Primary osteosarcoma of the sternum of a dog. Primary osteosarcoma of the fifth sternebra is reported in a 6-year-old male Great Dane. Presenting signs were suggestive of myocarditis and pulmonary congestion. Electrocardiography revealed R waves of low and variable amplitude and the plasma alpha-hydroxibutyrate dehydrogenase level was elevated. Radiography revealed neoplasia of the fifth sternebra with extensive bilaterial pulmonary metastases. Histologically the neoplasm showed typical osteosarcoma with plentiful osteoid production.


A world of cities: dream or nightmare?

A world of cities: dream or nightmare? With the progress of civilization cities, many of which originally developed in Mesopotamia and Egypt, spread northwards into Europe to proliferate there and, later, in the New World. The industrial Revolution, a predominantly British phenomenon, was the original stimulus to Western urbanization, a process that continues to this day. City living has many advantages, but also many drawbacks including increased mortality and urban stress; psychiatry has had to concern itself with many of its difficulties. Rural-urban migration is also currently taking place in Asia, Latin America and Africa; in these continents the problems of urbanization, exacerbated by indigenous factors, have proved to be considerable. Some remedies for overurbanization are considered, as is also city development in the future.


Negative capability as a factor of problem-solving within the psychotherapeutic process. It is proposed that negative capability, that is, the capacity for tolerating uncertainty, doubt and not-knowing, is a factor that contributes to a problem-solving approach utilizable in some aspects of the psychotherapeutic process. Negative capability can be demonstrated both in therapists and patients. An analysis of the functions of negative capability within the psychotherapeutic process shows five stages in its utilization. These are the activation of therapist's negative capability; which is followed by observations about the patient's response to his perception of the therapist's negative capability; then the therapist's clarification of the patient's problem contained within the patient's response; followed by a working-through by the patient and therapist of the problems which are demonstrated and clarified; and lastly, a transfer to or enhancement of the patient's use of negative capability as a continuing behavioural mode. Some theoretical bases for the concept of negative capability and its application as a factor of problem-solving within the psychotherapeutic process, are proposed. Clinical excerpts from psychotherapeutic work are given to exemplify the stages as defined above.


Parental deprivation and depression in a non-clinical group. Despite a large number of studies it remains unclear whether early parental loss or separation experiences from parents are associated with depression in adult life. In order to circumvent the possible confounding influence of psychiatric patients status, a non-clinical group was used to study any influence of early permanent parental loss and early parental separation on subsequent depressive experience in adulthood. The depressive experience of 236 post-graduate students was assessed using measures of trait depression, self-esteem, alienation, and incidence of depressive episodes. Depressive experience was not increased in those 27 subjects who had been permanently separated from a biological parent before the age of 16 years. When duration of separation from influential parent-figures was examined it was found that trait depression scores were increased in those who had experienced longer separation, but those subjects also rated their parent-figures as having been less caring. Findings are consistent with the view that it is the quality of any parental contribution, rather than its continuity, that is associated with subsequent depressive experience in adulthood.


Onset of mania in bipolar manic-depressive patients. Onset of mania was evaluated retrospectively in 48 bipolar manic-depressive patients. Mania occurred as the initial episode in 40% of cases. In patients with initial episode of depression, approximately 80% developed mania prior to their third episodes of depression and within 5 years from the onset of this illness. Differences in type of illness onset were related to family history of bipolar illness and sex of the proband. Male patients with a positive family history were significantly more likely to manifest mania at onset of illness.


Diethylpropion and paranoid psychosis.

Diethylpropion and paranoid psychosis. The case of a 36-year old woman who developed a paranoid psychosis while abusing diethylpropion is reported. It is suggested that the newer appetite-suppressing drugs have a bigger abuse potential than eas previously thought and may therefore be a hazard for a minority of susceptible subjects. The need to test separately for diethylpropion in cases of suspected drug-induced psychosis is emphasized.


Length of residence, life change and psychiatric morbidity in an Australian urban population. A component of a large population study of a random sample of 750 Canberra residents is described, in which length of residence in Canberra is related to the quality and quantity of recent life experiences, and to indices of minor psychiatric morbidity (the General Health Questionnair and the Zung Depression Scale). Life event frequency, but neither measure of morbidity, distinguished between persons with different lengths of residence in Canberra. It can be suggested that a random sample, containing an under-representation of migrants and persons moving from rural to urban environments, in whom the transition in shifting place of residence would be expected to be greatest, is an inappropriate sample to test hypotheses concerning length of residence and psychiatric morbidity, Future studies should give due emphasis to the adequate inclusion of these groups of persons.


Studies in acute leukemia. I. Antibody-dependent and spontaneous cellular cytotoxicity by leukemic blasts from patients with acute nonlymphoid leukemia. Leukemic blasts from patients with acute nonlymphoid leukemia were examined for the presence of Ig, receptors for IgGFc, and for their capacity to mediate antibody-dependent cellular cytotoxicity (ADCC) against chicken red blood cells (RBC) coated with IgG and spontaneous cell-mediated cytotoxicity (SCMC) against cells of K562 cell line. Leukemic blasts from acute myeloblastic leukemia (AML) patients lacked both Fc receptors and Ig on their surface, had no SCMC activity and majority, but not all of them, lacked ADCC activity. Leukemic blasts from patients with acute monocytic leukemia (AMOL) had Fc receptors, and 50% had IgG on their surface. IgG was cytophilic and appeared not to be directed against cell-surface antigens. This antibody did not interfere with the ADCC activity of leukemic cells. Leukemic blasts from majority of patients with AMOL mediated ADCC, but had no SCMC activity. An association between ADCC and presence of Fc receptor was observed.


Lithium and granulocytopenia during induction therapy of acute myelogenous leukemia. Twenty-seven patients receiving a standard cytosine arabinoside and daunorubicin regimen as induction of reinduction therapy of acute myelogenous leukemia were randomly assigned to receive lithium carbonate, 300 mg t.i.d., or no lithium. Treatment groups were comparable with respect to age and baseline granulocyte counts. All patients developed granulocyte nadirs below 100/cu mm. By actuarial analysis, the median duration of granulocytopenia, less than 1000/cu mm, was 16.0 days in the lithium group and 24.6 days in the no-lithium group, p = 0.013. The median duration of granulocytes less than 500/cu mm also favored the lithium group but only approached statistical significance: 14.0 days versus 20.5 days, p = 0.054. Lithium levels between 0.5 and 1.0 meq/liter were easily maintained in 11 of 12 patients receiving lithium, 300 mg t.i.d., and toxicity directly attributable to lithium was not observed. Despite the shortened duration of neutropenia, the incidence of infections and the rate of remission were not affected.


Hand-mirror cell leukemia associated with mental retardation: immunologic, chromosome, and morphological studies. Cycochemical, morphological, immunologic, and cytogenetic studies were carried out on hand-mirror cells (HMC) from a mentally retarded patient with a constitutional chromosome abnormality, 46,XX,r(21), and acute lymphoblastic leukemia. Scanning electron and differential interference contrast microscopy showed microspikes on the uropodia, but little evidence of cellular motility, despite formation and disappearance of individual uropodia in cell suspensions. The cells rosetted with sheep erythrocytes, suggesting T-cell origin. Cells derived from the bone marrow (80% HMC) showed a high degree of polyploidy (60%) and a bimodal chromosome number of 49 (49,XX,+10,-21, +3 rings) and 94 (6 no. 10, 3 no. 18, 2 no. 21 chromosomes, 3 ring chromosomes, plus 4 copies of each other chromosome).


Characterization of the continuous, differentiating myeloid cell line (HL-60) from a patient with acute promyelocytic leukemia. In a prelminary communication, we described the establishment of a continuous human myeloid cell line (HL-60). Here we report the detailed properties of this cell line and document its derivation from the peripheral blood leukocytes of a patient with acute promyelocytic leukemia. As characterized by light and electron microscopy, the predominant cell type in both the fresh and cultured sources is a neutrophilic promyelocyte with prominent nuclear/cytoplasmic asynchrony. Up to 10% of the cultured cells spontaneously differentiate beyond the promyelocyte stage, and the proportion of terminally differentiated cells is markedly enhanced by compounds known to stimulate differentiation of mouse (Friend) erythroleukemia cells. The HL-60 cells lack specific markers for lymphoid cells, but express surface receptors for Fc fragment and complement (C3), which have been associated with differentiated granulocytes. They exhibit phagocytic activity and responsiveness to a chemotactic stimulus commensurate with the proportion of mature cells. As characteristic of transformed cells, the HL-60 cells form colonies in semisolid medium and produce subcutaneous myeloid tumors (chloromas) in nude mice. A source of colony-stimulating activity stimulated the cloning efficiency in soft agar 5--30-fold. Despite adaptations to culture, the morphological phenotype and responsiveness to chemical induction of differentiation is essentially unchanged through at least 85 passages. Cytogenetic studies reveal aneuploidy. Metaphases with 44 chromosomes predominated in vivo and in early culture passages; however, clones with 45 or 46 chromosomes became predominant with continued passaging. The most consistent karyotypic abnormalities were the deletion of chromosomes 5, 8, and X and the addition of a marker resembling a D-group acrocentric and of a submetacentric marker, most likely an abnormal E-group chromosome. No DNA herpesvirus or RNA retrovirus was isolated in the fresh or cultured cells. The HL-60 cultured cell line provides a continuous source of human cells for studying the molecular events of myeloid differentiation and the effects of physiologic, pharmacologic, and virologic elements on this process.


Library development and the joint commission on accreditation of hospitals standards. The author traces the historical development of standards for library services prepared by the Joint Commission on Accreditation of Hospitals, emphasizing those elements of the present standards that auger well for the development of libraries in hospitals. Then examined are the role of librarians and new roles for libraries, stressing sound management practices that ensure continued development.


5-Aminolevulinic acid stimulation of porphyrin and hemoglobin synthesis by uninduced Friend erythroleukemic cells. Porphyrin synthesis and iron accumulation was stimulated by exogenous 5-aminolevulinic acid (ALA) in uninduced Friend erythroleukemic cells (FELC). Uroporphyrin and protoporphyrin were the major intermediated precursors produced. All porphyrin types were conjugated to protein insoluble cellular components and could be extracted only by methanol sulfuric acid esterification. Heme content of the uninduced FELC was increased 6-fold in the presence of 5 x 10(-4) M ALA. As a consequence, the synthesis of the minor murine hemoglobin component was preferentially induced, an effect similar to that expressed by exogenous hemin. Addition of exogenous ALA to 0.5% DMSO-induced cells increased total hemoglobin synthesis with a higher efficiency of the minor hemoglobin. The endogenous synthesis of porphyrin from exogenous ALA was markedly reduced by hemin. Uroporphyrin, coproporphyrin, protoporphyrin and heme were equally repressed, indicating an inhibitory effect of hemin on ALA dehydrase and urosynthetase activities. In addition, hemin repressed [3H]leucine incorporation into protein by uninduced cells. Incubation of uninduced cells in culture medium without serum in the presence of hemin blocked their protein synthesis activity, whereas addition of serum exerted a protective effect on living FELC.


