Lipodystrophy: a case report of partial lipodystrophy of the face. Lipodystrophy is a disorder of the subcutaneous adipose tissue. It can occur in two forms--partial and total. Gorlin and Goldman (1970) suggested that facial lipodystrophy can only occur bilaterally, and should it occur unilaterally, then it is hemifacial atrophy. A case is reported to illustrate that partial lipodystrophy can occur unilaterally.


Suppurative cervical adenitis caused by opportunist mycobacterium. Of 45 consecutive submandibular abscesses treated by external drainage in a district oral surgery unit, four cases, representing nearly 9% of the sample, were caused by opportunist Mycobacterium avian-intracellulare, an organism known to give a poor response to all known antimycobacterial chemotherapeutic agents. Treatment by excision of the diseased tissue is indicated in these cases. The diagnosis and management of these conditions is discussed.


Ph1-positive childhood leukemias: spectrum of lymphoid-myeloid expressions. Two children presented with Ph1-positive leukemia, confirmed by Giemsa banding as 22q-. One child showed an initial presentation characteristic of acute lymphoblastic leukemia, followed by development of chronic myelocytic leukemia 2 yr later. A second child presented in blast crisis. Both patients showed blast cells possessing both lymphoid and myeloid characteristics, as demonstrated by histochemical, biochemical, or surface receptor properties of each cell series. The evidence provided supports the assumption of mixed lymphoid-myeloid properties of blast cells in chronic myelocytic leukemia in children. Detailed study of the leukemic cells may aid in the understanding of complex stem cell relationships and suggest more effective therapeutic approaches.


Treatment of juvenile chronic myeloid leukemia with sequential subcutaneous cytarabine and oral mercaptopurine. Three cases of the juvenile type of chronic myeloid leukemia are described, all of which have shown a clinical and hematologic response to repeated cycles of sequential subcutaneous cytarabine and oral mercaptopurine. It appears that this regime, as described, may afford some control of a disease process previously supposed to be unresponsive to chemotherapy. This control, however, is likely to be reflected in an improvement in well-being, rather than overall survival time. Patient 1 survived 26 mo from diagnosis, and patients 2 and 3 are alive and well 12 and 9 mo from diagnosis, respectively.


Clearance of phenylalanine ammonia-lyase from normal and tumor-bearing mice. Yeast phenylalanine ammonia-lyase was administered i.p. to normal and tumor-bearing mice, and its clearance from plasma was studied. Single and multiple weekly injections at dosages of 10,20,50 and 100 units/kg were administered to C57BL female, C57BL X DBA/2F1 male, and A/J female mice. L5178Y murine lymphoblastic leukemia, B16 melanoma, BW10232 adenocarcinoma, and 15091A anaplastic carcinoma were implanted 7 to 11 days prior to enzyme injection in the appropriate host. After a single injection, the average plasma half-lives of phenylalanine ammonia-lyase were 18 to 24 hr in all groups studied. While the other tumors had no effect on the plasma level of phenylalanine ammonia-lyase after a single injection, L5178Y murine lymphoblastic leukemia and 15091A anaplastic carcinoma significantly depressed the maximal level of phenylalanine ammonia-lyase attained in the plasma. After repeated injections of phenylalanine ammonia-lyase, the initial plasma enzyme level was significantly reduced when 20 units/kg were administered, and the clearance of the enzyme from the plasma was greatly accelerated regardless of the amount administered. Furthermore, in tumor-bearing mice, the rate of clearance was significantly more rapid than in the appropriate non-tumor-bearing control.


A preliminary study of the predictive value of the IPAT. Articulation test scores for 278 subjects with cleft palate were compared with the normative data of Templin and Darley on the Iowa Pressure Articulation Test and the Templin-Darley Screening test of Articulation. In addition the predictive value of the Iowa Pressure Articulation Test in relation to the need for secondary management was examined. The results indicate that, at no age level between four and ten years, do more than 9% of the subjects achieve the mean on the IPAT without secondary management. Examination of the data in regard to "risk rates" indicates that the IPAT is very useful in predicting the need for secondary management. Subjects who obtained scores of zero on the IPAT at four and one-half years of age had a 96% risk of requiring secondary palatal management.


Post-fusion cleft of the fetal rat palate. Several hypotheses of post-fusion rupture of the previously intact palate as a cause of cleft palate have been advanced but with minimal supportive experimental evidence. In this investigation an animal model was evolved in which the intact palates of 19 1/2 day Sprague Dawley rat fetuses were surgically ruptured. Fetuses were grossly and histologically examined at 0.24, 48, and 72 hours after surgery. The operation resulted in a range of clefts including complete cleft of the hard and soft palate, isolated cleft of the hard palate and submucous cleft palate. There were no associated defects, and the fetal mortality was low. The various hypotheses of post-fusion rupture were reviewed, and it was concluded that this model supports the hypothesis that isolated clefts of the hard palate may result from post-fusion rupture and submucous cleft from late disturbances in palatal mesenchyme.


Mental, motor, and social behavior of infants with cleft lip and/or cleft palate. This is a report of analyses of cross-sectional and longitudinal samples of the mental, motor, and social behavior of children with cleft lip and/or palate as measured by the Bayley Scales for Infant Development. Seventy-five patients of the Lancaster Cleft Palate Clinic were the subjects for the sample. The longitudinal sample consisted of 28 of these Ss for whom there were complete data at 6, 12, 18, and 24 months. The results indicated that there were no significant differences in mental and motor functioning. In both analyses, the social behavior of patients with oral-facial clefts was more passive than the Bayley normative sample. The implications of these findings for future research are discussed.


Incongruous movements of the velum and lateral pharyngeal walls. Five patients evaluated via multi-view videofluoroscopy were found to have incongruous movements between the velum and lateral aspects of the pharyngeal walls. All five patients had velopharyngeal insufficiency resulting from either absent lateral pharyngeal wall motion in the presence of velar mobility or absent velar mobility in the presence of lateral pharyngeal wall motion. The data indicates that these valving patterns are not rare phenomena of velopharyngeal valving. Treatment by pharyngeal flap or other methods for velopharyngeal insufficiency must be suited to these peculiar valving patterns based on adequate diagnostic information.


The timing of height and weight deficits in twins discordant for cleft of the lip and/or palate. The concept that clefting is associated with diminished height and weight was examined in a cross-sectional sample of 45 pairs of twins discordant for cleft of the lip and/or palate from three to 17 years of age. Contrary to expectation, a remarkable similarity between cleft and non-cleft twins was found from three to 10 years of age. It was only from 10 to 17 years of age that the expected diminution in height and weight was observed. Average heights and weights at two-year intervals were compared with population norms for the age range in question for cleft and non-cleft twins. For both height and weight, the "over 10" decrease below the population norms was attributable to the DZ cleft twins. The MZ cleft twins remained very close to the norms while their non-cleft matched siblings exceeded the norm after 10 years of age. In addition, the decreased weight for cleft twins was seen to occur earlier for girls than for boys, suggesting a relationship with the onset of puberty. This was not seen for height. It is, therefore, proposed that the endocrine controls of maturation at puberty are linked in some fashion to cleft of the lip and/or palate.


Correction of poor speech due to a low pharyngeal flap attachment by a V-Y advancement procedure. Four post cleft palate patients with persistent hypernasality resulting from low superiorly based pharyngeal flap attachments were operated on using a V-Y Advancement procedure. In each patient, the tethering effect of the flap on the soft palate was overcome. Gratifying correction of hypernasality was achieved and articulation ability considerably improved. Long-term follow-up results are not yet available as our experience with this procedure extends over a period of only two years in all.


Velopharyngeal insufficiency after maxillary advancement. This paper reports velopharyngeal insufficiency after maxillary advancement in a 16-year-old boy. It underlines the need for systematic, quantitative investigation of the effects of this new operation on speech and velopharyngeal function.


Electrophoresis of lysozyme into Microscoccus-containing agarose gel: quantitative and analytical applications. Electrophoresis of lysozyme into agarose gel containing Micrococcus lysodeikticus causes lysis of the microorganism, allowing the development of two methods, one for quantitation ("lyso-rocket electrophoresis") and the other for electrophoretic characterization ("crossed lyso-electrophoresis") of lysozyme. The lyso-rocket technique provides an alternative to the method currently used for quantitative assay. By the use of crossed lyso-electrophoresis we have provided evidence, for the first time, of the electrophoretic heterogeneity of urinary lysozyme from patients with monocytic leukemia. We halve also documented the influence of concentration on the electrophoretic  mobility of lysozyme.


Tentative analysis of the efficiency of fissure sealant in a public program in London. A tentative analysis was made of the efficiency of allocating resources to fissure sealing, rather than to restorative care, in a public dental program. Data for the study were taken from a 2-year clinical trial in London. The analysis is necessarily tentative because the clinical trial employed the half-mouth design, which does not represent a true-life situation. Over the 2 years of the study, it was found that sealing the population of study teeth took from 24.9% to 33.8% more time than treating the lesions which developed in the control teeth would have. Reasons are given why this finding cannot be accepted as conclusive; rather, it is presented to raise questions and to stimulate additional studies into the efficiency of preventive programs. Guidelines for such studies, which should be conducted in different populations with varying caries prevalence, are suggested.


Dental caries prevalence in 5-year-old children in Barnsley Area, England. It is important that baseline studies of dental caries prevalence are available prior to the introduction of community water fluoridation. This survey was carried out during the winter of 1975/76 in the low-fluoride Barnsley Area (F= 0.1 parts/10(6)). Caries prevalence is in accord with that of other low-fluoride areas. The mean dmf was 4.5. For the group of children with rampant dental caries, the mean dmf value was much greater (11.3).


Prevalence of upper lip posture and incisor overjet. 1,159 children (612 girls and 547 boys) aged 11-12 years were examined to determine the range and mean overjet values in four defined upper lip-maxillary central incisor relationships. No clinically significant differences were found on comparison of the data relative to each upper lip position. The findings suggest that upper lip posture is adaptive to the maxillary central incisor angulation and that the upper lip musculature is unlikely to influence the development of the incisor occlusion.


