithelium, 4) a limited mononuclear inflammatory cell response during experimental gingivitis, and 5) a delayed establishment of an infiltrated connective tissue portion during experimental gingivitis. In addition, during experimental gingivitis, subgingival plaque formed along the tooth surfaces to a lesser extent in the juvenile stage compared to adult dogs.


Aminoglycoside nephrotoxicity: comparative assessment in critically ill patients. In a prospective trial to determine the incidence of nephrotoxicity with each of three aminoglycoside antibiotics, adults in intensive care units with presumed or proven bacterial infections were treated with intravenous gentamicin, tobramycin, or amikacin. Treatment groups were similar with respect to age, other medical disorders, type of infection, duration of aminoglycoside therapy, additional antibiotics used, other drugs prescribed (notably diuretics and corticosteroids), and rate of superinfection. Nephrotoxicity occurred with gentamicin during 44/121 (36.3%) treatment courses, with tobramycin during 21/92 (22.8%) courses, and with amikacin during 4/16 (25.0%) courses. Although frequent, nephrotoxicity reversed after treatment stopped. Tobramycin nephrotoxicity occurred significantly less often than did gentamicin nephrotoxicity (p less than 0.05). The relative safety of tobramycin may result from lower tissue accumulation during therapy.


Effects of renal failure on leukotaxis.

Effects of renal failure on leukotaxis. Effects of renal failure  and experimental azotemia on in vitro leukocyte migraton were studied. Migration of normal leukocytes in sera from patients with untreated renal failure was regularly decreased, while sera from patients on chronic dialysis exerted no inhibitory effect. Serial sera obtained from two patients starting chronic dialysis exhibited a gradual decrease and ultimate disappearance of the serum inhibitory effect. Experimental azotemia serum supported increased migration of normal leukocytes. Leukocytes from renal failure patients migrated normally when incubated in autologous uremic serum or in normal homologous serum. These results provide evidence that serum from untreated renal failure patients inhibits the in vitro migration of normal leukocytes. This inhibitory capacity is apparently correctable by hemodialysis.


A familial bisatellited extra metacentric microchromosome in man. A bisatellited, extra metacentric microchromosome was found in a normal male and his father. This extra marker participated in satellite association in over 50 percent of the cells; silver-staining revealed only one active NOR region. Other banding studies identified two other cytogenetic "markers" in the family-a 9qh+ and a 21s+. Risk for a carrier of such a microchromosome is probably low but cytogenetic amniocentesis is recommended to rule out aneuploidy in the fetus.


Genetics of aggregation pattern mutations in the cellular slime mould Dictyostelium discoideum. A class of aggregation pattern mutants called 'streamers' have been isolated from Dictyostelium discoideum and analysed genetically. The streamer phenotype is the formation of very large streams of centripetally moving amoebae which are collected from abnormally large territories during the aggregation phase of this organism. Such mutants do not show the pleiotropic developmental defects seen with most other classes of aggregation mutants and after the abnormal aggregation phase they develop into normally differentiated stalk cells and spores. Twenty-four haploid streamers were isolated and assigned to seven complementation groups, stmA to stmG, after selecting diploids formed between pairs of the mutants. The complementation loci were assigned to the following linkage groups using parasexual genetic techniques: stmA and stmF, linkage group VII; stmB, stmD and stmG, linkage group II; stmC and stmE, linkage group III. Use was made of a new temperature sensitive for growth marker, tsgK21, which was assigned to linkage group VII. The total number of complementation groups giving the streamer phenotype is estimated from statistical calculation, based on the frequency of allelism, to be between seven and nine.


Long term effect of systemic tetracycline administration on the severity of induced periodontitis in the rat. The present investigation was undertaken to determine the influence of systemically administered tetracycline on periodontitis in the rat. Thirty Sprague-Dawley rats were arranged into two groups, one group received 21 mg of tetracycline hydrochloride each day for 10 weeks in the drinking water. Periodontitis was induced in the maxillary left segment with a 0.008 inch stainless steel ligature wire and by modifying the normal diet with sucrose. The direct microscopic and histometric measurements obtained were analyzed for statistical significance, which revealed the following: 1. Tetracycline-treated animals demonstrated significantly less resorption of the buccal alveolar bone. There were no statistical differences however, in the amount of alveolar bone resorption palatally or interdentally. 2. Tetracycline-treated animals demonstrated significantly less apical migration of the junctional epithelium on the distal root of the maxillary first molar tooth. 3. Tetracycline-treated animals demonstrated significantly fewer inflammatory cells. In conclusion, long term systemic administration of tetracycline in the rat may be of value in reducing the amount of tissue destruction in experimentally induced periodontitis.