Changes in the skull in acute lymphoblastic leukaemia of childhood. The changes in the skull in acute lymphoblastic leukaemia were reviewed in 26 children. In nine cases typical abnormalities were seen. In this small series there were none with sutural diastasis.


[Acute lymphatic leukaemia in children: re-examination after remission of at least five years (author's transl)]. Full remission of more than five years was observed in nine of 24 children with acute lymphatic leukaemia. They had been treated by a scheme similar to the Pinkel VII one, and all had been discharged from treatment. The immune status, bone marrow, radiological, neurological and psychosomatic studies, as well as various laboratory tests indicated that in seven of the children the findings, are essentially normal. But two children have lasting severe organ damage, portal fibrosis in one and bilateral intracerebral calcification in the other, both presumably due to the methotrexate treatment.


[Acute lymphoblastic leukaemia and malignant non-Hodgkin-lymphoma in childhood (author's transl)]. 28 children with acute lymphoblastic leukaemia and 7 with malignant non-Hodgkin-lymphoma had a computerised tomography (CT) of the brain 2--84 months after the diagnosis was made. The treatment of these children included skull irradiation with a local dose of 1500--2400 R 60Co in the initial therapeutic phase and 4--5 intrathecal methotrexate injections in a dose of 10 mg/m2 body surface per dose during the phase of the skull irradiation. Abnormal CT results were found in 10 children. In some children CT investigations were also performed before the treatment to the CNS began. Abnormal findings before treatment remained unchanged in the follow-up investigations. Thus a large proportion of the abnormalities described had been present before treatment. It appears that pathological changes in the computer tomogram occur in a relatively large number of children after acute lymphoblastic leukaemia and non-Hodgkin-lymphoma, and that most of these changes can be found before CNS treatment. It is unlikely that prophylactic treatment to the CNS can cause pathological changes in the brain detectable by computerised tomography.


[Developmental trends in dental amalgams]. The new copper-rich silver amalgams differ from the standard amalgams because the corrosive-prone gamma 2-phase is absent. They are also superior to standard amalgams in terms of creep values. Edge strength therefore is improved.


[A scanning electromicroscopic determination of the depth of penetration of dental enamel adhesives in the etched enamel]. The surface tension of the liquid preservative was held responsible for the loss of plastic tags in the penetration zone between sealer and enamel due to the preparation. This loss is demonstrable with fluorescence, interference, and polarization microscopy. With the help of freeze-drying procedures, tags of approximately 200 mum could be exposed and photographed with the scanning electron microscope.


[Comparative study on the abrasion behavior of composite filling materials]. Twenty-two commercially available composites, a new resin without inorganic filler and two amalgams have been investigated to compare their abrasive behaviour. In laboratory tests, an abrasion model of tooth against filling has been simulated. The results indicate a dependence of the abrasive behaviour on the type of filler in the different composites. Composites with quartz as filler have the greatest resistance to abrasion, whereas those with lithium-aluminium-silicate show the strongest abrasion. Mean abrasion values are obtained for the composites with barium-glass or a mixture of barium-glass and quartz as filler. The resin and the two amalgams have abrasion values comparable to the abrasive resistant composites.


[Systematic studies on decision making in dental therapy]. The decision for restorative treatment was analyzed in this study, and models were discussed. As model of the first approach, the dental treatment was reproducible, but the findings should not be considered universally valid since psychic factors were not considered.


[Uses of the occlusal registration instrument (ORI)]. By means of the occlusal recording instrument (ORI), jaw models can be measured three-dimensionally and filed with respect to axes and skull. In clinical trials evaluated with the ORI, it was shown that the position of the maxilla in the skull can be transferred to the articulator with great accuracy. Suggestions are given for improvements to refine the method of measurement. If the third point of reference is also tattooed, the accuracy of the transference of the face-bow is considerably increased. Under these conditions the apparatus is suitable for checking the accuracy of the transference of the face-bow and for photographic documentation.


[Dental studies on the protective effect of breast feeding]. The frequency of disease for children who were breast fed as babies is lower than that for children who were bottle fed. Breast milk contains specific and nonspecific proteins which act against pathogens. The influence of breast milk on the development of juvenile periodontitis was examined. It was shown that, out of 55 children raised on bottle milk, 9 children up to 14 years of age showed inflammatory changes in the gingiva while only 1 child out of the 17 fed with breast milk during the first few months of life had gingivitis. The lower frequency of gingivitis can probably be explained by the immunopathology of periodontitis.


[Hypocycloidal tomography of the temporomandibular joint region]. Tomography has become an important diagnostic method today. Clinically it is necessary to recognize the interpretative problems with tomographs. The reason for and the development of a few frequent tomographic phenomena were described using the results of comparative anatomic and roentgenographic examinations.


[In vitro experiments on plaque formation]. The mechanisms contributing to plaque formation have still not been adequately explained. An attempt therefore was made to form plaque in vitro in order to acquire a model for the processes and what influences them. Plaque forms in various stages, analogous to the natural condition when saliva and microorganisms are present on the surface of the teeth. Microorganisms from plaque formed in situ demonstrate a decreased ability for adhesion and cohesion when compared with free salivary microorganisms. Sucrose encourages more rapid and thicker plaque formation.


[Biochemical and morphologic studies on prostaglandins E and F in the normal and inflamed gingiva]. With the help of a radioimmunoassay for prostaglandins E and F, an attempt was made to determine the actual concentration of these substances in normal and inflammatorily altered gingival tissue. The content of PGE and PGF was significantly higher in the inflammatorily altered gingiva than in normal tissue. Morphologic examination using immunologic methods showed prostaglandin E particularly in the monocytes.


[Patient motivation for oral hygiene from the dentist's viewpoint]. Inhibiting factors to patient motivation for oral hygiene are found both with the patient and the dentist. These factors were considered in terms of the daily practice. The concept of oral hygiene motivation, described used primarily with children was.


[Methods for the partial preservation of teeth (hemisection etc.)]. The term hemisection, root amputation and tooth separation are defined. These methods of treatment should be employed after other proven therapeutic measures have failed and there is justification in the total situation for partial tooth preservation. Correct root canal filling of the remaining dental stumps is essential. Special indications exist in the molar region in the presence of deep parodontal disease. The technical details of the individual methods are described. Prognosis is good if the indications were correctly established.


[Antigenicity and resorptive behavior of the usual gelatin preparations and of dry fibrin foam]. Immunofluorescence studies of Gelastypt, Gelfoam, and Fibrospum showed species-specific, protein-dependent antigen characteristics. Additional experimental studies using guinea pigs revealed that, after subcutaneous implantation, these materials do not lose their antigen characteristics during the resorptive process. Remnants of subcutaneously implanted material could be demonstrated intracellularly (macrophages) in the spleens of the experimental animals four weeks later.


[Studies on cariogenicity of sugar substitutes in xerostomized rats]. A comparative study of the cariogenic characteristics of sugar substitutes Xylitol, L-sorbose, and Palatinit as well as saccharose and lactose was carried out in programmed feeding experiments with xerostomized and nonxerostomized rats. The xerostomized animals developed more caries with all substrates than did the nonxerostomized animals. The differences in the saccharose and the lactose groups however were significant. Compared with saccharose, it was confirmed with this method that the cariogenic characteristics of the sugar substitutes tested was low. Xylitol proved to be the least cariogenic.


[The course of caries and frequency of dental restorations in low sugar diet]. The influence of a restricted low molecular carbohydrate diet was tested in 101 children and juveniles with diabetes mellitus. Due to the influence of this diet deep carious lesions develop more slowly. Children in whom the diabetes manifested itself at an early age had a lower index of filling and a higher index of defect. The degree of dental care was altogether alarmingly low.


[Possibilities and limits in dental health education--experiences in a day nursery]. Purposeful and supervised oral hygiene in an institution such as a child day care center is successful and should be generally required. The desired long-term success however cannot be predicted if all persons involved in the program do not reorient their thinking and if sugar is not eliminated from the diet.


Biochemical properties and localization of the chromosomal protein IP25. The protein IP25, which has previously been reported to accumulate in the chromatin during erythroid differentiation of Friend-virus-transformed erythroleukemia cells (FL cells), is shown to behave like histone H1 without being structurally related to it. Like H1, IP25 is not released by digestion of FL cells nuclei with DNAse I. After micrococcal digestion IP25 and H1 are differentially distributed in the nucleosome monomers and dimers. This distribution suggests an internucleosomal location for IP25 and H1. Different rates of digestion are observed between nuclei of differentiating and non-differentiating FL cells with both DNAse I and micrococcal nuclease. These differences could be due to the presence of IP25 in the chromatin of differentiating cells.


Scanning electron microscopy of antibody-dependent cell-mediated cytotoxicity of Friend leukemia virus-infected spleen cells. Friend leukemia virus (FLV) infected splenocytes treated with rabbit anti-FLV serum and subsequently incubated with splenic lymphocytes from non-immune Balb/c mice were examined by scanning electron microscopy. Villous-covered lymphocytes adherred to the tumor cells and induced surface blebs, numerous membrane pores and eventual tumor cell lysis.


Impacted canine teeth.

Impacted canine teeth. To correct pathologic conditions and to prevent future problems, all supernumerary, impacted, and malposed teeth should be evaluated with prospects of providing an anatomically acceptable solution. Through logical clinical and radiologic resources, localication of the malpositioned structure is possible. Correction or control of the affected tooth may follow the tenets of deft, delicate, and accurate surgery in consultation with an orthodontist, a cooperative relationship based on mutual respect.