Observer variation in the clinical diagnosis of mandibular pain dysfunction syndrome. In preparation for a survey to investigate the prevalence of mandibular pain dysfunction syndrome (MDS) in a non-hospital group of individuals, the measure of agreement obtained by two observers when recording signs and symptoms of MDS in the same subjects was investigated. The criteria used for this purpose are defined. Two groups of subjects, 50 MDS patients and 50 individuals not complaining of the condition, were examined independently. Considerably more agreement between the two observers was reached with regard to patients than contrast subjects. Both observers showed more agreement in assessment during the opening movement of the mandible. It was suggested, therefore, that in order to reduce the observer error inevitably present during a survey, the signs and symptoms which manifest themselves during the opening movement of the mandible should be used to diagnose MDS rather than a more elaborate time-consuming technique.


Constancy of clinical signs in patients with mandibular dysfunction. Repeated clinical examinations were performed 6 weeks apart on 34 patients with mandibular dysfunction to estimate the consistancy of clinical signs. The clinical examination of the patients included the masticatory muscles, the temporomandibular joint (TMJ) and the mandibular movement capacity. The clinical dysfunction index (Di) was calculated as a measure of the degree of mandibular dysfunction. The highest agreement between examinations was found for maximal mouth opening and protrusion. The agreement for palpation tenderness of the masticatory muscles and TMJ, limited movement of the TMJ, TMJ sounds, and pain during movement was considerably lower. The lowest agreement within 6 weeks was found for the clinical dysfunction index. No statistically significant difference could be detected between the two examinations for any of the clinical signs, as a result of given information and counseling before the 6-week period. It was concluded that all clinical signs, except maximal mouth opening and maximal protrusion, showed low consistancy.


A new transport ventilator: an evaluation. Transportation of patients requiring continuous ventilatory support and increased inspired oxygen concentrations may be cumbersome, inefficient, and dangerous. We evaluated a new time-cycled transport ventilator, which provided simple operation, ample inspired oxygen concentration, and adequate minute ventilation in every patient tested.


[Clinically undiagnosed glycogen storage disease type I as cause of postoperative death (author's transl)]. A 30-year-old patient was admitted to hospital for cholecystectomy with a diagnosis of complete obstruction of the cystic duct. The preoperative clinical and chemical findings were normal. Following cholecystectomy the patient recovered normally from the anaesthetic. Three hours later sudden cardiac arrest occurred. Necropsy revealed glycogen storage disease type I. Hypoglycaemia and metabolic acidosis had probably led to hypokalaemia which is considered as the cause of cardiac failure.


[Rapid intra-operative histological diagnosis of bone tumours (author's transl)]. The main deficiency of rapid intra-operative histological diagnosis of bone tumours is the possibility of biopsy error. If this is avoided, rapid sections can be made from tumour biopsy specimens either with the simple freeze-microtome or a cryostat. The specially thin cryostat sections are particularly suitable for revealing cytological details and may be superior even to paraffin sections. On the other hand, cell-deficient tumours with a great deal of intercellular substance or carcinoma metastases can be diagnosed more reliably from usual frozen section than cryostat section. Considerable experience is required to avoid misdiagnosis. One of the most difficult problems is the diagnosis of chondromas of the long bones and the pelvis. The term "semimalignancy" is a suitable one for many forms of those giant-cell tumours which have special tendency towards recurrence even after years. Dangers and limitations of the rapid diagnosis of bone tumour are demonstrated most clearly on purely histomorphological assessment, without knowledge of history, clinical findings or X-ray diagnosis. This is especially striking in the case of fracture callus which may be misdiagnosed as osteosarcoma.


[Electronic studies of the 3-dimensional movement of the mandible]. With an improved electronic test arrangement, mandibular movement is recorded three-dimensionally as a function of distance and time and simultaneously as a kind of movement. The movement patterns registered by Posselt are, in principle, confirmed. As parameters for the further analysis of the mandibular movement, the characteristic function curves of the sagittal, vertical and lateral movements are presented as distance-time functions.


[The reproducibility of occlusal contacts in the Dentatus and Stuart articulators]. The reproducibility of occlusal contacts of 30 subjects was tested in the Dentatus and Stuart articulators. Primary contacts in the terminal hinge axis position were reliably reproducible in both articulators. Contacts in habitual intercuspidation were reproduced only approximately by both devices. Contacts in eccentric occlusion were satisfactorily reproduced in the Stuart articulator only. The findings show that doubts are indicated about the simulating capacity of semi-adjustable articulators which is frequently rated too high.


[Methods of registration and the position of the mandible]. Various methods of checkbite may lead to displacement of the condyles by about 0.5 mm. Repetition of the method used two weeks later, may show dispersions comparable to the results of other checkbite methods. The condyles tend to change their position primarily in a vertical direction. Given normal compressive load, this suggests that the ligaments are not extended by the load during positional relation registration. The shift is rather due to compression or distraction of the condyles in the temporor-mandibular joint.


[The shaping of the margin in cast objects in oral rehabilitation]. Various preparations of margins in cast replacements as well as their insertion and finishing are studied and measured by means of radioactive isotopes. It was found, in particular, that the conventional preparation of cavity margins and the finishing of cast margins of tightly cemented cast replacements should be discontinued.


[The dentist's responsibility in the oral rehabilitation of patients with chronic kidney diseases]. It is important that the dentist knows about disturbances of blood coagulation during and after hemo-dialysis, so that he avoids administration of platelet-inhibiting medication like aspirin and that he recognizes radiologically visible signs of insufficient dialysis in the jaws. Because of the reduced protection from infections, antibiotic prophylaxis should be carried out before every dental operation, the medication of choice being penicillin. Due to the high rate of infection by the hepatitis B virus, adequate protection is required.


[Reconstructive surgery on the temporomandibular joint within the framework of oral rehabilitation]. After conservative functional therapy has failed, two operating methods are applied for oral rehabilitation: 1. Extraarticular bolting of the temporo-mandibular joint (indication: recurrent dislocation/habitual partial dislocation). 2. Reconstructive arthroplasty with a cartilage/bone graft (indication: loss or serious deformation of the mandibular condyle). Functional analysis with a detailed examining method showed a high rate of success with regard to improvement of function and freedom from symptoms.


[Surgical treatment of old alveolar process fractures for the rehabilitation of mastication]. Surgical therapy of old fractures of the alveolar ridge is indicated if masticatory disturbances exist or are expected. Bony fragments of the alveolar ridge which carry teeth and are consolidated in dislocation are osteotomized, repositioned and fixed by dental splints for more than eight weeks. The guidelines for segmental and en bloc osteotomy in orthodontic surgery are applicable. Defects of the alveolar ridge are treated by vestibuloplasty or reconstructive surgery. It is also possible to combine the two methods. For the reconstruction of the alveolus, recently almost exclusively homologous transplants preserved in Cialit are used. Following reconstruction, additional vestibuloplasty may be carried out three months after the transplantation of bone or cartilage.


[The value of orthodontics in oral rehabilitation]. Orthodontic measures can create improved functional conditions for optimum rehabilitation of the masticatory system. Prerestorative orthodontics involve relatively great efforts, but the results of consistent treatment justify them. The range of indication of such treatment should, therefore, be very restricted and the patient must be instructed in detail and thoroughly motivated.


[External-internal tooth resorption as a delayed effect of thorium X (Ra224)]. Twenty-five years after treatment with thorium X (Ra 224), we found unusual, multifocal dental resorptions in four patients. The results of gamma-spectrographic, auto-radiographic and histological examinations suggest that Ra 224 caused such changes.


[Growth of the jaw after preoperative orthodontic treatment of cleft lip and cleft palate]. In 48 patients a systematized therapeutic model plan for the preoperative and postoperative orthodontic treatment of patients with unilateral or bilateral cleft lips and palates is pursued. In addition to stimulation and growth control of the maxillary alveolar segments in a transverse direction and at the segment poles, increasing sagittal development is observed in a later developmental phase.


[Animal experimental studies on the prevention of cleft palate and other malformations in the region of the head]. In fetuses of eight-week old female Swiss mice, teratogenic effects were produced by cyclophosphamid on different days of pregnancy. Frequently and combinations of malformation of a positive control group (30 mg/kg b.w. on the 11.5th day of pregnancy) were compared with "prophylaxis" groups. Pyrithioxin (Encephabol) significantly reduces the number of some malformations. The goal, i.e. to obtain normal fetuses without malformations, was not achieved, however. The best effect was obtained with 1/160 LD50 of Encephabol administered in four doses prior to Endoxan.


[Treatment of an orbital defect with an eye prosthesis with an electronically controlled eyelid, synchronous to the intact eye]. For the treatment of an orbital defect after exenteratio orbitae, an eye prosthesis with flexible upper eyelid was developed. The artificial eyelid moves synchronously with the natural contralateral upper eyelid by electronic control. The electric signal of a light barrier mounted on to a spectable frame in front of the intact eye is intensified and transmitted to an electromagnet. The electromagnet is located in the obturator prosthesis and lifts the artificial eyelid.


[Globodontia--a new familial tooth abnormality]. A new, congenital anomaly of tooth form transmitted as an autosomal dominant trait was found in a father and two of his three sons. While the incisors appeared unchanged, the posterior teeth have characteristic massive globe-shaped crowns with irregularly arranged, rounded cusps. The occlusal surfaces resemble in their extreme form the underside of a tomato. The relation to the otodental syndrome is not clear as yet.


[Functional analysis in stomatology].

[Functional analysis in stomatology]. A survey of diagnostic details is made on which functional analysis is based. Symptoms connected with the temporo-mandibular joint, muscle palpation, radiological demonstration of the temporo-mandibular joint, and registration of the positional jaw relation are especially dealt with. The methods of examination which are prerequisite to a safe diagnosis are critically evaluated.