Plaque growth and removal with daily toothbrushing. Dental plaque growth was observed among 180 teenage boys during a 28-day period following prophylaxis. During this period, subjects brushed their teeth under supervision for 2 minutes daily. Plaque levels were measured immediately after brushing and 24 hours after brushing. Both levels increased rapidly during the first 14 days and appeared to be leveled off at 28 days. Less than half of the plaque was removed with one brushing per day leaving about 60% after brushing to promote rapid regrowth. Regrowth rate after brushing on the 28th day was 0.032 plaque units per hour over a 24-hour period. The regrowth rate for the group brushing with dentifrice was 27% lower than for the group brushing without a dentifrice.


The erythropoiesis in acute lymphoblastic leukaemia. A morphologic study. The erythropoietic part of the bone marrow has been morphologically analyzed in 18 patients with acute lymphoblastic leukaemia, 44 patients with acute myeloblastic leukaemia and in 20 controls. There were significant differences between the findings in the lymphoid and the myeloid leukaemias and it seems possible that the erythropoietic cells are not involved in the leukaemic process in the lymphoblastic leukaemias in contradiction to the myeloid ones.


Localization of proteins S1, S2, S16 and S23 on the surface of small subunits of rat liver ribosomes by immune electron microscopy. Ribosomal proteins S1, S2, S16 and S23 were localized on the surface of the small subunit (40S) of rat liver ribosomes by immune electron microscopy. Antibodies against the single proteins were raised in rabbits and chicken and purified by affinity chromatography. 40S-IgG-40S complexes were obtained by incubation of 40S subunits with non-cross-reacting antibodies specific for each of the four proteins and subsequent sucrose density gradient centrifugation. The location of the proteins was determined by means of antibody binding sites visualized in negative contrast in the electron microscope. The four investigated proteins are mainly located in the head region of the small subunit. Exposed antigenic determinants of proteins S1 and S2 were found to be located at different sites of the small subunit whereas proteins S16 and S23 were mapped in a limited region only.


Promotion of uniparental inheritance of mitochondrial drug resistance by delayed division of yeast zygotes. Uniparental inheritance of mitochondrial markers conferring resistance to 3 (3,4-dichlor-phenyl)-1,1-dimethylurea (diuron or DCMU) and antimycin in the fission yeast Schizosaccharomyces pombe is promoted by delaying first division of zygotes.


Serum creatinine concentration in children: normal values for sex and age. This paper presents the normal serum creatinine values in a population of 639 male and 631 female young people aged between one year and 20 years. In addition, preliminary data are presented which indicate the serum creatinine of male and female infants aged between one day and 14 days.


Stopping smoking. Symptoms and objective assessment in ex-smokers. The results of a respiratory questionnaire and spirometric tests of 133 ex-smokers out of 649 male public servants aged 15--64 years have been analysed. When the population was adjusted for age, height and the presence or absence of chronic respiratory symptoms the FEV1 of the ex-smokers had not returned to normal but fell between that of the light (less than 10 a day) and moderate cigarette smokers. Factors contributing to this have been investigated. Factors affecting the FEV1 of the ex-smokers were found to include duration of smoking, quantum smoked and years since smoking ceased. An interactive effect has been demonstrated between quantum smoked and duration of smoking such that ex-smokers who used to smoke 10 or more cigarettes a day for more than 10 years had the lowest lung function but duration of smoking was not important if less than 10 cigarettes a day had been smoked. Only just over a third of the ex-smokers gave health related reasons for giving up smoking, a proportion which is considerably lower than has been found in other studies. Possible reasons for this difference are discussed. As in other studies less than 10 percent gave up smoking because of its cost. Respiratory screening to include questions on cough, phlegm and wheeze together with measurement of the FEV1 is an important way of demonstrating to individual smokers evidence of any damage caused by their smoking.


Carcinoma of the ureter.

Carcinoma of the ureter. A case of primary carcinoma of the ureter is presented. The features of 12 previous cases are summarised and discussed with reference to the literature. The tumour occurs most commonly in the sixth and seventh decades and is often diagnosed late. Subsequent bladder tumours are common, so vigilant follow-up is necessary.