Decrease in insulin receptors during Friend erythroleukemia cell differentiation. The Friend erythroleukemia cell has an insulin receptor with all the properties of mammalian insulin receptors: rapid, reversible, and saturable binding of insulin; specific for insulin and insulin analogs; inversely proportional to temperatures; sharply pH dependent (optimum = 8.0); and demonstrated ligand-induced accelerated dissociation consistent with negative cooperativity. There were 17,200 sites per cell. After induction by dimethylsulfoxide, 80% of the cells became benzidine positive (i.e., contained hemoglobin). The receptor concentration dropped to 4300 sites per cell, while the remaining receptors retained all the initial binding characteristics. This loss of receptors could not be attributed directly to either dimethylsulfoxide or changes in cell size. Thus, during the process of differentiation, the concentration of insulin receptors in the Friend erythroleukemia cell decreases.


How to prepare for a JCAH evaluation.

How to prepare for a JCAH evaluation. A Hospital Survey Profile and presurvey conferences are offered by the Joint Commission on Accreditation of Hospitals to help hospitals that are to be evaluated prepare for a survey.


Translocation between chromosome 7 and chromosome 22, t(7;22)(p22;q12), in a patient with chronic myelocytic leukemia. A 46-year-old man with chronic myelocytic leukemia had a new variant translocation between chromosome 22 and chromosome 7 in bone marrow cells. No involvement of chromosome 9 was seen. The patient entered blastic transformation within half a year, by which time he had acquired an isochromosome 17 in addition to the variant translocation.


Chromosomal marker 20q- in cases of osteomyelosclerosis and CML. Two male patients with myeloproliferative disorders (osteomyelosclerosis in one and CML in the other) were found to have a chromosomal marker 20q- in blood cells (unstimulated short time cultures). Marked erythropoietic disturbances were not revealed in these cases. The specificity of the 20q- marker for red cell disorders is discussed.


Natural cytotoxic reactivity of human lymphocyte subpopulations. The spontaneous cytotoxicity of human peripheral blood lymphocyte preparations from normal donors for K562 target cells was examined. Effector cells were separated into SRBC rosette forming cell (RFC) and non-rosette forming cell (non-RFC) fractions using optimal and suboptimal rosetting procedures. RFC and non-RFC fractions both had high cytotoxic activity irrespective of the rosetting procedure. Owing to the larger size of the RFC fraction, it contained a higher proportion of the total activity in the preparation. Nylon fibre column adherent and non-adherent fractions also both produced cytotoxicity. Nylon fibre non-adherent cells separated by SRBC separation gave a RFC fraction with low activity and a non-RFC fraction with high activity. Separation of nylon fibre adherent cells gave RFC and non-RFC fractions with high cytotoxic activity. Therefore cytotoxic cells did not form a discrete subpopulation and either occur in several lymphocyte subsets or show a variable capacity to form SRBC rosettes and adhere to nylon fibre.


Tourette's syndrome symptom onset at age thirty-five. It is apparent to the authors that the primary factors influencing this particular case of Tourette's Syndrome are psychological. The condition appeared to result from threatening environmental conditions causing repression. The repressed material manifested itself in multiple tics, echolalia and coprolalia. Because of this patients's extreme resistance to accept the true conditions of his situation, individual and group psychotherapy have been difficult modes of treatment.


Primary malignant mesenchymoma of bone (case report). A case of primary malignant mesenchymoma of bone is reported. It's a very rare kind of tumor of which only four cases were previously reported in the literature. It's a malignant neoplasm where histological aspects of both liposarcoma and osteosarcoma coexist. Prognosis appears to be similar to that of osteosarcoma.


Mechanism of synergistic cell killing when methotrexate precedes cytosine arabinoside: study of L1210 and human leukemic cells. Synergistic killing of L1210 cells occurs when methotrexate (MTX) is administered just before 1-beta-D-arabinofuranosylcytosine (Ara-C). This pehnomenon is dependent upon both the dose and time of exposure to MTX. Such increased killing of cells can be explained by the enhanced intracellular accumulation of Ara-C in cells exposed to MTX. This enhancement of Ara-C entry into cells was only observed when the dose of MTX was high enough (1, 10, and 100 muM) to result in free intracellular nondihydrofolate reductase-bound MTX. At the highest doses of MTX (10 and 100 muM) Ara-C triphosphate was increased eightfold and deoxycytidine triphosphate was decreased by 50%. Therefore, the maximum synergistic cell kill when MTX precedes Ara-C may be the consequence of greater inhibition of DNA polymerase by th;e increased Ara-C triphosphate in the presence of the decreasing natural substrate of this enzyme, deoxycytidine triphosphate. Enhanced Ara-C accumulation after administration of MTX was also observed in human acute myelogenous leukemia cells.


A comparative study of chromosome G-banding using trypsin, papain, and pretreatment with emulphogene. G-banding of chromosome metaphase preparations derived from haemic cells of healthy individuals and from patients with acute myeloid leukaemia was performed with the aid of trypsin, papain, and pretreatment of the chromosome spreads with emulphogene before proteolytic digestion. Papain digestion revealed more distinguishable bands than did trypsin digestion. Pretreatment of the chromosome spreads with emulphogene greatly enhanced the number of distinguishable bands for both enzymes. The combination of pretreatment with emulphogene and digestion with papain revealed optimal numbers of bands for individual chromosomes essentially identical with those agreed at the Paris Conference 1971. The use of the emulphogene-papain technique appears also to offer an advantage in the banding of chromosomes from leukaemic cells.


Assessing the periodontal treatment needs of a population. A longitudinal study was conducted on 106 patients attending a dental school and undergoing periodontal treatment, to assess the relationship between some commonly used periodontal indices and the time taken to treat periodontal disease. The data were analysed by assessing the times taken for examination, motivation, scaling and surgery for persons with ranges of indices such as D.I., C.I., O.H.I., G.P.I. (Ging), G.P.U. (Perio), G.P.I. (Comp) and P.I. A one-way analysis of variance was carried out to test the significance of trends. Next, a Spearman correlation coefficient was calculated for each index and its components and treatment time. The index which correlated most closely with examination time was the P.I. The G.P.I. (Ging) was the best predictor of motivation time and three indices, C.I., G.P.I. (Perio) and P.I. correlated significantly with scaling times. The P.I. and G.P.I. (Perio) correlated with surgery time. By converting periodontal indices into treatment times, planners can estimate with a fair degree of accuracy the time and resources required to carry out periodontal treatment for a population.


Recession: a 4-year longitudinal study after free gingival grafts. Free gingival grafts were performed on recession areas around 42 teeth in 12 patients, with postoperative evaluation of recurrent recession after 1, 6, 12, 24 and 48 months. No changes in degree of recession were observed during the 4-year period. The vestibuloplasties, which were always wider than the transplants, exhibited recurrence up to the transplant margin 6 months after surgery, while the transplants themselves exhibited an average shrinkage of 25%. In addition, 25% of the increase in vestibular depth achieved by the surgery was lost 1 month postoperatively, but there was a tendency toward increasing vestibulum depth during the ensuing 47 months. Gingival sulcus depth was not affected by the surgery.


Oral hygiene levels and behavious in pre-clinical and final-year dental students. The oral hygiene levels and behaviour in pre-clinical and final-year dental students attending Birmingham University 1977 were investigated. Gingival inflammation, bacterial plaque and calculus accumulations were clinically recorded. Tooth cleaning habits were assessed by a questionnaire. Oral hygiene habits differed between the two groups and an improvement in oral hygiene levels was evident in the final-year students. Statistically significant differences (P less than 0.05) were found between the plaque index scores of the pre-clinical and final-year students, and for the gingival and calculus index scores of the male students. Thus in this investigation it was possible to show that improvement in oral hygiene does occur between the pre-clinical and final year of the undergraduate course.


The effect of time and force magnitude on orthodontic tooth movement. The holographic technique, recently developed for precise and accurate measurement of tooth displacements, was used to study the three-dimensional motion of human teeth. Maxillary central incisors were loaded with forces of 300 grams and 500 grams. Translations and rotations in three-dimensions were measured over 45 seconds. The experimental results, presented as a function of time, indicate that the instantaneous centers of rotation can be represented by space centrodes that are characteristic for each patient and the applied force system.


Intraoral transmission of Streptococcus mutans by a dental explorer. A streptomycin-resistant strain of S. mutans was introduced into the mouth as adherent growth on an artificial fissure (AF). A second AF, which was initially sterile, was placed in a crown on the opposite side of the dentition. The labeled strain was not found in 8 initially-sterile AFs which were left in vivo for 2 to 6 days and were not examined with a dental explorer. The labeled strain was detected in 7 of 9 initially-sterile AFs which were probed with the dental explorer.


The distribution of metallic constituents in dentin subjected to iontophoresis. The concentration gradient and distribution of a metallic constituent in dentin which has been subjected to iontophoresis, using a water solution of silver diamine hydroxide and zinc chloride, were analyzed by means of EPMA as a basic study for pulp capping or cavity lining. Line scanning analyses parallel to the tooth axis showed that the transportation distance of metallic ions depends strongly on potential, period of iontophoresis and structural differences in dentin. Although metallic silver or zinc was found in the dentinal tubules, there was one case in which no metal was observed. The change in the distribution can be described as power function.


Cellular responses to the dispersion amalgams in vitro. Three dispersion amalgams were tested in vitro. Spherical-D and Dialloy showed very similar effects on the cells as did the Spherical and fine cut amalgams. The other disperison amalgam, Dispersalloy, had intense and persistent cytotoxicity even 24 hours after trituration. Difference of the results was presumed to result from different alloy composition.


Storage stability of dental composites.

Storage stability of dental composites. Composites made from powder-liquid constituents and subjected to elevated temperatures during storage are more stable than those employing pastes. The decomposition of the benzoyl peroxide ingredient is mainly responsible for the increased setting time and the decreased mechanical properties of the resulting composite.


Viscoelastic and dynamic properties of soft liners and tissue conditioners. The creep compliance and dynamic modulus of two tissue conditioners and five soft liners were determined after storage in water at 37 degrees C. Under static conditions the tissue conditioners functioned like viscous liquids, whereas the soft liners were more elastic. In general, linear viscoelasticity was not observed. Under dynamic conditions, the materials were stiffer.


Diphenylhydantoin induced gingival hyperplasia in ferrets: a precautionary note. Diphenylhydantoin appears to modify the tissue response in ferrets to a gingival irritant. In the present study, ferrets were tested for the tissue response to a local irritant in their maxillary right quadrant, while their maxillary left quadrant was the control. A low incidence of hyperplasia was induced only in irritated gingival tissue of animals receiving DPH. The problems encountered in comparing the hyperplasia produced in ferrets and humans were also discussed.