[Functional analysis in orthodontics and pedodontics]. The special examination of occlusion in the gnathological sense is less important for functional analysis in orthodontics and pedodontics. At the beginning of and during therapy, simple clinical examinations and observations provide the necessary diagnostic and prognostic information on the functioning of the individual parts of the masticatory system or their relation to each other. The clinical relevance of these findings was tested by electromyographic examinations, electronic pressure and volume measurements and tele- and cineradiographic tests. In the retention period, i.e. after therapy had been concluded, a gnathological examination was made in some cases in addition to the general functional analysis. The examination mainly centered on anatomic regions: lips, tongue, masticatory muscles, and temporomandibular joint. The following functions were examined: closing of the mouth, breathing, swallowing, speech, mandibular movements and the relation of rest position to habitual occlusion. In addition, general posture and habits like suckling and nibbling were studied.


[Functional analysis in orthodontics].

[Functional analysis in orthodontics]. After completed orthodontic treatment, clinical functional analysis and instrumental occlusal analysis were carried out in 60 patients, with the Stuart pantograph and the Stuart articulator. The results of the functional analysis were put into relation with orthodontic qualification and the technique used.


[Pantographic studies in orthodontics].

[Pantographic studies in orthodontics]. The temporo-mandibular joint situation was pantographically examined in class 1, class II and class III cases who had or had not been submitted to functional orthodontic therapy. The adaptation of the temporomandibular joint appears to be less complete in treated class II cases than in treated class III cases. The present investigation in 115 subjects also showed that pantography is a suitable means of analyzing the temporo-mandibular development in adolescents and the temporo-mandibular reaction to orthodontic measures.


[Functional analytic studies on mandibular motility after fractures of the mandibular condyle]. In 42 patients, the mandibular protrusion and lateral excursions after fractures of the mandibular condyles were recorded using the "arrow-angle" registration method. The opening of the mouth was measured directly. The restriction of the mandibular mobility did not always correspond to fracture-mechanical expectations. Mobility improved as the time passed after the trauma, without the movement pattern changing.


[Functional analysis and reproducible technic for the radiography of the temporomandibular joint]. An improved x-ray machine is presented with which it is possible, for the first time, to take and exactly reproduce roentgenograms of the temporo-mandibular joint focussed bilaterally on to the transverse hinge-axis. This technique permits the accurate radiological comparisons required for diagnosis and therapy, in the asymmetric skull.


[Tooth mobility in relation to the stress on functional facetes]. By means of inductive motion recorders not in contact with the teeth, tooth movements in buccal and lingual directions were recorded with load being exerted on the different individual functional facets. When loading the retrusion facets the maxillary tooth is displaced lingually and the mandibular tooth buccally. This is significant for grinding-in.


[Do pin guides have any effect on the limits of mandibular movements?]. In the Denar and Stuart pantographs, the movement limits in one subject using 12 different tracing pin guides were recorded and evaluated. No changes in the movement of the terminal hinge axis were found. By means of a registration device fixed to the Denar articulator it was found that the tracing pin guide has an influence on the inclination of the functional facets of the teeth: the flatter or more convex the tracing pin guide, the flatter the occlusal structures.


[Quantitative interpretation of registrations on the Stuart pantograph I. the method]. Stuart pantography records the extreme movements of the mandible. A modified reproducible method is described which furnishes comparable graphs, if the apparatus is mounted and the pantographic records are made in a standardized way corresponding to the geometric relations. This standardized method is presented and discussed.


[Technical requirements for taking radiograms of the temporomandibular joint]. The technical possibilities for taking roentgenograms of the temporo-mandibular joint according to Schüler's projection are analyzed. This study also includes intraoral x-ray sources. The latter is usable for temporo-mandibular joint radiograms to a very limited degree only.


[The caries inhibiting action of fluoride gels in animal experiments]. In a short-term animal test, 70 rats were classified into five groups, two fluoride gel groups with and without phosphate addition, one Elmex Gelée group and one placebo gel group. Another group served as a control group. The results found in the active substance groups were statistically significant, as compared to the placebo and control groups. The question as to why the phosphate addition used inhibited caries more successfully, could not be answered.


[Recording of the surface topography of teeth and ground dental surfaces by means of a mechano-electric measuring device of high resolving capacity]. Arrangement and functioning of a measuring equipment are described by means of which it is possible to scan and record the microstructure of plane and slightly curved surfaces with a mechano-electric transformer. Accuracy, resolving power and possible errors of the method are explained.


[A particular type of dominant hereditary enamel dysplasia?]. An enamel dysplasia which is obviously transmitted as a dominant trait, is observed in various members of one family over three generations. The picture of affected and non-affected teeth of both dentitions is different from the usual behavior of generalized enamel hypoplasia, as only a delimited period of enamel formation is affected. Findings of exogenous inflammatory changes in enamel make the nature of this hereditary odontopathia more understandable. The origin of this enamel hypoplasia is supposed to be a genetic phase-specific process in the stage of maximum metabolic activity (enamel formation). In different age groups, this disorder shows different degrees of severity, suggesting the existence of modifying factors. Among the subjects, the male sex is predominant, while the females exhibit more marked hypoplasias. Whether this is a new variant of hereditary dusturbance of enamel formation can be confirmed by examination of other large families.


[Radiation monitoring in the area of metallic dental replacement during cobalt 60 gamma radiation and in electron radiation of oral tumors]. In the radiotherapy of malignant tumors of the oral cavity, the exact distribution of radiation dosage in the neighborhood of metallic dental replacement has been uncertain so far. Many authors therefore asked that crowns and bridges be removed before radiotherapy. By means of lithium fluoride thermo-luminescence dosimetry, punctate measurements of doses are possible for the first time. In view of the dose values obtained, removal of metallic dental replacement before the beginning of radiotherapy as a prophylactic measure to prevent radioosteomyelitis appears not to be necessary.


Cell-free granulocyte colony inhibiting activity derived from human polymorphonuclear neutrophils. Human PMN (non-adherent: density greater than 1.070 g/cm3) were used to prepare cell-free colony inhibiting activity (CIA). Intact PMN, PMN conditioned media (serum-free or serum-containing) and supernatant from immediately lysed PMN equally reduced the numbers of spontaneous bone marrow (density less than 1.070 g/cm3; depleted of PMN) colonies and clusters. Addition of CIA reproducibly reduced colony and/or cluster numbers by 35-70%. CIA was heat labile being inactivated at 37 degrees C. Daily additions of CIA reduced colony numbers even further; inhibition was dependent on [PMN] used to prepare CIA and on the potency of stimulation produced by colony stimulating cells (CSC). PMN from some patients with leukemia were inactive as inhibitors and did not condition media with CIA. All experiments were thereafter controlled by parallel assessment of supernatant of lysed PMN not demonstrating any CIA. CIA appears to be not only stored in PMN but released from viable, as well as degranulating PMN. Although not species-specific, CIA was specific in its nontoxic action on CSC; colony forming cells and cell-free colony stimulating activity were not affected. The influence of CIA on CSC could be reversed within 10 minutes, but not within 35 minutes of incubation. CIA may have possible physiological relevance.


Diagnosis and treatment planning.

Diagnosis and treatment planning. A diagnosis based upon a haphazard examination is an invitation to failure. A thorough diagnostic service is essential for optimal results. Successful resolution of the complete denture problem depends upon many factors. The dentist's knowledge, possession of the necessary technical skills, sound clinical judgment, experience, and psychological management of the case, combined with the patient's willingness and capacity to persevere and master the use of well constructed dentures, are factors of major consideration which are vital to the ultimate result.


Use of tissue conditioners and resilient liners. The application of elastomer polymers in the prevention and treatment of chronic tissue irritation from dentures is an excellent alternative to the use of hard polymer resins and it is useful for preserving the health of the remaining denture-supporting tissues. Wider applications will be found in the future once the present shortcomings of the available materials are overcome, whether by improving these materials or by developing new ones. Specific uses for these materials have been outlined with an awareness that the readers may be able to add other applications to the list. At the same time, it is not the intent of this article to imply that the use of elastomer polymers is the panacea for all prosthodontic problems or that fundamental principles can be neglected.


Recording edentulous jaw relationships.

Recording edentulous jaw relationships. An attempt has been made to present a practical method of transferring interocclusal records to an articulator. More complicated methods and fully adjustable articulators are available if desired. The Whip-Mix articulator and Quick Mount face bow is a combination that is very adequate in the fabrication of complete dentures. There is little excuse for not using a face bow. There is much to be gained and it is relatively easy to use. An effort has been made to give reasons for the steps outlined in that the why is an important as the how in technical procedures. If the reader is stimulated to pursue the subject, the texts listed in the references are recommended.


Biological properties of denture base resins. The biocompatibility and clinical efficacy of dental materials have been and continue to be a major concern of the dental profession. There are some cases of dental materials that have demonstrated problems with biocompatibility, for example, silicone soft liners. Although rare, allergic stomatitis caused by denture base resin is another example. High purity, very large polymer size, and nonoccurrence in nature significantly contribute to the acceptance of polymers used as biomaterials. New Federal Food and Drug Administration law and requirements of the specification and testing program of the American Dental Association will control the biocompatibility and clinical efficacy of dental biomaterials presently available to the dental profession.


[Neutral factors in gastrointestinal diseases]. The study of the relationship between gastroenterologic diseases and/or symptoms and mental factors still presents serious problems both to internal medicine and to neuropsychiatry. According to recent findings, the influence of psychological factors is not essential in the etiology and pathogenesis. However, it seems to play an important role on the levels of syndrome formation and of the situational interaction system. Diagnostic and therapeutic consequences are discussed, with special emphasis on the diagnostic problem of patients with endogenous depression who complain mainly of gastroenterologic symptoms.