Skin testing for coeliac disease.

Skin testing for coeliac disease. Subfractions of gluten from two genetically different New Zealand wheats were injected intradermally in 16 patients with coeliac disease and 20 healthy controls. The coeliac patients as a group exhibited greater skin reactions when examined at seven hours than the controls. However, the skin test did not give sufficient discrimination to make it clinically useful as a screening test for coeliac disease.


Children in cars. Results of an observational study in New Zealand. If children under the age of 14 years were adequately restrained while travelling in cars, many deaths and injuries could be prevented. Seventeen thousand, one hundred and fifty-five children under 14 years of age were observed in cars. Only 20 percent overall were appropriately restrained. A breakdown into different age groups showed that the percentage of children who were adequately restrained varied with ages: less than six months 54 percent; six months-four years 18 percent; five-seven years 9.5 percent; 8--14 years 45 percent. Thirty-two percent of infants less than six months of age were travelling on their parents' knees in the front. Overall, 31 percent of the children were travelling in the front seat. Some recommendations are made and the preventive role of the health professional in this area is examined.


A cytogenetic study of eight human melanoma cell lines. Eight cell lines established originally at the Queensland Institute of Medical Research from human malignant melanoma explants have been studied by means of cytogenetic techniques. All showed abnormalities characteristic for each individual line and consisting of marker chromosomes and of changes in ploidy due to the addition of extra copies of normal chromosomes. Repeat cultures of some lines after one or two years contained most of the markers which had characterized the original samples; additional chromosome abnormalities were also found. An anlysis of the break points concerned in the production of markers showed preferential involvement of chromosomes 1 and 5, with a prevalence of centromeric breaks on No. 1. These findings add further weight to the evidence suggesting that changes in chromosome 1 may be of special significance in the pathogenesis of some solid tumours.


Increase of superoxide dismutase activity in various human leukemia cells. (1) Superoxide dismutase activity in polymorphonuclear cells from human blood is considerably lower than that in lymphocytes. Macrophages from ascites show the middle level between the other two cells. (2) In myelocytic, monocytic, and lymphocytic leukemia cells, the enzyme activities are increased compared to those in the corresponding normal cells. (3) Gel electrophoresis patterns of all normal cells reveal bands corresponding to the cytosol and mitochondrial bands reported in previous studies. However, the mitochondrial Mn-containing superoxide dismutase activities are diminished or absent in leukemia cells. CN-insensitive superoxide dismutase activity in leukemia cells is not detected under the conditions.


[Sialorrhea. Value of isotopic examination (author's transl)]. Three types of sialorrhea can be distinguished: -- deglutition disorders, especially in patients with Parkinson's disease and those with anxiety, -- ptyalomania, -- primary hypersecretion at rest. Functional scintigraphic studies enable a physiological approach to be made, and this tends to group together, under the name of primary hypersecretion at rest, various clinical manifestations occurring in two main groups: -- elderly women complaining of a bitter taste in the mouth, -- plethoric men with large salivary glands. The scintigraphic recording apperances of secretion at rest, which occurs early and without obvious food stimuli, are also noted in other clinical types. It remains to be demonstrated whether they have a common physiopathological basis arising from disorders of the normal sensitivity of the buccal cavity.


[Pathogenesis of reflex secretory dysfunctions. Value of isotopic techniques (author's transl)]. Many hypotheses have been advanced to try to explain the mechanism involved in reflex secretory dysfunctions. The use of dynamic isotopic techniques and their application in clinical research enable a more precise approach to be made to assist in solving the problem. Using several examples of dysfunction of various etiologies, the authors demonstrate the existence of an excretory blocking effect from parasympathetic inhibition.


[The buccal approach for excision of posterior submandibular gland calculi. A report on 10 cases (author's transl)]. The authors describe ten patients with calculi in various regions of the submandibular gland, who were operated upon using the buccal approach, and review the different therapeutic procedures available. Though removal of the submandibular gland is a mutilating operation and has many sequelae when operated upon through the submandibular approach, it is still, surprisingly, the standard operative procedure for removal of posterior calculi, even though Delaire had already expressed his logical preference for the buccal approach, 23 years ago. This procedure was used in the 10 cases reported here and results were very good, and there were no sequelae. A strict operative technique is necessary, including general anaesthesia and dissection of Wharthon's duct along its whole length as the essential factors.