Sensitivity of human oral tumor cells to human adenovirus. Human cells in early passage cultures of benign oral tumors, normal oral tissues, normal lung tissues and, especially, in long-term established oral carcinoma cultures were highly susceptible to infection by human adenovirus types 5, 21, and 31. In contrast, replication of each adenovirus type was markedly limited in inoculated cells of newly-established oral squamous cell carcinoma cultures.


The antimicrobial effect of fluorides (acidulated phosphate, sodium and stannous) on Actinomyces viscosus. The effect of three commercially prepared fluoride compounds (acidulated phosphate fluoride 1.23% F-, stannous fluoride 0.4%, and sodium fluoride 0.05%) diluted to various concentrations with brain heart infusion broth, on the growth of five strains of Actinomyces viscosus following 1 and 24 hours' exposure to the fluorides was studied. Results demonstrated that SnF2 was the most effective growth inhibitor of the organisms at 500 ppm F- after 1 hour and at 100 ppm F- after 24 hours' exposure. APF and NaF were not effective within a 1 hour exposure period, but did suppress growth of the organisms at 200 ppm in the cultures exposed for 24 hours.


Selenium uptake into teeth determined by fluorimetry. Selenium concentrations in successive layers of bovine incisor enamel showed no concentration gradient and no increase with age. Selenium was taken upt into the continuously-growing rat incisor in proportion to the amount of selenium in the diet. A sensitive (approximately 1 ng Se) and relatively simple fluorimetric method for determining selenium in small amounts of hard tissues is presented.


Positional changes in mesio-angular impacted mandibular third molars during a year. The results of this study show that positional changes occur in the mandibular third molar at least until 20 years of age. A significant number of mandibular third molars in young adults in positions of mesio-angular impaction attain an upright position in a year. A significant relationship exists between the initial age of the patient and the amount of change in the inclination of the third molar. Initial inclination is closely related to the change in inclination in mandibular third molars.


Air sampling for hepatitis B surface antigen in a dental operatory. Forty samples of air with a mean sample volume of 104 liters were collected during the treatment of patients whose blood was positive for HBsAG: no samples contained HBsAG and occult blood. These findings suggest that, if environmentally mediated transmission of hepatitis B occurs in the dental operatory, it is more likely to occur through contact with contaminated surfaces than through the airborne route.


Linear dimensional change of copper-rich dental amalgam. Copper-rich amalgams made from alloy mixtures have large expansions in air at 105 +/- 2 weeks that range from 100 to 194 micrometers/cm at 60 C, from 36 to 101 micrometers/cm at 37 C, and from 14 to 44 micrometers/cm at 23 C on unrestricted 8- x 4-mm cylinders (Dispersalloy, Micro II, and Optaloy II). Other copper-rich amalgams made from one alloy usually had a slight shrinkages at the three temperatures with an exception, a slight expansion of 12 micrometers/cm at 60 C (Aristaloy CR, Indilogy non-zinc, Sybraloy, and Tytin). Dimensional changes during hardening ranged,on the average, from -3 to +19 micrometers/cm when measured by ADA Specification methods and from -2 to +25 micrometers/cm when measured by an indirect method. The clinical significance of the foregoing findings is unknown; nor is a relationship known among dimensional change of unrestricted specimens, dimensional change of restricted specimens, creep value, and clinical behavior of amalgams generally. In specific instances, however, a relationship is sometimes shown.


Self-shearing retentive pins: a laboratory evaluation of pin channel penetration before shearing. This laboratory study determined the depth reached by self-shearing pins in dentin pin channels. Pin channels were prepared with the self-limiting shoulder twist drill for each of the four systems tested. Mean channel depth reached for the various pin systems was: Stabilok (small), 2.31 mm; Stabilok (medium), 1.78 mm; Reten Pin, 1.40 mm; and TMS (Regular), 2.04 mm. A coparison was also made by calculating the mean percent of penetration in relation to the depth of prepared pin channel: Stabilok (small), 92.50%; Stabilok (medium), 63.62%; Reten Pin, 66.67%; and TMS (Regular) 81.75%.


Pulpectomy procedure for deciduous teeth with severe pulpal necrosis. Pulpectomies of deciduous teeth with severe pulpal necrosis should be considered as a possible treatment plan. Systemic and dental criteria have been devised to help the clinician to select cases in which successful results may be produced. A clinical success occurs when the pulpectomized tooth is painless, is firm in its alveolar socket, and is without a fistulous tract. Radiographically, any radiolucent area should be resolving with six months, and no pathologic root resorption should be observed. Research should determine whether pulpectomies may be done on children with severe systemic disease and should determine long-term consequences of underfilled and overfilled pulpectomies.


Triple mesiodentes.

Triple mesiodentes. An unusual case of three mesiodentes has been reported. The mesiodentes resulted in the impaction of the left central incisor.


Fracture of the anterior nasal spine.

Fracture of the anterior nasal spine. Fracture of the anterior nasal spine is so rare that clinicians do not specifically look for it if other fractures of the middle third of the face have been ruled out. However, as suggested by this case, the possibility of fracture of the nasal spine should not be overlooked.


Communication in patient management as seen in a patient with multiple sclerosis. A case report has been presented showing the possible psychological impact of a debilitating disease, such as multiple sclerosis, on a patient. Medical and dental evaluations had determined that it was necessary to delay making dentures until oral conditions improved. As this did not satisfy the patient's immediate objectives of treatment, he chose not to follow the proposed treatment plan. Instead he searched to find someone who would give him what he wanted. Dentists must evaluate the patient's objectives in relation to the physical criteria for treatment and should not compromise standards of care to accommodate the patient's demands.


A method for obtaining human bone marrow specimens enriched for myeloblasts and promyelocytes. A simple method has been developed for obtaining specimens of human marrow which are enriched for myeloblasts and promyelocytes. The erythrocytes are lysed, the marrow is incubated with iron particles, and the cells that phagocytize the iron are removed with a powerful magnet. The marrow is then subjected to a density-cut centrifugation using Ficol-Hypaque with a density of 1.084 gm/mm3. The cells that do not enter the Ficol-Hypaque are removed from the surface and studied. The proportion of myeloblasts and promyelocytes in this subpopulation of cells exceeds 50%. Total recovery of these immature myeloid progenitor cells is 50% of that in the original marrow specimen. This method has been used for cell suspensions containing as many as 10(9) cells. Cells prepared using this method incorporate 3H-TdR, 3H-UR, and 3H-Leu at a higher rate than the unseparated specimens and have a cloning efficiency of 2.0% to 19.4% compared with 0.1% to 2.17% for the unseparated marrows.


Neuroendocrine effects of haloperidol in an adolescent with Gilles de la Tourette's disease and delayed onset of puberty. The effects of haloperidol on the release of prolactin, growth hormone, and luteinizing hormone during sleep were studied in an adolescent male who had Gilles de la Tourette's disease and delayed onset of puberty. At doses of 5 and 2 mg, haloperidol led to an increase of prolactin secretion and a suppression of luteinizing hormone release. Growth hormone was unaffected. Despite these changes, the patient had normal secondary sexual development consistent with puberty.


Ontogenesis of circadian rhythm of melatonin synthesis in pineal gland of rat. Serotonin N-acetyltransferase (NAT) activity regulates the circadian rhythm of melatonin synthesis in pineal gland. NAT rhythm persisted in continuous darkness or in blinded rats. Development of the circadian rhythm of NAT activity was followed in the infant rats raised under various lighting schedules. The pups born and raised in continuous darkness or under constant illumination showed a rhythmic change indicating that the biological clock for NAT is generated inborn independent of environmental light-dark schedules. In the absence of light, the rhythms of pups synchronized with mother's rhythm. When rats were maintained under a ultradian light-dark schedule (LD 6:6), NAT activity showed a circadian change increasing once a day. When pups were born and raised under the ultradian lighting condition, NAT activity rhythm coincided with mother's rhythm. When pups were raised by a foster mother who had an inverted rhythm from that of an original mother, the rhythm of the pups synchronized with that of the foster mother. Whe pups were separated from their mother daily for 12 hours, their NAT rhythms reappeared when they were separated from their mother. These observations indicated a novel mechanism that in the absence of light-dark schedule, mothers taught the circadian rhythm to the pups as they raised them.


Evidence for an endocrine function of the human pineal gland. Chairman's introduction. Research to date indicates that the human pineal gland synthesizes and secretes hormones which probably influence the functioning of the neuroendocrine axis. There is no basis for the idea that the human pineal becomes less functional with age, or as it becomes calcified.


The measurement of melatonin in mammalian tissues and body fluids. A quantitative bioassay for melatonin and a radioimmunoassay for melatonin are described and evaluated in terms of their specificity, sensitivity, and practicability. A thin-layer chromatographic method is presented whereby the specificity of the radioimmunoassay for melatonin in blood and tissue extract is affirmed and its specificity in the assay of urinary melatonin is described. Preliminary observations on the relationship between the rate of melatonin excretion and blood levels of melatonin are also reported.


Melatonin assays in body fluids.

Melatonin assays in body fluids. A variety of methods now exist for the assay of melatonin in body fluids. Their relative merits are compared and the validation of one in particular (RIA) described. Physiological studies of melatonin by RIA have shown probable modulation of its secretion by gonadal steroids. The circadian activity maximum in the dark phase of one of the pineal melatonin synthesizing enzymes, N-acetyltransferase, is reflected in peripheral melatonin levels. Man, like all other species studied so far, has a dark phase rise in circulating melatonin. During the menstrual cycle, melatonin shows a luteal phase rise. Further evidence of pineal rhythmicity is found in seasonal melatonin variations in man. The study of the rhythmic properties of peripheral melatonin in man may provide important information on central nervous function.


The application of mass spectrometry to the study of the pineal gland. This paper presents briefly the basic principles of operation for the mass spectrometer (MS) and gas chromatography-mass spectromtery (GCMS) systems as well as discuss some of the analytical and assay methods for indole compounds which utilize GCMS. Using 5-methoxytryptophol as an example, the development of such an assay method is examined in detail. Finally, some of the most recent methodological and instrumental developments in mass spectrometry, including field disorption mass spectrometry (FDMS), negative ion chemical ionization mass spectrometry, and isotope dilution techniques are discussed in view of the contributions they may be expected to make to the study of pineal chemistry.