Effect of human leukocyte interferon on the growth of human osteosarcoma cells in tissue culture. Nine osteosarcoma cell lines, originally developed from six osteosarcoma tumours in five patients, and two cell lines of non-tumour origin (glia and fibroblast) were grown in vitro in the presence of human leukocyte interferon (L-IF). L-IF exerted a dose-dependent inhibition of growth in all these lines. The inhibitory activity displayed characteristics typical of interferons. Inhibition of cell growth occurred at a much lower L-IF concentration for the osteosarcoma than for the non-tumour-derived lines. Inhibition of tumour cell growth was observed at concentrations obtained in the serum of osteosarcoma patients treated with interferon.


Characterization of human cells transformed in vitro by N-methyl-N'-nitro-N-nitrosoguanidine. Human osteosarcoma (HOS) clonal cells transformed in vitro by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) were characterized, and compared to non-producer HOS cells transformed by Kirsten murine sarcoma virus (Ki-MSV). The MNNG- and virus-transformed cells grew in the aggregate form above an agar base, grew in soft agar, and had a high fibrinolytic activity. When inoculated into nude mice, all the chemically or virally altered cells produced tumors or tumor nodules. When transplanted into ATS-treated hamsters, the cells transformed by MNNG (0.01 mug/ml) and Ki-MSV produced tumors but MNNG (0.1 mug/ml) transformed cells did not produce tumors. The control HOS cells did not grow in the aggregate form but formed colonies in soft agar, and had low fibrinolytic activity and no capacity to form tumors in nude mice and ATS-treated hamsters. However, one of the control clonal lines had a high level of fibrinolytic activity. Cellular aggregation properties of human transformed cells did appear to correlate with tumorigenicity in nude mice.


[Study of a non-collagen protein fraction of dentin during minerlization]. A protein fraction of mineralizing porcine dentine was analysed after E.D.T.A. demineralization. This fraction of heterogeneous composition had a high content of phosphorus. Its acid character, deductible from the amino acid analysis, was confirmed by electrophoresis. After Sephadex gel filtration, five fractions were obtained. They could be characterized by amino acid analysis and phosphorus dosage. Two fractions contained phosphorus and were very rich in aspartic acid and serine. The three other fractions were characterized by their very high content of glycine.


Affinity of a sulphated rabbit submandibular glycoprotein for hydroxyapatite in vitro. The sulphated rabbit salivary glycoprotein had a high affinity for hydroxyapatite in vitro and could be eluted by phosphate buffer, pH 6.8. Such substances may have an enamel-protecting effect by providing an organic matrix for repair and remineralization of the tooth surface.


[Ultrastructure of the ligamental surface of the rat alveolar process]. The ultrastructural study of the alveolar bone surface of adult rat molars has shown the presence of resting, developing and resorbing areas. Intermediary, tight and gap junctions were observed between the cell processes of osteoblasts and osteocytes. In developing zones, the progressive differentiation of bone lacunae was followed. In resting zones, fibroblast-like cells with large intercellular spaces were observed. The ultrastructure of the osteocytes and the organic periosteocytic space was variable. The osteoclastic resorption showed an initial mineral attack followed by a collagen breakdown. Some observations suggested a relationship between the osteocytes and the origin of the osteoclast.


[Semiquantitative study of periodontolysis and experimental bone repair in the golden hamster]. 80 golden hamsters received Keyes high carbohydrate diet 2 000 and a therapy with the unsaponified fraction of corn germ oil extract (UCOE). 40 hemialveolar molar sockets were preserved and a quantitative study was carried out with the scanning electron microscope and the use of two statistical methods. The effects of UCOED are: a reduction of resorption areas, a decrease in size of resorption lacunae and an increase in the attachment surface of periodontal fibres. These results are connected to the quantity of UCOED ingested. Further, the quantifying of the resorption areas indicates that the periodontal lesions induced by Keyes diet 2 000 are balanced by the ingestion of 20 mg/kg/per day of UCOED, whereas the ingestion of 50 mg/kg/per day induced a larger increase in bone apposition.


[Factor analysis of correspondances applied to a study on oral hygiene]. A global analysis method (the factorial analysis of correspondances) was applied to a study of oral hygiene. This first trial showed that this method of analysis is valid in this field confirming the relationship "absence of hygiene"--"periodontal disease" and the antogonism between the presence of caries and periodontal diseases in young subjects on military duty.


Megakaryoblastic transformation of chronic granulocytic leukaemia. An electron microscopy and cytochemial study. Morphological, cytochemical, and ultrastructural electron microscopic (EM) studies were performed on blood and bone-marrow cells of case of Ph1-positive chronic ganulocytic leukaemia in megakaryocytic acute transformation. The entire leukaemic cell population was found to consist and of megakaryoblasts and megakaryocytes. Intermediate stages of maturation between blasts and micromegakaryocytes were observed at EM level.


Plaque control in the treatment of juvenile periodontitis. With the purpose of establishing to what extent "periodontosis" responds to total plaque control, 21 such patients were observed over periods ranging from 8 to 34 years. Total plaque control in the present context means complete removal of all supragingival plaque by the patient and complete removal of all subgingival plaque by the dentist. The results were evaluated in terms of the number of lost teeth and the percentage of lost attachment during the observation period. It was observed that "periodontosis" cases responded to total plaque control in the same way as do ordinary cases, but with periodontosis, incomplete plaque control on any teeth led to extremely rapid bone loss and eventually to extraction. The reason for this is the unusually rapid apical migration of the subgingival plaque which is the most typical feature of the juvenile periodontitis. Some attachment and some teeth were lost in most of the patients, but a sufficient number of teeth with a sufficient amount of supporting tissue were maintained to provide a set of natural teeth that functioned well. This study shows that the reduced resistance to the invasion of subgingival plaque can be compensated for by a correspondingly strong emphasis on total plaque control. The term "periodontosis" is misleading, and should be replaced by the name "juvenile periodontitis" as suggested by Lehner et al. (1974).


The effect of partial dentures and chlorhexidine gluconate gel on plaque accumulation in the absence of oral hygiene. A study was made of the effect of wearing partial dentures upon plaque accumulation in a group of 24 partial denture wearers, when oral hygiene procedures were withdrawn. The modifying effect of a 1% chlorhexidine gluconate gel on this plaque accumulation was measured. Plaque accumulation was measured at the end of four different denture-wearing regimens each 3 days in length. The wearing of a partial denture either day only or day and night, significantly increased plaque accumulation over not wearing a denture. There was no significant difference between plaque accumulation with day wear and day and night wear. The increase in plaque accumulation with day and night wear resulted from an equal and significant increase in both buccal and lingual plaque accumulation. Chlorhexidine gluconate in the form of a gel significantly reduced plaque accumulation during daytime wear. These results tend to confirm that plaque control is a major factor in determining the long-term effects of partial dentures upon the periodontal structures and emphasize the importance of oral hygiene in partial denture wearers.


Endodontic classification.

Endodontic classification. Clinical and histopathologic findings are mixed in current endodontic classifications. A new system, based on symptomatology, may be more useful in clincial practice. The classifications are vital asymptomatic, hypersensitive dentin, inflamed-reversible, inflamed/dengenerating without area-irreversible, inflamed/degenerating with area-irreversible, necrotic without area, and necrotic with area.


Permeability and wetting properties of four cavity liners. Four commercially available cavity liners were evaluated as to their permeability characteristics. The contact angle measurement of each liner also was calculated. S. S. White liner was found to have the lowest contact angle and permeability values with a better wetting property. Copalite, on the other hand, was found to have the highest contact angle and permeability values with a poor wetting property. Caulk varnish and Polyvar had values lying between the two materials. Copalite is the preferred material in decreasing marginal leakage because of its high contact angle, whereas the S. S. White liner is preferred in pulpal and axial surface protection because of its good wetting properties.


Relationship between formocresol pulpotomies on primary teeth and enamel defects on their permanent successors. Twenty-five permanent premolars were evaluated for enamel defects. The primary molars that they succeeded had been successfully treated with a formocresol pulpotomy. A relationship between the enamel defects and the pulpotomy procedures has been found.


Speech screening of children in the dental office. Screening for speech problems in the dental office involves less than five minutes. Procedures include the sampling of a child's pronunciations in counting activities, word responses to pictures or questions, and conversational speech situations. Use of a normative sound development chart will help judge each child's pronunciation skills. Oral diadochokinetic testing provides a means of evaluating the maturational level of the neuromotor components of the oral structures used in support of sound production. Finally, the child's ability to modify sound production after stimulation, that is, his "stimulability," adds important data for determining the child's potential for outgrowing his problem. The screening assessment of these several characteristics of speech performance, then, provides sufficient diagnostic criteria for the dentist to recommend those children for speech therapy whose error productions will not likely improve through maturation alone. In instances where examination indicates that maturation should cause spontaneous improvement of speech, the dentist would then be able to inform the parents.


New Jersey dentists' opinions on women as associates. This survey sampled a small population in a small area. Results showed that, with minor exception, sex of an individual had no bearing on employement possibilities. Perhaps the unreturned 139 questionnaires would have been negative, but this cannot be assumed. I hope this study will stimulate similar efforts in other geographical areas.


Scanning microscopy of cervical erosion. The dentitions of 900 dentists were examined for the presence of cervical erosion. Of these, 48 individuals of 5.3% had obserable erosion. Silicone impressions were made of the eroded labial surfaces in a typical quadrant, and epoxy resin models were constructed. These were examined in the scanning electron microscope. Cross sections of the replicas were examined in the light microscopy. Of the 48 replicas (24 of the maxilla and 24 of the mandible), the most severe erosion was found on the first premolars in 62% of the individuals, on second premolars in 19% on cuspids in 12%, and on first molars in 6%. The margin of the defect toward the gingiva was level with or just below and parallel to the gingival crest. The erosion pattern was distinguished by two shapes--an angular lesion with a flattened floor associated with deep lesions (68%), and a rounded, smaller defect with no sharp interior angles and less tooth damage (32%). It is postulated that cervical erosion may result from two different mechanisms--a more common, destructive process, angular and deep; and a less severe, shallow process with rounded form.