Cervical spinal cord lesions disrupt the rhythm in human melatonin excretion. To determine whether spinal cord lesions disrupt the diurnal activity of the human pineal, urinary melatonin levels were measured over 24 hours (4 or 8-hourly intervals) in male patients with clinical evidence of cervical spinal cord transection. During the waking state, levels of melatonin in these subjects ranged from 3.2--13.5 ng/4 hours; during sleep and darkness, values ranged from 1.8--10.5 ng/4 hours. Levels of serum cortisol, aldosterone, and growth hormone showed rhythmic variations in these subjects. The absence of significant nocturnal melatonin increases distinguishes quadriplegic subjects from normal males and from one subject with a lesion of the lumbar spinal cord. These differences may be caused by "decentralization" of the pineal organ due to a lesion within the cervical spinal cord interrupting descending sympathetic fibers. If so, the human pineal, like that of other mammals, is regulated, at least in part, by activity within the central nervous system via sympathetic nervous connections.


Studies of the 24 hour rhythm of melatonin in man. In a series of four separate studies of the 24-hour pattern of melatonin secretory function in man, the following results were obtained. Sequential measurement of the concentration of melatonin in plasma and urine demonstrated a 24-hour rhythm in which more melatonin is secreted during the sleep-lights off as compared to the waking-lights on period. However, during "free-running" and after an acute phase shift of the sleep-wake cycle, a melatonin rhythm can be dissociated from the sleep-lights out rhythm. A radioimmunoassayable plasma melatonin substance was found in significant amounts throughout the entire 24-hour day using a frequent sampling technique (every 20 min). Melatonin appears to be secreted into the blood in discrete brief episodes superimposed on a maintained "baseline" concentration. The half-life appears to be less than 30 min.


Physiological control of melatonin synthesis and secretion: mechanisms, generating rhythms in melatonin, methoxytryptophol, and arginine vasotocin levels and effects on the pineal of endogenous catecholamines, the estrous cycle, and environmental lighting. Daily rhythms in pineal methoxyindole metabolism have been described in rodents and humans: serotonin levels in rat pineals are highest during the daylight hours and fall markedly soon after the onset of darkness, coincident with increases in the levels of pineal melatonin and 5-methoxy-tryptophol and the activities of pineal serotonin-N--acetyltransferase (SNAT) and hydroxyindole-O-methyltransferase (HIOMT). The fact that the levels of melatonin and 5-methoxytryptophol vary in parallel suggests that the major factor generating the methoxyindole rhythms is not SNAT activity, as has been suggested, but a proximal step, perhaps a change in the availability (for metabolism) of "stored" serotonin. Melatonin levels in human serum and urine exhibit rhythms similar to those observed in rats, i.e., they rise sharply during the daily dark period. When the onset of darkness is delayed by 12 hours, human melatonin rhythms usually require 3 or 4 days to adjust to the new lighting regimen. Environmental factors, other than light, that activate the sympathetic nervous system or cause epinephrine to be secreted from the adrenal medulla (e.g., the stress of immobilization; insulin-induced hypoglycemia) can override the inhibitory effects of light and accelerate melatonin synthesis. Melatonin levels in rat blood and urine are lowest during the proestrous and estrous phases of the estrous cycle. Although this effect of the ovarian steroid hormones is accompanied by a reduction in urinary norepinephrine levels, it is not caused simply by a decrease in the quantity of norepinephrine acting on the pineal but also involves a direct action of the hormones.  Ovariectomy increases serum melatonin levels, whereas the administration of estradiol plus progesterone (to ovariectomized animals) lowers melatonin levels.  The spectral and intensity-response characteristics of the photic inhibition of melatonin synthesis have been established for the rat. Rhythms in melatonin synthesis apparently persist among animals placed in environments of continuous darkness; the source of the cyclic signal (mediated by the pineal sympathetic nerves) has not yet been identified. Preliminary evidence suggests that levels of a peptide hormone, arginine vasotocin, in rat pineals and sera also exhibit daily rhythms and are increased by norepinephrine.


Hemangiopericytoma of the oral cavity: report of case and review of the literature. A case of hemangiopericytoma of the tongue has been described. The literature regarding hemangiopericytoma of the oral cavity has been reviewed; 35 cases have now been reported. There is essentially no difference in clinical behavior, treatment, or recurrence rate reported in the oral cavity and, because of the high recurrence rate and difficulty in predicting the clinical behavior of hemangiopericytoma, long-term follow-up care is important.


Extracapsular fibrous ankylosis of the mandible after open reduction of a zygomatic arch fracture: report of case. A case of fibrous ankylosis of the coronoid process to either the zygomatic arch or maxilla, or both, as a complication after open reduction of a depressed zygomatic arch fracture is presented. The rationale for diagnosis and treatment is reviewed.


A new surgical procedure for correction of lip deformity in cranio-carpo-tarsal dysplasia (whistling face syndrome). A child with cranio-carpo-tarsal dysplasia or whistling face syndrome is described together with a new surgical procedure for the correction of the mouth deformity. The syndrome is rare; only approximately 40 cases have been described in the literature since 1938. Correction of the facial appearance is of great importance to the affected individuals because of emotional problems they may develop as a reaction of their anomalies. Although the majority of cases have been sporadic, the syndrome can be transmitted as an autosomal dominant trait. Therefore, genetic counseling for affected persons should be offered.


Esophageal achalasia after maxillofacial surgery. An unusual, characteristic case of etiopathic achalasia of the esophagus is reported and the literature is reviewed. This disease has not previously been reported in the dental literature, but is well-known in the medical field. The case report illustrates the salient features of previosuly described achalasia in adults: vague history of asthma with respiratory symptoms of wheezing, obstruction to swallowing, regurgitation, intermittent pain, and peripheral neuritis in a thin patient who claims to be a light eater. The primary concern of the oral surgeon is the management of nutrition. In the case reported, to ingest food. After mobilization of the jaws, the patient could not longer eat the small amounts she could preoperatively. Suspected achalasiactic symptoms should be investigated thoroughly through proper work-up to rule out this disorder before elective surgery is performed. In nonelective cases, the practitioner must be prepared to manage the problems and complications and obtain the proper consultations.


Surgical recontouring of a panfacial fibro-osseous deformity. A report of the surgical management of a patient with a panfacial fibro-osseous deformity resulting from fibrous dysplasia, hyperparathyroidism, or both, is presented as a sequel to a previous article discussing the initial work-up and diagnostic considerations. The literature pertinent to the surgical correction of fibro-osseous lesions irformed through an oral approach. Regrowth of the lesion after three years was minimal in the maxilla and approximately 20% in the mandible.


Influence of plaque control on the healing of experimentally-induced bone defects in the dog. The aim of this investigation was to induce alveolar bone defects experimentally in dogs and to study the effects of mechanical tooth cleaning on their subsequent development. Thirty premolars from four beagle dogs were used. Bone defects were created by surgically exposing the adjacent alveolar bone and applying steel or silk ligatures around the roots of the chosen teeth. After 8 weeks the ligatures were removed. Dental plaque was allowed to accumulate on 20 premolars whereas daily plaque elimination by toothbrushing was carefully performed on 10 premolars. After 1, 3, and 6 months of plaque accumulation, gingival inflammation, periodontal pocket depth, gingival recession and the radiographically observed degree of bone destruction were registered. Histological examination was performed in conjunction with the registrations made 6 months after removal of the ligatures. The clinical, radiographic and histologic findings all confirm that a regeneration of the experimentally induced destruction of the periodontal tissues had taken place. This reaction was most evident in teeth exposed to mechanical plaque control. The remaining bone defects were consistently accompanied by recession of the gingival margin.


Longitudinal evaluation of the excisional new attachment procedure in humans. Evaluation of the Excisional New Attachment Procedure (ENAP) was extended to 3 years postoperatively. Generally, there was an overall mean increase in sulcus depth of 0.5 mm; an overall mean increase in recession of 0.1 mm; and an overall mean decrease in the amount of previously gained new attachment of 0.6 mm between 1 year and 3 years after surgery. These values reflected a statistically significant, but clinically insignificant, difference in mean sulcus depth and mean attachment level between the two evaluation periods. Only one tooth site demonstrated clinical findings worse than those determined preoperatively. These results are similar to those of other longitudinal studies.


Microscopic demonstration of the position of periodontal probes. This study reported on the histometric evaluation and microscopic description of eight specimens obtained from six subjects. Blades from University of Michigan "O" periodontal probes were placed into sulci under standard pressures. With the metal probes in place, specimens were obtained in block sections, processed, stained and evaluated.


The angiographic tension test in mucogingival surgery. Attached gingiva's integrity was studied with the aid of fluorescein angiography and a standardized frenal tension test in 15 subjects aged between 19 and 41 years (9 female, 6 male) with mucogingival pathology in the region of the mandibular labial frenum. Each subject showed preoperatively gingival angiographic ischemia under 200 p frenal traction. The angiographic ischemia was in no case congruent to the clinical ischemia. One month after surgical enlargement of attached gingiva (eight grafts of palatal mucosa, seven subperiosteal vestibulum extension) both mucogingival surgery techniques successfully prevented the gingival blood circulation from showing ischemia clinically as well as angiographically under 200 p frenal traction.


The papilla rotation flap.

The papilla rotation flap. A new technique is described for correction of specific mucogingival defects which is designed to encourage rapid healing of the defect and donor areas. Further, this approach often yields a greater width of attached gingiva than other techniques, and is well tolerated by the patient.


Techniques for the protection and coverage of the donor sites in free soft tissue grafts. Palatal donor sites used for free soft tissue grafts are commonly left exposed during healing which occurs by secondary intention. This often results in postoperative discomfort and pain and in some cases apparent delayed healing of the donor sites. Various techniques for the protection and coverage of donor sites have been presented and the rationale, advantages and disadvantages of coverage of gingival wounds have been discussed.


Periodontosis: a case report with scanning electron microscopic observations. A tooth and associated periodontal tissues from a patient with the diagnosis of periodontosis was subjected to scanning electron microscopic evaluation after reflection of the soft tissue portion of the lingual defect. The cemental surface of the apical portion of the lesion was found to be populated by markedly similar rod-shaped organisms. The microorganisms were observed to be continuously present in a coronal-apical direction as the transition from cementum to the attached soft tissues at the base of the defect were examined. These findings provide additional evidence that the lesion of periodontosis is characterized by a rather distinct microbial population of rod-shaped organisms located predominately at the base of the defect.


The true gingival fibroma. An analysis of 129 fibrous gingival lesions. A histologic review of 129 circumscribed mesenchymal lesions of the gingivae was performed. Two cases were peripheral reparative giant cell granulomas; eight were peripheral odontogenic fibromas; 41 were inflammatory hyperplasias; 68 were pyogenic granulomas; 11 were "hard fibromas"; one lesion exhibited the histologic features of a true fibroma.


A method for securing conservative block section in the mandibular anterior region. A conservative method for removal of histologic block tissue sections has been presented. Its application permits the operator to conserve a portion of lingual alveolar bone in the mandibular anterior region to allow maintenance of a sufficient amount of ridge bone and tissue for construction of a functional and esthetic removable or fixed prosthetic appliance. This block section procedure may be modified to permit more conservation of human tissues in those studies involving human subjects.


Detection of tumor antibodies in patients with gastrointestinal carcinomas by a solid-phase radioimmunoassay. Metastatic tumors from livers of 5 patients with gastrointestinal carcinomas and from the liver of 1 patient with malignant breast carcinoma were extracted with 3 M KCl; similar extracts were prepared from normal human colon and liver and from human fetal gut. The extracts were depleted of serum globulins by passage through reverse immunoadsorbent columns consisting of rabbit antibodies to the F(ab)2 fragment of human IgG and were then coupled to CNBr-activated paper disks. These "antigen" disks were used in a radioimmunoassay, with the aid of 125I-labeled rabbit antihuman F(ab')2 antibodies for the assay of circulating tumor antibodies produced by cancer patients. Statistical evaluation of the results with plasma samples from 47 patients with colorectal carcinomas and from 7 patients with other gastrointestinal disorders (polyps, villous papilloma, diverticulitis, and Crohn's disease) indicated that a significant number of patients had antibodies to cross-reactive tumor antigen(s). The cross-reactive tumor antigen(s) involved in the reaction was not detected in extracts of the gastrointestinal tract from 12-week human fetuses and did not cross-react with carcinoembryonic antigen.


Cancer incidence by marital status: U.S. Third National Cancer Survey. Site-specific cancer incidence rates were computed by sex, age, and marital status for whites and blacks separately for ages 35-64 years with the use of population-based incidence data from the Third National Cancer Survey (1969-71) and with demographic data from the 1970 U.S. Census. Although rates were presented for all cancer sites combined and for 44 specific sites or rubrics, discussion focused on the 17 most common cancers. Within age, race, and sex groups, patterns of cancer incidence by marital status were compared by means of standardized incidence ratios, and the consistency of marital status patterns across age groups was assessed statistically. Among the most notable findings were: excess cancer rates across most sites and age groups in single black males, consistently high rates for cancer of the lung and bronchus in divorced white males and in single black females, low rates for the hormone-dependent reproductive tumors (prostate gland, breast, uterine corpus, and ovary) in separated white males and females, and high rates for cervical cancer among separated white women. Marital status patterns, where found, frequently differed between whites and blacks and between males and females.


Detection and analysis of a glucose 6-phosphate dehydrogenase phenotype B cell line contamination. Eight of approximately 100 cell lines derived at the Scott and White Clinic from human solid tumors were found to have the same phenotypes when analyzed for 15 polymorphic enzymes at the Sloan-Kettering Institute for Cancer Research. These data were confirmed at the M. D. Anderson Hospital and Tumor Institute. The similarity was supported by cytogenetic studies at both institutions. The chronology of the establishment of these cell lines and isoenzyme and cytogenetic studies indicated that six of these lines have cross cell contamination. These include SW-527 and SW-613 mammary carcinomas, SW-598 meningioma, SW-608 astrocytoma, SW-732 cervix carcinoma, and SW-733 bladder carcinoma. Our data supported the authenticity of SW-480 and SW-620, which were derived from a colon carcinoma and its metastasis, respectively, from the same patient.


N-ethyl-N-nitrosourea-induced spinal tumors in an inbred strain of W albino rats. Exposure to N-ethyl-N-nitrosourea (ENU) either transplacentally via the maternal bloodstream or postnatally by direct injection into the cerebellum or the cisterna magna resulted in a high incidence of spinal tumors in an inbred strain of W albino rats. After prenatal exposure to 60 mg ENU/kg maternal body weight, as many as 92% of the offspring developed 1 or more tumors in the spinal cord, whereas after postnatal exposure to 0.2 mg ENU/animal, 50% of the animals eventually developed spinal tumors. These tumors included relatively pure oligodendrogllomas, astrocytomas, and the usual mixed gllomas. Obvious clinical symptoms of paralysis of the limbs and weight loss accompanying the high incidence of tumors in the spinal cord make this system pertinent to the study of carcinogenesis in the central nervous system as well as to the study of related problems to the incidence of these tumors are discussed.


Trisomy of chromosome No 13 in spontaneous mammary tumors of GR, C3H, and noninbred Swiss mice. Karyotype analyses were conducted on spontaneous mammary tumors of 11 GR, 2 C3H, and 2 noninbred Swiss mice with the use of trypsin-Giemsa banding procedures. All tumors manifested trisomy of chromosome No 13 in most cells, and all except 1 tumor had cells with a model chromosome number of 40.


Cigarette smoke inhalation studies in inbred Syrian golden hamsters. Invasive carcinoma of the larynx was induced in 36.8% of inbred Syrian golden hamsters from strain B10 15.16, susceptible to this type of cancer when exposed to smoke from reference filter cigarettes for 59-80 weeks. Nearly half the animals (47.4%) showed laryngeal cancer, including noninvasive carcinoma and carcinoma in situ, which occurred with daily smoke exposures (twice a day for 12 min each time, for 27 sec out of each min) 7 days a week at smoke concentrations of 22%. When the smoke concentration was reduced to 11%, the number of induced lesions was reduced proprotionately. When a portion of tobacco was replaced in the cigarettes by a tobacco supplement, Cytrel (a trademark of the Celanese Corp., Charlotte, N.C.), a reduction of carcinogenesis proportionate to the Cytrel content of the cigarette took place. Smoke from cigarettes containing only Cytrel and no tobacco induced no carcinomas under the conditions used. Other dose-related changes observed were laryngeal papillomas, laryngeal epithelial hyperplasia, tracheal epithelial hyperplasia, and metaplasia and accumulation of alveolar macrophages. Tar deposition in lungs and accumulation of alveolar macrophages. Tar deposition in lungs and larynges was determined in a separate study by means of a marker, decachlorobiphenyl, added to the cigarettes. Admixture of Cytrel to cigarettes reduced tar deposition in the respiratory tract, which paralleled the decrease in the incidence of laryngeal carcinoma. However, the amounts of tar deposited in the larynx when 100% Cytrel was smoked were still significant, even though no carcinomas were observed. Thus smoke from Cytrel tobacco supplement may be less carcinogenic than equal amounts of tobacco smoke.


Morphologic and DNA autoradiographic studies of the microcirculation in a transplantable rat fibrosarcoma: growth phase. The morphology and tritiated thymidine uptake of the vascular channels in a transplantable W rat fibrosarcoma sampled at various times during growth are documented. New vessels originated primarily from normal venules in the subcutaneous tissue surrounding the neoplastic implant and grew at least twofold faster than did wound-induced vessels. During the 4-week observation period, partial maturation of vascular channels newly induced by the neoplasm was seen. This partial maturation was evidenced by an increase in the concentration of micropinocytic vesicles, a reduction in concentration and localization of intraluminal processes at or near interendothelial cell junctions, changes in the endothelial cell nuclei, and partial deposition of basement membrane material. The development of smooth muscle and nerve tissue was not seen. The proportion (13%) of labeled endothelial cells in normal subcutaneous connective tissue surrounding the 3-day-old fibrosarcoma implant was significantly higher than that seen in controls, as was the labeling index (14-25%) for endothelial cells in the fibrosarcoma up to 2 weeks after implantation. Vascular channels in the established neoplasm were examined by scanning and transmission electron microscopy and freeze-fracture techniques, and a resemblance to venular morphology was detected.


Organ-selective action of an antitumor drug: pharmacologic studies of liposome-encapsulated beta-cytosine arabinoside administered via the respiratory system of the rat. beta-Cytosine arabinoside (Ara-C) in free and liposome encapsulated form was administered to Wistar rats by intratracheal institution. Free [3H]Ara-C administered in this manner rapidly left the lung and entered the systemic circulation. Liposome-encapsulated [3H]Ara-C persisted in the lung for a long period, with little redistribution to other tissues. Liposomes administered via the trachea became widely distributed throughout the lung air spaces, as evidenced by the histochemical localization of liposomes containing horse-radish peroxidase. Free Ara-C (5 mg/kg) administered into the trachea effectively suppressed macromolecular incorporation of [14C]thymidine ([14C]dThd) in the bone marrow and gut as well as in the lung. Liposome-encapsulated Ara-C (5 mg/kg) effectively suppressed macromolecular incorporation of [14C]dThd in the lung but had little effect on this process in the gut and bone marrow. Our results suggest that liposome-encapsulated Ara-C may be able to produce a local pharmacologic effect within the lung without producing adverse side effects in other tissues. This observation may be relevant to the chemotherapy of pulmonary metastases.


Capacity of mammary fat pads of adult C3H/HeMs mice to interact morphogenetically with fetal mammary epithelium. When rudimentary mammary epithelium from 13- to 17-day female C3H/HeMs fetuses was transplanted into gland-free mammary fat pads of 3-week-old mice, organogenetic development of the grafts occurred, resembling that seen in normal mammary gland morphogenesis. Initial developmental growth did not require the reproductive hormones. Mammary fat pads of juvenile (3-wk-old), young adult (8- to 12-wk-old), and fully matured (40-wk-old) females had equal ability to interact morphogenetically with fetal mammary epithelium. Fetal pulmonary, pancreatic, and salivary gland epithella showed no morphogenetic response within adult mammary fat. An exception was rudimentary hair follicle epithellum, which underwent extensive development toward hair follicles within mammary fat. Mammary glands that developed from rudimentary mammary epithellum transplanted into gland-free fat pads underwent morphologic changes characteristic of lactation when the hosts bore young.


Tumor-associated immunity in bovine ocular squamous cell carcinoma detected by leukocyte adherence inhibition microassay. A microplate modification of the leukocyte adherence inhibition (LAI) assay was used with blood leukocytes from cattle with ocular squamous cell carcinomas (OSCC); control groups were cattle with ocular or cutaneous lesions (not carcinoma) and healthy normal cattle. For the assay, saline extracts of OSCC and skin from the same donor, lymphosarcoma, and mastocytoma (M) were used as antigens. Specific LAI reactivity to OSCC extract (but not to skin extract) was detected in 14 of 18 animals with squamous cell carcinoma. One animal with OSCC showed LAI reactivity to OSCC extract, but 1 clinically normal cow had LAI with the M-extract. Leukocyte adherence stimulation reactions with the various antigens were seen in all groups of animals.