Survey of myofascial pain-dysfunction syndrome and pathologic bruxing habits among dentists. A survey of the presence of MPD syndrome and bruxing habits among 899 dentists was carried out at the 1973 ADA annual session. The findings reported here suggest that MPD syndrome occurs less frequently in dentists than in dental patients, and there is no difference in the incidence of pathologic bruxing habits between dentists and non-dentists. Of additional interest was the observation that dentists tend not to seek treatment for the relief of MPD. The most frequent form of treatment for both MPD and bruxing habits was occlusal equilibration.


Torulopsis glabrata infections in Singapore: a 4-year study. During the period 1971-4, Torulopsis glabrata formed 42% of yeasts isolated from 5677 clinical specimens from patients with cancers, diabetes mellitus, chronic renal failure, pregnacy or major surgical operations complicated by mycotic infections. The significance of T. glabrata in these patients is discussed.


Path analysis: application in an epidemiological study of echinococcosis in New Zealand. The method of path analysis is described in detail. Application of this analyogical systems is demonstrated using data from an epidemiological study of echinococcosis in New Zealand. The results identified the major causal pathways determining Echinococcus granulosus prevalence in dogs, based on multiple regression analysis of a linear causal model constructed from prior biological and epidemiological knowledge. Only ethnic and sheep husbandry variables had important direct effect on prevalence in the North Island of New Zealand, with some climate factors (maximum temperature and relative humidity) and soil porosity acting indirectly through animal husbandry practices. It is suggested that path analysis, by permitting interaction between epidemiological theory and statistical analysis, provides a valuable additional tool to epidemiologists for the study of causal relationships among variables in multivariates systems.


Epidemiological analysis of factors influencing rate of progress in Echinococcus granulosus control in New Zealand. The factors influencing the rate of progress in Echinococcus granulosus control in New Zealand were analysed by hydatid control area using stepwise multiple regression techniques. The results indicated that the rate of progress was related positively to initial E. granulosus prevalence in dogs and the efficiency with which local authorities implemented national control policy, and negatively to the Maori proportion in the local population and the number of dogs per owner. Problems in analysis of the New Zealand data are discussed and improved methods of monitoring progress in hydatid disease control programmes are described.


Survival of aerosolized bacteriophage phi X174 in air containing ozone--olefin mixtures. The effects of ozone and ozonized olefins on aerosol survival of bacteriophage phiX174 were studied. The ozone concentrations used were between 0 and 110 parts/10(9), giving decay rates up to 0-03 min-1. The olefins used were trans-2-butene and cyclohexene in concentrations of 500 parts/10(9) and 2-4 parts/10(6), respectively. Olefins alone have no effect, whereas in combination with ozone, decay rates of 0-1 min-1 and higher were obtained. The results are discussed in relation to the viricidal effect of open air.


Mechanisms of inactivation of bacteriophage phiX174 and its DNA in aerosols by ozone and ozonized cyclohexene. The mechanisms of inactivation of aerosolized bacteriophage phiX174 in atmospheres containing ozone, cyclohexene, or ozonized cyclohexene were studied by using 32P-labelled phage. The inactivation of the aerosolized phage in clear air or in air containing cyclohexene is due to damage of the protein coat since the deoxyribonucleic acid (DNA) extracted from the inactivated phage retains its biological activity. Inactivation of the phage in air containing ozonized cyclohexene is due both to protein and DNA damage. Sucrose gradient analysis shows that aerosolized inactivated phiX174 releases unbroken DNA. In contrast, the DNA from phage phiX174 inactivated by ozonized cyclohexene is broken. The inactivation of aerosolized phage phiX174-DNA was studied in the same atmospheres using 32P-labelled DNA. phiX174-DNA aerosolized in clear air or air containing cyclohexene at 75% r.h. is inactivated by a factor of 2 in 30 min. The inactivated DNA is broken. Ozone as well as ozonized cyclohexene inactivates KNA very fast causing breaks in the molecule. This is in contrast with the intact bacteriophage in which ozone does not produce breaks in the DNA.


Influenza A neuraminidase antibodies in children and young adults studied by serum absorption. A study is described of influenza A anti-neuraminidase antibodies in the sera of young people of three different groups. Each serum was individually absorbed with viruses containing the N2 neuraminidases of 1957, 1968 and 1972. Rabbit antisera prepared against the viruses were similarly absorbed. Results obtained with the animal sera suggested that these neuraminidases were antigenically distinct, but the human sera had a broader range of anti-neuraminidase activity and gave indication of asymmetric antigenic relationships. Earlier workers who surveyed anti-haemagglutinin antibodies reported that the virus of primary infection absorbed all antibodies, and the virus of secondary infection only those directed against itself. We too found that the virus of secondary infection absorbed only homologous anti-neuraminidase antibody. However, although the primary infecting virus did absorb some secondary antibody, this absorption was incomplete and it lessened with the lengthening of the time interval between the primary and secondary infecting viruses. A similar pattern was seen with anti-haemagglutinin antibodies. Absorption of anti-neuraminidase antibodies from human sera proved much more difficult than absorption of anti-haemagglutinin antibodies particularly after repeated influenza virus infections. The relative rarity of antigenic shift in the neuraminidase subunit also creates problems in the interpretation of results of serum neuraminidase antibody surveys.


Influenza surveillance 1972-75. By the Public Health Laboratory Service Standing Advisory Committee on Influenza. The surveillance programme described in an earlier report was used to monitor outbreaks of influenza in three successive winters. Influenza virus A was active in all of them, but the only major outbreak of influenza B was in 1973--4. The highest incidence of influenza A was in the 0--4 age group in all three winters, but schoolchildren bore the brunt of infections by influenza virus B.


Salmonella in pig carcasses for human consumption in Hong Kong: a study on the mode of contamination. A very high proportion (75%) of the pigs slaughtered in Hong Kong were found to be infected with salmonellas. Seven serotypes including Salmonella choleraesuis were isolated but the majority (91%) were S. anatum and S. derby. These serotypes, especially S. anatum and S. derby, had been isolated frequently from clinical cases, symptomless carries and in this study from abattoir workers, suggesting that the pig was a significant source for human salmonella infection. The majority of pigs slaughtered are imported and the high level of apparent infection was thought to be due to cross-infection during transport of the pigs under stress. S. anatum and S. derby were also isolated from pigs at 60 degreesC for 5 min caused no great reduction in the degree of superficial contamination. The two predominant serotypes were isolated from the tank and from drain swabs, and also from the latter held under scalding tank conditions. Thus, in spite of the introduction of hygienic slaughter under modernized conditions employing an automatic conveyance system 55% of the carcases were superficially contaminated after dressing before despatch to customers. Control of infection before slaughtering would appear crucial and a more thorough rinsing or washing of the dressed carcasses desirable.


The prevalence and epidemiology of toxoplasmosis in Ontario. The results of testing 7060 human serum specimens obtained in the Province of Ontario, Canada, were analysed for the presence of antibodies to Toxoplasma gondii. Of these samples 38% were serologically positive at a titre of 1/16 or greater. The age-specific rates climbed from 2.7% in infants between 6 months and 1 year of age, to about 50% in individuals aged 25 years or over. Variations in prevalence were noted between different areas within the province and evidence is put forward to show that an inverse relation exists between urban size and toxoplasma prevalence. Seasonal and annual variations were not shown to be significant. On the basis of a very small sample of specimens, cat ownership not appear to cause a significant increase in the risk of acquiring this infection.


Effect of tongue reduction on the orthodontic and surgical treatment of dysgnathia. The results of reduction of tongue size in connection with orthodontic and surgical correction of prognathic anomalies of the jaws are presented. It is shown that reduction of the tongue size combined with orthodontic treatment arrests of tendency to prognathic growth when it is performed early. The results further indicate that the effect of prophylactic reduction of tongue size to check relapse following surgical correction of prognathism or open bite can only be confirmed in cases of genuine macroglossia. Since there was only one relapse in our cases without reduction of tongue size, the indication for preoperative prophylactic reduction of the tongue is limited. Personal results and experience have been compared with the findings published in the current literature.


Changes in nasal profile after maxillary advancement in cleft and non-cleft patients. Based on 25 cases with unilateral clefts of lip, alveolus and palate with retromaxillism (CLAP) and 25 cases with pure retromaxillism (RM) the effect on the nose of advancing the maxilla by a Le Fort I osteotomy is analyzed. It can be shown that on average the base of the nose which is at the same time the base of the upper lip, follows the base of the maxilla in the ratio of 4 : 7 while the nasal tip is advanced in a ratio of 2 : 7. This means that to achieve a specified advancement of the nasal base, the maxilla has to be brought forward about twice this amount. A planned advancement of the tip of the nose can, on average, only be obtained by an advancement of the maxilla by three times this amount. The tangent to the columella is tilted considerably forewards and upwards. The movement is a little more marked in CLAP than in RM. The amount of maxillary advancement influences the ratios very little. It seems that they are slightly better after significant advancement. Leaving the nasal spine intact and tilting the maxilla forwards and upwards have a favourable influence on the advancement of the nasal tip. There is no satisfactory explanation of why the extremes in all groups for all measurements are placed so very far apart. As was found in the evaluation of lip movements (Freihofer 1976) this leads to the conclusion that in spite of careful planning the result in the individual case can differ considerably from that expected.


Masseteric muscle hypertrophy and its intraoral surgical correction. Seventeen patients with masseteric muscle hypertrophy (MMH) were surgically treated at the Maxillo-facial Surgery Clinic at the University of Zurich, Switzerland, during the past ten years. Etiology and symptomatology of MMH in these patients were recorded. A modified surgical procedure is presented which provides for the intraoral resection of a portion of the masseteric muscle, as well as the removal of the bone spurs on the lateral surface of the angle of the mandible. It is emphasized that the bony spurs must be removed down to cancellous bone for a pleasant esthetic result. The necessary postoperative treatment is described.