Manifestation of hyperplastic alveolar nodules and mammary tumors in "viable yellow" and non-yellow mice. The time course of appearance of hyperplastic alveolar nodule(s) (HAN) and mammary tumor(s) (MT) was determined in untreated virgin "viable yellow" (Avy/A) and non-yellow (A/a) (C3H/HeNIcrWf X VY/Wf)F1 female mice. The first HAN was detected in a yellow female at age 16 weeks, the first period in which mice were killed. HAN were not found in the non-yellow mice until they were 19 weeks old. The incidence of HAN increased to 92% among yellow females and to 75% among non-yellow females by 36 weeks of age. MT were first observed at age 22 weeks in yellow mice and at 28 weeks in non-yellow mice. The incidence of MT at 36 weeks was 75% among yellow mice and 22% among non-yellow mice. Type B adenocarcinoma was the predominant class of MT found in the yellow mice. The time courses of appearance and incidence of HAN and MT in the non-yellow F1 mice were similar to those observed in inbred C3H female mice. MT first appeared in each population when the incidence of HAN bearers had reached 40--45% regardless of age, body weight, or number of HAN per HAN bearer. Apparently, the phenotypic effects of the Avy gene primarily stimulated the multiplication of nodule-transformed cells to form HAN and thus indirectly enhanced MT formation.


Quantitative comparison of BCG strains and preparations in immunotherapy of a rat sarcoma. Ten preparations of BCG, six clinical vaccines, and four experimental preparations were compared for suppression of tumor growth by regional application. The preparations differed widely in their proportions of viable bacterial units and in bacterial unit:dry weight ratios. As assessed by their ability to suppress tumor development following direct admixtures with cell inocula of a rat sarcoma, one of the six clinical vaccines (Connaught) was significantly superior to Glaxo on any parameter (dry weight, No. of total units, or No. of viable units), immuno BCG Pasteur F was superior to Glaxo on two parameters (dry weight and No. of viable units), and Pasteur scarification was superior to Glaxo only on a viable unit basis. The Tice and Rijks Institute vaccines were not significantly different from Glaxo on any basis. Experimental vaccines from the Trudeau Mycobacterial Collection, stored as frozen liquid suspensions, showed a less marked variation in physical properties; here too, the Pasteur strain was superior to two other Trudeau preparations examined (Tice and Phipps). Viable organisms were not essential for tumor suppression, gamma-radiation-sterilized vaccine being equally effective. Tests with pulmonary tumor deposits, treated by iv BCG, and tests with pleural deposits, treated by intrapleural BCG, indicated that agents identified as superior in the subcutaneous screening system were also superior in the treatment of thoracic deposits.


Spontaneous tumors and common diseases in three types of hamsters. Hamsters of three types designated as inbred cream (Epp/e/e), linebred white (EPP/cdcd/RB/A), and linebred albino (EPP/cdcde/e) were thoroughly examined histopathologically for spontaneous diseases. All hamsters were maintained simultaneously for life under identical standard laboratory conditions. Marked differences were found in longevity of the animals and in incidence, sites, patterns, and types of spontaneous diseases. In cream hamsters (CH), survival time was shorter than in white hamsters (WH) and albino hamsters (AH). More tumors and malignant lesions unrelated to survival were found in AH compared to CH and WH; also, the multiplicity of neoplasms were more pronounced in AH. The predominating tumor types differed in each line: Pancreatic islet cell neoplasms were most common in CH, adrenal gland tumors predominated in WH, and thyroid gland tumors in AH. Also, the relative incidence of spontaneous tumors varied among the lines. Some tumors seemed strain-specific and were not seen in other lines; malignant melanomas, for example, occurred only in CH and WH. Certain neoplasms, e.g., those of the thyroid and adrenal glands, were found more often in one sex than the other. The three hamster groups differed also in nonneoplastic diseases. Detailed histopathologic findings are presented and compared with data on the Syrian golden hamster, the ancestral line of these three groups.


Partial deletion of chromosome No. 2 in myelocytic leukemias of irradiated C3H/He and RFM mice. Chromosomes of mouse myelocytic leukemias that developed in 7 irradiated mice, 3 C3H/He males, 1 RFM female, and 3 RFM males were analyzed with chromosome-banding techniques. Chromosomes No. 2 were partially deleted in 6 of the 7 mice. Although the deleted No. 2 chromosomes varied in size in the 6 mice, one common characteristic was noted in all these deletions: A segment lying between a certain band in the region 2C and a band in the region 2E, including the whole region 2D, was missing. Another consistent abnormality was an addition or a loss of the Y-chromosomes in the fraction of cells in all 6 males. In addition to these consistent abnormalities, various chromosomes had structural abnormalities. The RFM female, which did not have the abnormal No. 2 chromosome, had abnormalities in chromosomes No. 3, 4, 11, 12 and 15 and in the X-chromosome. Of the 20 chromosome pairs, only such chromosomes as No. 1, 5, 8, 14, 17, and 19 and the Y-chromosome did not have the structural abnormalities. The possible role of the partial deletion of the No. 2 chromosome was considered in relation to the development of mouse myeloid leukemias.


Neoplastic and nonneoplastic lesions in aging (C57BL/6N x C3H/HeN)F1 (B6C3F1) mice. Neoplastic and nonneoplastic lesions in untreated (C57BL/6N x C3H/HeN)F1 (B6C3F1) mice used as controls in carcinogenesis tests were tabulated and evaluated. The most common neoplasms in 2,543 male mice were hepatocellular adenomas and carcinomas. In 2,522 female mice, common tumors were lymphomas, leukemias, pulmonary adenomas and carcinomas, hepatocellular adenomas and carcinomas, and pituitary adenomas. The risk of developing most neoplasms increased with the age of the mouse. Hepatocellular carcinomas metastasized in 12% of the animals with these tumors. Other than lymphomas and leukemias, few other tumors metastasized. Nonneoplastic lesions included cystic hyperplasia of the uterus, nephritis, ovarian and uterine cysts, inflammatory lesions of the lung, mineralization in the brain, and focal hyperplasias in several tissues. The focal hyperplasias in lung and pituitary, adrenal, and thyroid glands were suggestive of the early stages of neoplasia. Comparative aspects of lesions in aging mice and their interpretation in carcinogenesis tests are discussed.


Experimental induction of hepatomas, mammary tumors, and other tumors with metronidazole in noninbred Sas:MRC(WI)BR rats. Metronidazole, a chemotherapeutic agent against trichomonas infection, was tested for carcinogenicity in noninbred Sas:MRC(WI)BR rats. Three groups were given the drug for life at dose levels of 0.6%, 0.3%, and 0.06% in a powdered diet. The incidence of mammary tumors (P less than 0.020) and hepatomas (P less than 0.050) increased significantly among females given the highest dose (0.6%). Also, the rates of Leydig cell tumors of the testes (P less than 0.040) and pituitary adenomas (P less than 0.040) were statistically significant among males given the highest dose (0.6%). Results are discussed in light of a possible hazard of this drug to humans.


Osteogenic sarcoma in siblings.

Osteogenic sarcoma in siblings. A brother and sister with osteogenic sarcoma are reported. A review of the literature reveals thirty additional cases of osteogenic sarcoma in familial aggregation, sixteen of sibling relationship. Genetic and environmental etiologic factors of osteogenic sarcoma are discussed.


[Complete clinical remission over 50 months of a patient with acute monocytic leukaemia (author's transl)]. A case of Schilling type pure acute monocytic leukaemia (M5 variety of the FAB classification) in a 38-year-old man is presented. The initial predominant clinical manifestation was an increase hypertrophic gingivitis. The cytological type was established according to the morphologic and cytochemical criteria currently in use. The patient was treated with daunomycin (60 mg/m2 one day) and ARA-C (100 mg/m2/12 hours for 7 days) in a 2-week interval cycles. Total remission was achieved after the fifth series. The series have been repeated over 4 years with intervals of up to 6 or 8 weeks. Complete haematologic remission has been constant, with normalization of the serum muramidase levels. A gingival biopsy taken at the same time has shown no evidence of leukaemic infiltration. The high incidence of malignancy in this cytological variety of acute leukaemia is pointed out; it is normally less sensitive to chemotherapy than the myeloid types. Remission has been total over a long period of time, which is exceptional in this type of leukaemia. The mean survival rate as recorded in the literature is only a little over 3 months.


Ribosomal DNA of fly Sciara coprophila has a very small and homogeneous repeat unit. In this report we show by hybridization of restriction fragments and by Miller spreads that the unit repeat of the fly Sciara coprophila is only 8.4 kb which is the smallest known for a multicellular eukaryote. The 8.4 kb EcoR1 fragment containing a complete unit of Sciara rDNA was cloned in pBR322, and mapped by the method of Parker (1977) and also by double digestions. The coding regions for 28S, 18S, and 5.8S RNA were localized by the method of Berk and Sharp (1977). From these data we conclude that the nontranscribed spacer, external transcribed spacer, and internal transcribed spacer are all shorter than in other organisms, thereby giving rise to the shorter overall rDNA repeat unit of Sciara. At least 90% of the Sciara rDNA repeats are homogeneous, with a length of 8.4 kb, but a 700 bp ladder of minor bands can also be found in digestions of total genome DNA. This profile of major and minor bands is identical between the X and X' chromosomes, as seen by a comparison of several genotypes. There are only 45 rRNA genes per X chromosome of Sciara (Gerbi and Crouse, 1976). These can easily be counted by low magnification Miller spreads which show that virtually all gene copies are actively being transcribed in the stage of spermatogenesis examined. This is the first demonstration for any reiterated gene family where all copies are shown to be simultaneously active.