A modified anterior maxillary ostectomy. Two basic operative approaches for anterior maxillary ostectomy have been used by most surgeons; the Wassmund (1935) and Wunderer (1962) techniques. Both have been clinically and experimentally tested and found to be sound procedures (Bell 1969, Jensen et al. 1976, Sokoloski et al. 1976). The author has developed and used for the last five years a modified surgical procedure for anterior maxillary ostectomy which has some technical advantages. The purpose of this paper is to describe this technique. No significant complications have occurred with this procedure in over eighty cases.


Correction of myopathic face associated with myotonic muscular dystrophy. A case report. Two cases of myotonic muscular dystrophy manifested oro-facial disharmony and dento-labial dysfunction. Le Fort I osteotomy, sagittal osteotomy of the mandible, genioplasty and wedge excisions of the mucosa of the lower lip were performed on both patients. The desired results with regard to oro-facial appearance and dento-labial function were achieved in both patients after follow-up periods of six and twelve months.


Cerebrospinal fluid (C.S.F.) rhinorrhoea without frontobasal fractures. C.S.F. Rhinorrhoea must not be considered only in conjunction with fronto-basal fractures. If the patient's history provides no indication of a traumatic cause, various intracranial and extracranial changes must be taken into consideration and a comprehensive diagnostic investigation of the base of the skull instituted. C.S.F. Rhinorroea may also be caused by fractures of the posterior and middle fossae of the skull. Possible forensic difficulties should be taken into consideration by carrying out a complete diagnostic investigation at the earliest possible time and involving all the appropriate specialities.


The use of lyophilized dura in reconstruction of the orbital floor. The results and experiences with the use of lyophilised human dura in 52 cases are reported. Experimental work carried out on rabbits demonstrate that human lyodura is replaced by a layer of connective tissue. Both, the results of animal experiments as well as those experienced in 52 clinical cases suggest that lyodura is an excellent material for the reconstruction of defects of the orbital floor.


Follow-up studies in oral leukoplakia.

Follow-up studies in oral leukoplakia. Follow-up examinations of 670 patients with oral leukoplakia during a 30-year-period showed cancer development in 40 cases, i.e. 6%. Dysplasia was observed in 24% of the histologically examined leukoplakia cases; 13% of the dysplasia cases subsequently showed development of carcinoma. The age distribution revealed the prevalence of leukoplakia in the age-group 51-60 years; that of carcinoma in the age-group of 61-70 years. The sex distribution showed a male-female ratio of 3.2 : 1 in the leukoplakia-group, and a 1.9 : 1 ratio in the carcinoma-group. The tongue and the lips were the site of predilection for malignant transformation and for dysplasia. Among aetiological factors, Candida albicans infection and the simultaneous existence of several aetiological factors seemed to play a role in malignant transformation. Erosive leukoplakia showed the highest risk, developing in 25.9% of the cases into cancer.


The benign lymphoepithelial lesion of the salivary glands. A case report. The literature on the so-called benign lymphoepithelial lesion of the salivary glands is reviewed. A case is reported demonstrating progression to malignant lymphoma (lympho-sarcoma) over two years. Other examples of autoimmune disorders developing malignant lymphoma are recalled.


Short-term changes in the perception of comfortable mandibular occlusal positions. In search of a new clinical method for determining the occlusal height of full dentures, the perception of the comfortable zone was studied in fifteen edentulous patients. In each experimental session perceptual changes were recorded from forty-four consecutive applications of a screw jack per subject. Two stages in perceptual acuity were found. An initial stage, in which only minor variations occurred among the final screw adjustments which the subjects made when they assessed the borders of the comfortable zone. In the ensuing stage greater variations emerged, indicating a deterioration in the ability of the subjects to discriminate.


A galvanic study of different amalgams.

A galvanic study of different amalgams. Due to the difference in open circuit potential (OCP) versus SCE for Aristaloy amalgam (-969 mV) and Dispersalloy amalgam (-549 mV) in Ringer's solution at 25 degrees C, a galvanic cell was created with Dispersalloy amalgam as cathode and Aristaloy amalgam as anode. The galvanic corrosion current was studied as a function of time for the above cell as well as for a cell of type III dental gold (OCP is +0-5 mV) versus Aristaloy amalgam. The initial corrosion current of the latter cell (105 micronA) is about twice that for the cell of Aristaloy amalgam versus Dispersalloy amalgam (54 micronA), however, their passivating behaviour is quite similar. Also, an interrupted galvanic corrosion test simulating the oral 'make and break' situation was performed. A much higher corrosion current than the steady state was found when the two electrodes resumed contact.


The role of retro-disclusion in the treatment of the TMJ-patient. A clinical procedure is described for treatment of patients with condylar malposition. The method of construction of the occlusal splint used is outlined and its mode of action discussed.


Oral rehabilitation of adult class II, division 1 malocclusion complicated by collapse of posterior occlusion. The complications and limitations in rehabilitating an adult woman with class II, division 1 malocclusion and posterior occlusal collapse is described with special consideration given to the aspects of time, the patient's personality and socio-economic situation. Fixed restorations were chosen for optimum function, comfort and to enhance the patient's emotional security. The importance of an individual treatment approach is stressed.


The need-demand problem in patients with oro-mandibular functional disorders. General conditions and facts concerning need-demand will be discussed and applied to oro-mandibular functional disorders. The balance between demand for treatment and offer of treatment will be considered and with this the importance of prevention, attention to the risk groups and early treatment will be shown.


An application of potentiostatic current--time transients to study the corrosion of dental amalgams. Potentiostatic current-time transients obtained during anodic polarization of a conventional dental amalgam and its component phases have been analysed to characterize the possible electrochemical reactions involved in amalgam corrosion. These reactions involve such surface phenomena as adsorption, anodic film formation, film dissolution, etc. which are well reflected in current-time transients. The analysis of these transients from the standpoint of thermodynamics, suggests that the saline corrosion of dental amalgam may occur through the dissolution of the passive anodic films on Sn7Hg(gamma2) and Cu6Sn5 (eta') and the dissolution reaction appears to be related to the formation of tin-oxychloride.


Bruxism and its effect on the teeth.

Bruxism and its effect on the teeth. This study presents the progress of tooth wear and the change in structural morphology on individual teeth of bruxist subjects, compared with non-bruxers. From the results of this investigation it can be concluded that the tooth wear progressed faster in bruxers than in non-bruxers. Scanning electron microscope investigations revealed in 10 teeth the same pattern of deep grooves and striations on the wear-facets of active bruxers.


The variation in contact angle of fissure sealant on enamel surfaces. For strong adhesion of ultraviolet initiated polymeric fissure sealants to dental enamel, a well-formed tag structure is necessary. This requires that the unpolymerized sealant must be able to flow quickly into the etched surface before polymerization is initiated. The variation in contact angle, O, with time (the spreading ability) of unpolymerized Nuva-Seal has been measured on unetched, etched and moist enamel surfaces. This spreading ability varies with the condition of the surface. It is estimated that, in the system investigated, the roughness of the enamel surface is increased by up to 13% on etching, but is reduced again if moisture is present, due to condensation into the etch pits. An etched, moisture free enamel surface is therfore necessary for strong adhesion of polymeric materials.


The relationship between the metacarpal index and the rate of mandibular ridge resorption. This study tried to determine whether a relationship exists between the degree of alveolar resorption of the edentulous mandible and the degree of osteoporosis, as expressed by the metacarpal index. Eighty patients were examined. Each had a radiograph of the left hand to show the second metacarpal, and a standard pan-oral radiograph. A morphological measurement of the metacarpal bone, which is a good indication of the mineral content of the skeleton, was made on each hand radiograph. Alveolar resorption was estimated on the pan-oral radiograph by taking the original height of the alveolar process as being three times the distance from the inferior border of the madible to the inferior edge of the mental foramen. The regression analysis revealed no relationship between osteoporosis, as measured by the metacarpal index, and the amount of alveolar bone resorption.


Long-term changes in the perception of comfortable mandibular occlusal positions. The aim of this study was to disclose, whether use of a screw jack device to set the distance between the jaws, would contribute towards a stabilization of the magnitude and position of a comfortable zone of mandibular positions or even eliminate it. Thirteen subjects participated in each of fifteen experimental sessions distributed over a 3-week period. Throughout the investigation the zone prevailed at an average width of 1-3 mm. The gap shrank 0-08 mm on average per experimental session. Although this latter value was found to be significant statistically, it can hardly be of clinical importance, considering the time needed for a total contraction of 0-8 mm to develop.


High temperature behaviour of hydroxy- and fluorapatite. Crystalchemical implications of laser effects on dental enamel. The application of laser rays for caries prevention as for restorative purposes in oral rehabilitation causes severe changes in the structural and textural assembly of the dental hard tissue. Electron microscopical and X-ray investigations of the new calcium phosphate phases which arise demonstrate a deterioration of the affected tooth regions.


Incidence of epithelial atypia in radicular cysts: a preliminary investigation. Histologic sections of 100 radicular cysts were scored for epithelial atypia, inflammation, and presence of other histologic features. No atypia was found in 32 cases. In 34 cases, atypia occurred in epithelium that was heavily infiltrated with chronic inflammatory cells. There were 26 cases of slight atypia, six cases of moderate atypia, one case of severe atypia, and one case that appeared to be carcinoma arising in a cyst wall. There was no evidence that inflammation in the connective tissues occurred more frequently or was more severe in cases that exhibited greater degrees of atypia.


Comparative study of healing and remodeling in various bones. The effects of normal physiologic stimuli on healing and remodeling in various bones of different embryogenic origin in the rabbit and dog were compared. The findings disclosed that the healing and remodeling of the tibia and mandible were consistent with the magnitude of the forces that act on these bones; namely, the tension created by muscle contraction and the compression exerted by body weight in the tibia, and masticatory compression in the mandible. The slower healing and remodeling in the maxilla was attributed to the selection of the excision of bone in the edentulous site with minimal masticatory compression and muscle-pull tension. The excision of the bone in the skull appeared to heal by fibrous tissue with no evidence of remodeling, which is consistent with the minimal external forces that act on this bone.


Arteriovenous malformation of the mandible: report of case. A case of a potentially lethal arteriovenous malformation of the right side of the mandible has been presented. Procedures that may be helpful in diagnosing the lesion have been discussed, and a protocol for treatment of these lesions in the mandible has been proposed. Research of the cause and management of these lesions is greatly needed.


Reconstruction of the temporomandibular joints in a patient with renal osteodystrophy. The pathophysiology and medical management of renal osteodystrophy are discussed and the surgical reconstruction of the TMJs in a patient with this problem is presented. The necessity of close postoperative supervision is emphasized.


A ganglion associated with the temporomandibular joint. A ganglion that occurred as a preauricular mass was reported. A review of the literature disclosed no previous report of a ganglion in this area. Although a ganglion is an innocuous lesion, its presence in the preauricular region must be considered a remote possibility in the differential diagnoses of masses in this area.


Transoral resection of a condylar osteochondroma: report of case. A rare case of osteochondroma (osteocartilaginous exostosis) of the mandibular condyle is described; this represents the seventh documented case in the English language literature. Treatment consisted of transoral surgical resection which maintained condylar integrity. No maxillomandibular fixation was placed and the patient's mandibular function was undisturbed. Postoperatively, mandibular deviation was minimal.


Monomorphic adenoma, canalicular variant: report of case. A case of monomorphic adenoma, canalicular variant, has been presented. This lesion is a rare benign neoplasm most often found in the minor salivary glands of the upper lip. This appears to be the first reported case of the lesion in a non-Caucasian.


Erysipelas: facial lymphangitis.

Erysipelas: facial lymphangitis. Two cases of facial lymphangitis have been described, and the pathophysiology of erysipelas has been discussed. Now rarely observed by hospital residents, this potentially serious infection can create considerable diagnostic confusion in medical as well as dental services. Rapid response of erysipelas to penicillin therapy is the modern expectation.


Vascular responses in the human periodontal ligament and alveolar bone detected by photoelectric plethysmography: the effect of force application to the tooth. A modification of the technique of photoelectric plethysmography has been developed to monitor changes in the microcirculation of the human periodontal ligament and adjacent alveolar bone, whereby detection is made of light reflected from or transmitted through a tissue during alterations in blood volume, flow or distribution. Light is conducted to and from the periodontal tissues via miniature fiberoptics placed within the root canals of endodontically treated teeth, or illuminated through the external surface of the gingiva towards the root. Circulatory activity was monitored both with the teeth at rest and under forces up to 480 gm. Horizontal and axial forces were found to produce a decrease in blood volume in the area of the periodontal tissue under compression. In an area under tension, an initial increase in blood volume was followed by a decrease as the magnitude of force rose above the critical 90 to 180 gm level. The pulse volume, however, was increased during both phases. Analysis of the biphasic and pulse volume changes suggests that autoregulation of blood vessel tone occurs in the periodontal tissues as a result of alteration in extravascular tissue pressure when the root is moved relative to the alveolus. It is proposed that this autoregulatory mechanism may play a role in alveolar bone metabolism by producing alteration in local tissue oxygen tension.


Experimental gingivitis in ODU plaque-susceptible rats. I. Changes of plaque formation and body weight. New strains of ODU plaque-susceptible and resistant rats have been developed starting from litter mating at our laboratory, in 1972. Those strains were selected and mated for further generations. ODU plaque-susceptible and resistant rats are those that show the presence or absence of plaque formation in their gingiva of lower incisors after they are fed a commercially available powder diet. Experiments were started when rats weighing 75 to 85 gm were about 5 weeks old being fed with 20 gm of a powder diet a day. Almost every 4 days, plaque formation was observed in terms of 5 degrees from zero to 4 degrees and body weight. As a result, plaque formation in plaque-susceptible and resistant rats clearly showed their quality in their 3rd generation. Those qualities will be further emphasized as the generation advances. In the 3rd generation of plaque-susceptible rats, no difference was found in growth between those ingested with a powder diet and those with a solid diet of the same ingredients. But in the first 2 months, male plaque-resistant rats of the 3rd generation grew more quickly than susceptible rats.


Gingivitis, bacterial plaque, and Streptococcus mutans in naval recruits from Saudi Arabia. Gingivitis, dental caries, bacterial plaque, and the prevalence of Streptococcus mutans in plaque were studied in a group of 52 naval recruits from Saudi Arabia at the Naval Training Center, Great Lakes, Illinois. Gingivitis and bacterial plaque were found at higher levels in Arabian navy men, compared to American navy men, but with similar relationships. The dental caries experience of the Arabians was low, and the prevalence of S. mutans in the bacterial plaque had no clear relationship to gingival inflammation.


Cytopathologic effects of chlorhexidine on human cells. Exposure of human cells in culture to chlorhexidine at concentrations equal to or greater than 0.004% resulted in impaired cellular function and/or cell death. Release of membrane bound 51Cr, inhibition of protein synthesis as measured by incorporation of 3H-leucine into protein-like material, and staining by trypan blue were seen as sequellae to exposure to 0.006% chlorhexidine for 3 hours. Lower doses were capable of inhibiting protein synthesis and releasing 51Cr, but did not result in staining of cells by trypan blue. Exposure of cells to 0.2% chlorhexidine for 30 seconds produced maximal suppression of protein synthesis and release of 51Cr.


The effect of an alexidine mouthwash on dental plaque and gingivitis. The alexidine mouthrinse used in this study (CP-101) is effective in reducing plaque. There was a reduction in gingivitis after 6-months use but not at a statistically significant level. An extrinsic brown stain occurred at a significant level on the teeth of participants using the active mouthrinse. Blood and urine laboratory results indicated that alexidine can be safely used over a 6-month period.


Oral hygiene in a group of supervised patients with fixed prostheses. The oral hygiene, the gingival condition, pocket depth, and the incidence of caries on crowned teeth were studied during a period of 5 years in a group of patients (114) who had been treated with fixed dental prostheses. Prior to the prosthetic treatment, the patients received periodontal treatment. During the study, the subjects participated in an oral hygiene program. Crown margins were located sub-gingivally, at the gingiva and supra-gingivally. When the crown margins were located sub-gingivally, there was an increase in Gingival Index scores 2, and in pocket depth, compared to supra-gingival placement. An improvement of gingival health was recorded where the crown margins were located supra-gingivally. Caries lesions developed on 3.5% of the tooth surfaces which had recieved crowns.


Gingival fenestration.

Gingival fenestration. A pathologic entity, the gingival fenestration, has been described. The lesion is seen infrequently in clinical practice, probably due to the short time span of its existence and the lack of acute symptoms. It is possible that it occurs with greater frequency than generally realized. A hypothesis is presented as to the method of formation of the gingival fenestration and it is suggested that the area should be treated as gingival recession extending to the apical border of the fenestration.


Acute toxicity testing of erythrosine and sodium fluorescein in mice and rats. Erythrosine and sodium fluorescein, two colors used as a dental plaque disclosing agents, have similar chemical structures differing only in that erythrosine has four iodine atoms in the molecule while sodium fluorescein has no iodine. A comparative toxicological profile was made on both compounds employing oral dose ranges and acute oral toxicity tests in mice and rats. The results show erythrosine to be approximately twice as toxic as sodium fluorescein with LD50 values of 2558 +/- 1.35 mg/kg in mice and 2891 +/- 1.02 mg/kg in rats for erythrosine and 4738 +/- 1.23 mg/kg in mice and 6721 +/- 1.26 mg/kg in rats for sodium fluorescein. The major toxic manifestations of both compounds were those indicative of central nervous system depression.


Occurrence and distribution of interdental gingival clefts following orthodontic movement into bicuspid extraction sites. Forty patients in active retention following orthodontic tooth movement into premolar extraction sites were examined for the occurrence and distribution of interdental gingival clefts, defined as an invagination of interproximal tissue with definite mesial and distal peaks having a depth of at least 1 mm. Fourteen of the forty orthodontic patients demonstrated clefts in one or more of the premolar extraction sites. No clefts were observed in premolar areas of orthodontic patients who did not require premolar extraction or in patients without previous orthodontic treatment. Interdental clefts occurred most frequently at the buccal aspect of mandibular first premolar extraction sites. The presence of the cleft appears to have clinical implications, both in terms of orthodontic relapse, and maintenance of gingival health.


Antibiotics and the intraoral abscess.

Antibiotics and the intraoral abscess. Sensitivity tests were administered to determine the effectiveness of several antibiotics in the management of the oral abscess. Cultures were taken from 13 patients who were diagnosed as having either a periodontal or periapical abscess. Results revealed the following 1. The most effective antibiotic was Chloromycetin. Yet it was felt that its medical contraindications far outweigh its use by the dental practitioner. 2. Tetracycline was the least effective antibiotic. 3. Penicillin, because of its high potency against microorganisms of the dental abscess, should be considered the drug of choice. Its use, however, must be restricted to patients who give a negative history to allergies and/or asthma; when such a history is positive, erythromycin should be used. 4. Appropriate culture and sensitivity tests should be performed to determine the susceptibility of the causative organism(s) to the drug of choice.


A new articulator emphasizing centric occlusion and the anterior determinants. A new articulator is described which has the advantages of the rigidity of a simple articulator in the upper member and the flexibility of an adjustable articulator in the lower member. A link between the members and the frame along with the posterior controls establishes a full range of functional chewing movements and defines the extreme lateral or border paths. The articulator has condylar element controls which permit releasing and remounting the mandibular cast in a manner that serves the same function as the split-cast technique, but this method is faster and shows the amount of discrepancy. The condylar element control is an improvement over existing devices for comparing interocclusal records in that it not only indicates differences in position but it also provides quick remounting of the casts in a working articulator. Other features of the articulator are: (1) a condylar lock mechanism which is activated by only a half turn, (2) adjustable spring tension, (3) precise long centric and wide centric controls, (4) an incisal pain which can be removed and replaced on the articulator without changing its setting, (5) a Bennett movement carefully selected to avoid the complication of a pantograph type of face-bow, and (6) a new sponge wall type of mounting plate which supports both casts for simultaneous mounting.