Chromosomal and extrachromosomal control of senescence in the ascomycete Podospora anserina. In Podospora anserina senescence leading to cellular death occurs regularly after prolonged vegetative propagation. However, the life span of this ascomycete may be extended by various means: 1. Mutations in a least 8 morphogenetic genes belonging to 4 linkage groups postpone drastically or even prevent in certain pairwise combinations (e.g. i viv) the onset of senescence. 2. Inhibitors of mt DNA and of mitochondrial protein synthesis show a life prolonging effect when added in low concentrations to the growth medium. 3. A similar effect was found when mycelia were fed exclusively on non repressive carbon sources. Whereas the anti-aging effect of specific mutated genes is rather permanent, the life prolonging action of the inhibitors and carbon sources is restricted and temporary. These substances have no long lasting effect, since after their removal from the medium aging proceeds. Physiological experiments have further shown the existence of three phases in the life span of Podospora anserina. During the juvenile phase aging is prevented by all of these compounds; during the presenescent phase aging is prevented by inhibitors of mt DNA only, and during the senescent phase aging is irreversible. Senescence may be induced in juvenile protoplasts by DNA extracted from senescent mycelia. This, together with the well known fact that senescence is extrachromosomically inherited, points to extrachromosomal DNA as the causative agent of senescence. This kind of DNA may be connected with or perhaps located in the mitochondria. Collectively, the data are consistent in showing that the syndrome of senescence in Podospora anserina is controlled by a chromosomal-extrachromosomal interaction. In this system, extrachromosomal DNA, perhaps a mt DNA, is identical with the infectious principle initiating the decay of the cell, and nuclear genes supervise its expression.


Extreme leucocytosis and prognosis of newly diagnosed patients with acute non-lymphocytic leukaemia. A group of 87 consecutive patients with acute non-lymphocytic leukaemia (ANLL) who had been treated with large doses of hydroxyurea (HU) as a preliminary to protocol combination chemotherapy is reviewed. The outcome in patients whose initial leucocyte count was 100x10(9)/L or higher (HC group) is compared with that in the majority who had lower leucocyte counts. Contrary to reports in the literature, patients in the HC group had the same chance of achieving remission as the rest, and the survival of the responders was equally long in both groups. There were no deaths from intracerebral haemorrhage in the reportedly high-risk HC group, a fact which was attributed to the administration of HU to all new patients. Hydroxyurea rapidly lowered the leucocyte count in nearly all patients with ANLL and appeared to be a valuable addition to protocol therapy of this disease.


The prognostic value of serum lysozyme activity in acute myelogenous leukemia. Serum lysozyme activity was measured in samples from adult patients with acute leukemia, malignant tumors, and in normal adults. Twenty-eight adult patients with acute myelogenous leukemia (AML) had significantly elevated levels of lysozyme at diagnosis, and none of the adults fell within the normal range. Thirty-two patients with AML in complete remission had lysozyme levels comparable to normal adults, whereas patients with AML in relapse (eight cases) also had abnormally high levels of lysozyme activity. Ten patients with AML in remission and off therapy also had normal lysozyme levels. Three patients with acute lymphatic leukemia had normal lysozyme levels, while one child with monomyelocytic leukemia had substantially elevated lysozyme levels before treatment. It seems that in patients in remission and with normal blood values, the serum lysozyme activity is valuable for monitoring the remission.


Intraventricular versus intralumbar methotrexate for central-nervous-system leukemia: prolonged remission with the Ommaya reservoir. Ten children had recurrence of central-nervous-system (CNS) leukemia despite monthly injections of methotrexate into their lumbar cerebrospinal fluid. Each child was then reinduced into remission and maintained with intraventricular methotrexate administered via an Ommaya reservoir and the length of this remission was compared with the duration of the child's previous intralumbar-treated remission. Of eight evaluable patients, seven had longer CNS remissions with intraventricular therapy than with intralumbar therapy (P less than 0.02). The median CNS remission duration in all patients was 475 days with intraventricular and 286 days with intralumbar therapy (P less than 0.05). The rate of CNS relapse was reduced from 2.94 relapses per thousand days at risk during intralumbar therapy to 0.93 relapse per thousand days of intraventricular therapy. We conclude that intraventricular chemotherapy is significantly more effective against CNS leukemia than the same therapy given by lumbar puncture.


Localized bone marrow relapse in acute lymphoblastic leukemia. Localized bone marrow relapse is rare in acute lymphoblastic leukemia. Discordant bone marrow specimens were found in an 11-year-old asymptomatic girl who had been in remission for six years and off chemotherapy for 2 1/2 years. One bone marrow sample showed marked leukemic infiltration, whereas marrow from another site was normal. Three months later, with normal peripheral blood counts, she developed severe back pain and x-ray evidence of vertebral collapse and periosteal changes in the pubic bone. At that time three of the four areas of bone marrow sampled showed leukemic involvement. Reinduction therapy was begun, and she is now in remission on maintenance chemotherapy. At this time, it is unclear whether routine performance of marrow aspirations and biopsies from multiple sites, in periodic follow-up examinations of patients with acute leukemia would allow earlier detection of relapse frequently enough to justify the procedure. The issue of localized bone marrow involvement, if more common than previously reported, should be addressed at the time a decision is being made to discontinue therapy.


Clinical engineering standards, obligations, and accountability. The growing volume and complexity of biomedical equipment in hospitals are creating legal implications for the clinical engineer. Statutory regulations, court decisions on product liability, and the patient's right to privacy and confidentially affect daily operations. The doctrines of agency, negligence, strict liability, and breach of contract, plus the medical Device Amendments of 1976 to the Federal Food, Drug, and Cosmetic Act, and the Joint Commission on Accreditation of Hospitals' 1976 standards, complicate the conventional clinical engineering functions. The need for the clinical engineer to be alert to his legal obligation is assessed.


[Comparative evaluation of the accumulation of bacterial plaque on human enamel and on the surfaces of various materials used for esthetic fillings]. Accumulation of the bacterial plaque on materials used for cosmetic fillings was comparatively evaluated against that on the dental enamel of males and females aged 40-50 yr using the index of Löe & Sillness. Significantly greater accumulation was noted on filling materials.


[Ambulatory therapy with fosfomycin in dentistry and stomatology]. 1-2 g/day or 3-4 g/day phosphomycin were administered per os to children and adults respectively for an average of 5.2 days in the outpatient treatment of 28 males and 18 females with parodontitis, gingivitis and dysodontiasis of bacterial origin. All patients presented swelling of the soft parts and 34 (74%) had hyperpyrexia. A clinical cure was obtained after 9 days in all cases. Fever lasted an average of 2.4 days and disappeared after 6 days. Swelling lasted an average of 3.6 days and disappeared after 8 days. Tolerance was excellent. Two patients (4.3%) displayed diarrhoea and nausea and one (2.2%) pruritus. These side-effects did not necessitate the suspension of treatment. It is felt that phosphomycin may be regarded as a drug of choice in the treatment of odontostomatological infection of bacterial origin.


[An unusual case of osteoclastoma of the mandible. Clinical and histological study]. The authors describe an interesting case of osteoclastoma of the mandible. After the clinical and anatomy-pathologic general picture, the problem of differential diagnosis between osteoclastoma and giant cell epulis is analysed.


[2 cases of hereditary recurrent neuropathy caused by compression of the peripheral nerves]. The authors describe two cases of recurrent neuropathy in members of two different families. Paresis of peroneal nerves was the only sign released by compression of the nerve during work in squatting or kneeling position. The members of one family had similar clinical and electrophysiological signs. The father of the second patient was clinically healthy but he had evidently reduced conduction velocity in peroneal nerves. The diagnosis was established after ruling out of exogenous and endogenous infectious and toxic factors, vitamin deficiency and allergy.


Acute arsenical poisoning in Dunedin.

Acute arsenical poisoning in Dunedin. Four cases of acute poisoning with arsenic are described. Although no new approach to therapy is proposed it is suggested from the data of arsenic recovery from the dialysate of one of the patients studied, that peritoneal dialysis is unlikely to be satisfactory.


A comparison of des-amino arginine vasopressin with pitressin tannate as diagnostic agents. A reappraisal of a previous opinion, and subsequent comparative work leads to the conclusion that 40 microgram desamino arginine vasopressin (DDAVP) administered instransally, is a preferable dose to 20 microgram to use as a urinary concentrating agent in the diagnostic context, and that it is quite comparable to the standard agent, five units of pitressin tannate in oil.


Maternal and cord blood ascorbic acid levels at parturition. A group of 50 healthy women and their newborn infants had leucocyte ascorbic acid (LAA) measurements carried out for after delivery. The mean corrected LAA level for mothers was 10.9 microgram/10(8)WBC and the newborn 17.1 microgram/10(8)WBC. A gradient between maternal and fetal levels was demonstrated.


Isolation of Actinobacillus actinomycetemcomitans and Haemophilus aphrophilus at Auckland Hospital. Actinobacillus actinomycetemcomitans and Haemophilus aphrophilus were each isolated three times at Auckland Hospital, over a one year period. Relevant clinical particulars of the major cases are given, and problems of isolation, identity and treatment discussed.


Double contrast arthrography of the knee. The author's experience with 280 double contrast knee arthrograms is presented. The accuracy of the procedure in 101 operated cases was 100 percent for normal menisci and 88 percent for abnormal. It is suggested that arthrography can be regarded as an integral part of the investigation of any knee in which a serious meniscal abnormality is suspected.


The Tokelau Islands children's study: atoll and New Zealand comparisons: physical growth. A comparison is made between the birth weights, weights, heights, skinfold thicknesses, and head circumferences of two groups of Tokelauan children aged under 15 years. One group was living in Tokelau on their three home atolls and the other group was living in New Zealand. The children living in New Zealand were in general heavier, taller, had more body fat and larger head circumferences than the children living in Tokelau.


Serum bile acids and rountine liver function tests in patients with chronic liver disease and cholestasis. Serum bile acids were measured in 28 patients with established liver disease. The peak serum level after a meal was as sensitive an index of liver disease as a combination of serum bilirubin, aspartate amino transferase, alkaline phosphatase and gamma glutamyl transpeptidase and was more often abnormal than any one of the four tests. Serum bile acid measurements may be of most value in detecting cirrhosis when the activity of disease is minimal.


Human sexuality: a survey of the knowledge of medical students. A survey of New Zealand medical students is described in which knowledge of human sexuality is documented to vary with age, sex, marital status, participation in a human sexuality teaching programme and year of course. Whilst no group scored disastrously and all groups scored well in some areas of sexuality, most groups also demonstrated significant gaps in their knowledge. Within any large medical school it is likely that there will be student subgroups with widely different levels of knowledge and therefore different needs requiring to be met in terms of education. Knowledge of sexuality was demonstrated to increase during the Otago medical course and for this process to have been facilitated by a formal human sexuality teaching programme. Support is therefore given to the need for, and effectiveness of, such teaching programmes in medical schools.