Interocclusal distance: a comparison between American Caucasians and Negroes. Cephalometric analyses were performed on groups of American Negro and Caucasian subjects to establish whether or not there were differences in interocclusal distance attributable to ethnic origin. Statistically significant differences were found between the mean interocclusal distances of the two treatment groups, supporting the hypothesis that American Negroes have an average interocclusal distance which is less than that of Caucasians. The findings of this study support the concept that fixing the interocclusal distance at 3 mm. for all complete and partial denture patients is not justified.


Maintenance procedures for patients after complete fixed prosthodontics. The philosophy of dental disease control has been discussed. Various devices used in the elimination of plaque have been listed and discussed. These include dentifrices, brushes, flosses, devices for holding and carrying floss, stimulating devices, disclosing solutions, and water irrigating devices. The responsibility for complete and thorough restorative therapy is shared by both dentist and patient. The treatment is not final when the restoration or prosthesis is inserted. Ongoing physiotherapy in the form of a rigid plaque-control program will influence the ultimate success or failure of any restorative treatment.


Intermaxillary fixation following mandibular resection. This report concerns 14 patients who were treated by use of immediate intermaxillary fixation after segmental resection of the mandible to eradicate cancerous lesions. Mandibular resection usually produces problems in surgical and prosthetic reconstruction. The use of intermaxillary fixation during the first 6 postoperative weeks will reduce the degree of deviation. In mandibular resection for edentulous patients, the original dentures were used postoperatively with slight modification or no modification at all. With fixation and encouragement of early functional movement of the mandible, the dentulous patients showed a lesser degree of deviation. Some of the patients of the latter group used guide flange prostheses during the postoperative period to return the mandible to the centric position. Edentulous patients who deviated slightly were fitted with a maxillary ramp which guided the mandibular segment, after the initial contact, into the proper centric relation.


A study of the variability of setting a fully adjustable gnathologic articulator to a pantographic tracing. The purpose of this study was to determine the variability encountered in setting a fully adjustable articulator to a pantographic tracing produced by the same articulator. It was shown that adjustments for top wall, vertical axis, and rear wall were of the greatest magnitude. The practical significance of this investigation lies in the data base that it provides for further analysis of tracings produced in a similar manner. The results show an inherent system variability and that mechanical and operator errors were involved only in the actual setting of the instrument. This problem deserves further research into the exact causes of the variability and the effects that the various adjustments have upon one another. Continued efforts in this vein can only lead to further elucidation of the complexities involved in mandibular movement and capture of such movements by mechanical means.


Panoramic radiography in the examination of edentulous patients. A radiologic survey covering 4 years and using orthopantomography was made of 287 edentulous patients prior to denture construction. Orthopantomographs revealed 155 significant lesions in 41 per cent of the patients examined. Therefore, the use of panoramic radiography before any prosthetic procedure is undertaken seems justified. Surgery would be indicated where cysts (residual and follicular), visible root fragments, and sequestra are detected. In most situations, such as deeply imbedded impactions, localized sclerotic bone, or foreign bodies, surgery would not be justified for elderly patients because of the possible unfavorable aftereffects. When this decision is made, the patient should be informed of the possibility of future surgical and prosthetic procedures.


A temporary space maintainer using acrylic resin teeth and a composite resin. A one-session technique for preparing a temporary space maintainer has been described. The technique consists of attaching an acrylic resin pontic to etched surfaces of natural adjacent teeth by means of a composite resin. The main advantages of this technique are elimination of premature tooth preparation, good esthetics, fair strength, low cost, and rapid completion of the restoration without the need of a dental laboratory.


TMJ dysfunction--principles of the clinical examination. Determining if head pain is related to occlusal disharmony can be a challenge. A brief outline of the clinical examination of these patients was presented. Gross interceptive occlusal contacts should be corrected in all patients. The evaluation of signs and symptoms is the basis for determining whether to "adjust" the asymptomatic patient. Consideration should be given to the intensity of the occlusal disharmony, the level of anxiety, and the patient's adaptive response.


Posterior unilateral condylar displacement: its diagnosis and treatment. The treatment procedure for posterior unilateral condylar displacement has been described. An acrylic resin repositioning prosthesis may be used to decrease trismus. Occlusal adjustment permits lateral freedom for mandibular movement to the opposite side which provides a dual, or a therapeutic, centric occlusion as well as the existing dysfunctional centric relation. This permits the patient's physiologic adaptive mechanism to choose between the existing dysfunctional centric relation, which resulted in unilateral condylar retrusion and pain, or a therapeutic centric occlusion which is aimed at anterior unilateral condylar repositioning. Over long period of time, muscle reprogramming produces maximum intercuspation of teeth in the planned therapeutic centric occlusion rather than in the original dysfunctional position. No explanation has been established for this phenomenon. It is important, however, to provide a technique that permits physiologic adaptability over a period of time. It should be emphasized that this is not TMJ "remodeling" but a functional change in the position of the jaw. The treatment objectives of bilateral and unilateral posterior condylar displacement are similar, but the clinical techniques are completely different. In either instance, TMJ radiographs are necessary to establish the diagnosis and treatment, as well as to document the postoperative results.


A simplified acrylic resin cast technique. A simple technique for construction of acrylic resin casts has been described. This procedure utilizes inexpensive and standard supplies found in a dental office.


Central nervous system (CNS) relapse following chemotherapy of WF rat acute myelogenous leukemia: a model for human CNS leukemia. The treatment of central nervous system (CNS) involvement in human acute myelogenous leukemia (AML) presents a serious therapeutic dilemma. In an attempt to study the pathophysiology of this diseases in an animal model, the incidence and sites of detection of CNS leukemia were evaluated in inbred rats receiving chemotherapy for the transplantable WF AML. Eight of 100 rats with untreated WF AML demonstrated CNS leukemia at death with concomitant widespread visceral infiltrates, ascites, bone marrow involvement, and peripheral blood leukemia. Similarly, 6 of 120 rats (5%) failing to attain a complete remission following adriamycin. Cytoxan, or cytosine arabinoside chemotherapy demonstrated CNS leukemia in addition to systemic disease at death. In contrast, 70 of 75 rats (93.3%) achieving a complete remission subsequently relapsed in the CNS, either in combination with widespread systemic disease in 48 (64.0%) or with minimal evidence of systemic relapse in 22 (29.3%). There was a greater frequency of detectable cerebral compared to spinal cord infiltrates in relapsing rats. The WF AML appears to be a valuable model for study of the mechanism and ultimately the prevention of CNS relapse following chemotherapy in human AML.


Survival of human cells in the aggregate form: potential index of in vitro cell transformation. The ability of cell populations to survive in the aggregate form was compared to colony formation in soft agar and tumorigenicity in nude mice. Nontumorigenic human osteogenic sarcoma (HOS) cells, which formed colonies in soft agar, could not survive in the aggregate form. Tumorigenic HOS cell lines, which also formed colonies in soft agar, survived and proliferated in the aggregate form. Other cell types were tested with the same results. This approach, based on cell survival in the aggregate form, may provide an additional, reliable method for predicting the tumorigenic status of a cell population.


Skin testing in the assessment of cell-mediated immunity. Cell-mediated immunity may be assessed by measuring the response to subcutaneous injection of a battery of recall antigens. The finding of cutaneous anergy (the failure to respond to testing) is strong evidence of either major pathology or a significant immunosuppressive event. A protocol for skin testing is presented together with some preliminary results, including normal values for a New Zealand population. Consideration of its adoption is urged.


Otolaryngeal allergy in Wellington. 1971-1975. Two thousand and twenty-nine patients received allergic therapy 1971-1975. Nine hundred and eighty-nine were followed up six to 24 months later. All received Rinkel's inhalant skin titration method. The first group 1971-1972 of 309 patients were investigated with Lee's food provocation method and useful relief of symptoms occurred in 27.6 per cent of patients. The second group 1973-1975 of 680 patients were investigated with Bryan's cytotoxic food test, 60 percent reported very good relief and 26 percent useful relief of symptoms. Successfully treated patients were able to curtail or abandon drug therapy and the frequency of surgery was decreased. The authors believe allergic symptoms are of common occurrence in patients frequently seeking medical attention.


The nutritional status of Auckland children. The nutritional status of children (and hence the community) was assessed in the five major races in Auckland by height, weight, and head circumference measurements. Under the age of two years Samoan children were significnatly taller and heavier than Europeans and Maori children. No significant racial differences occurred in children between ages two and 13 years. No racial variation in head circumference between races was noted at any age. More children of lower socio-economic class had weights about the 97th percentile especially in Samoan, Cook Island and Niuean children's groups, suggesting they are particularly vulnerable to obesity. Heal circumference of children of low socio-economic status was smaller than that of other children. Similarly non-breast fed children had smaller heads than breast fed children. This suggests these children may have impaired brain growth.


Endemic amoebic abscess.

Endemic amoebic abscess. An unusual case of endemic amoebic abscess of the liver in a New Zealand is presented. The clinical manifestations and treatment are discussed.


Death from massive hepatic necrosis in infectious mononucleosis. A case is reported of a 19-year-old youth who developed infectious mononucleosis and died 17 days after the onset of the illness. At autopsy massive hepatic necrosis was found, associated with enlargement of the liver.


The use of freeze-dried bone as a biologic crib for ridge augmentation. A preliminary report. Freeze-dried bank bone has been used as a biologic crib, packed with autogenous cancellous bone from the iliac crest, to augment mandibular and maxillary ridges. This technique entails little morbidity. It has been used in six patients, with good clinical success. Three of the patients who underwent mandibular augmentations began wearing dentures within 3 months after augmentation surgery. One patient had a soft-tissue breakdown overlying a graft to the maxilla and subsequently lost a portion (less than one third) of the graft; the other two patients are currently ungoing denture construction. Secondary procedures, such as vestibuloplasty, have been necessary in only two of the six patients. Long-term follow-up is needed, but clinical and radiographic evidence to date demonstrates good results.