EEG-changes during intensified induction-therapy of acute lymphoblastic leukemia. In 49 children with acute lymphoblastic leukemia serial EEGs were performed during the course of treatment. Therapy in the first four weeks consisted of: Prednisone, vincristine, daunorubicine and L-asparaginase. In the second month 6-mercaptopurine, cytosin-arabinoside, cyclophosphamide, methotrexate-i. th. and cranial irradiation were administered. Maintenance-therapy consisted of 6-mercaptopurine, cyclophosphamide and methotrexate i.v. Before treatment only 24% of patients showed normal EEG-findings, whereas 57% presented sly induced by leukemic infiltrations and partly due to the impaired clinical state. At the end of the first phase of therapy, the combined toxicity of vincristine and L-asparaginase led to the finding of 23% severely and 37% moderately slowed EEGs. Slightly disturbed EEGs were found in 29% and normal ones in 11% of children. Regression occurred duirng the phase of CNS-prophylaxis. At its end 37% of recordings were normal and 57% slightly abnormal. After maintenance-therapy of 1/2 to 1 year duration, there were 65% normal findings. Moderate and severe disorders were no longer demonstrated. Paroxysmal activity developed twice, each during the first phase of therapy and accompnaying convulsions. In both cases we saw slowing of background-activity and signs of increased excitability still months after. In one of these patients, the probable cause was a vincristin-encephalopathy, the cause of the second case remained unknown. EEGs of two furtehr patients with rubella-encephalitis and subarachnoideal hemorrhage exhibited severe unspecific changes.


Bone and bone marrow blood flow in blastic crisis of chronic granulocytic leukaemia. A 133Xe washout method has been used for measuring changes of blood flow in the proximal femur of a patient with the blastic crisis of chronic granulocytic leukaemia. In the hyperplastic phase the blood flow was highly increased and over three times greater than in the hypoplastic phase of the disease and over thirteen times greater than the value in normal bone. The bone circulation and especially the first component of the two-exponential bone washout curves appeared to reflect cell proliferation and neoplastic activity of the whole bone marrow. The method may provide clinically important information in the follow-up of selected haematological diseases.


[Application of the ultrafiltration method to the isolation of cholesterol oxidase of microbial origin]. Ultrafiltration of solutions of intracellular cholesterol oxidase of Actinomyces lavendulae through semi-permeable membranes (N-vinyl pyrrolidone and methacrylate copolymers) of varying porosity and acetyl cellulase ultrafilter UAM-200 M was investigated. The ultrafiltration through membranes of both types involved both concentration and purification of cholesterol oxidase from low molecular weight protein admixtures. When copolymer membranes were used, their performance and degree of purification were higher and losses were lower than in case of UAM-200 M filter. The optimum hydrolytic mode of ultrafiltration of intracellular cholesterol oxidase through both filters was determined.


Comparative bone morphometric analysis of mandibles and iliac crests. A comparative analysis of bone mass in the mandible and the iliac crest has been carried out in autopsy specimens from 30 subjects aged 23-84 years. Microradiograms of standardized 100-micrometer-thick sections of the undemineralized plastic embedded material from the two locations were used for quantitation. The following measurements were carried out by electronic point-counting: 1) the percentage of cortical bone mass in the subperiosteal and subendosteal layers, 2) mean cortical width, and 3) the percentage of trabecular bone mass in the iliac crest. Positive correlations were found in the expressions of bone mass within the mandible; the values were significantly higher in the 200-micrometer-thick subperiosteal layer than in the remaining part of the mandibular cortex. Only a poor or no correlation was found in the expressions of bone mass from the two sites. The investigation, therefore, shows that bone mass and cortical width in the mandible cannot be predicted from a biopsy from the iliac crest. This finding may partly be due to different age-dependent functional changes of the two bones.


Silent period and jaw jerk reflex in patients with osseointegrated oral implant bridges. The silent period in the masseter and in the anterior portion of the temporal muscle during tooth tapping, the rate of tooth tapping and the jaw jerk reflex evoked by a tap on the chin were compared in individuals with oral implant bridges and with natural teeth. Thirteen women with osseointegrated oral implant bridges in one or both jaws, aged 42-59 years, were compared with 10 women, aged 42-64 years, with natural teeth. There was no difference between women, aged 42-64 years, with natural teeth. There was no difference between women with implant bridges and those with natural teeth in tooth tapping rate or in the occurrence, latency or duration of the jaw jerk reflex. A silent period during tooth tapping was found in 12 of the 13 women with implant bridges. The latency of the silent period was the same as in the subjects with natural teeth but the duration tended to be somewhat longer. The jaw jerk and the silent period were the same in individuals with implants in both jaws as in the whole implant group. It is therefore concluded that periodontal or mucous membrane receptors cannot be solely responsible for the silent period.


Calcium fluoride containing granules produced in vitro in rat bones. Femurs and tibias of normal rats were fixed in 4% unbuffered solutions of glutaraldehyde or formaldehyde containing 1% NaF. Following washing, radiographically controlled demineralization was performed in 3.25% HNO3. Light microscopy and transmission electron microscopy revealed the presence of so-called fluoride granules in bone trabeculae, cartilage, cartilage remnants, bone cells, chondrocytes and in the bone marrow. Selected area diffraction indicated that the fluoride granules contained CaF2. X-ray diffraction analysis of non-demineralized NaF-fixed bones were negative for CaF2. The results are discussed and related to precipitation artifacts reported in demineralized hard tissues and to similar CaF2-containing granules observed in demineralized bones and incisors of rats given high doses of NaF in diet or drinking water.


Microleakage around preventive composite fillings in loaded teeth. The purpose of this study was to evaluate the microleakage around preventive composite fillings in teeth subjected to mechanical loading and thermal cycling, and to assess the influence of the consistency of the composite resin upon the leakage. The fissure enamel was partially removed without dentin exposure in 30 extracted maxillary pre-molars. The cavities were etched with phosphoric acid and filled with undiluted composite (Adaptic) or composite diluted with varying amounts of liquid resin (Adaptic Bonding Agent). Five teeth were not acid etched and served as a control group. All teeth were mechanically loaded and unloaded, simulating masticatory forces, and subsequently thermally cycled between two dye solutions. Extensive leakage was seen around all fillings in the control group, while slight leakage, restricted to the feather-edge margin, was seen in five teeth with acid etched cavities. Three of these contained undiluted composite fillings. Twenty teeth showed no leakage. The results show that preventive composite filling provides good sealing of occlusal fissures, and that the seal is resistant to those thermal and mechanical stresses which may be expected in vivo. The use of diluted composite resin in preventive composite fillings is recommended.


Affinity of hydroxyapatite for furfural and a brown pigment formed by furfural and glycine. The affinity of hydroxyapatite for furfural and a brown pigment formed by furfural and glycine was studied. A series of mixtures containing 1 M furfural and 0.25-2.0 M glycine were incubated at 37 degrees C and aliquots of hydroxyapatite added. The apatite showed a strong affinity for the brown pigment formed, and an excess of glycine in the mixtures appeared to enhance the binding. The adsorption of furfural to hydroxyapatite was estimated by a spectrophotometric method. The data revealed that pretreatment with CaCl2 and glycine significantly increased the adsorption of furfural.


Elements in minor or trace quantities in zinc phosphate cements. Eight powders and two liquids of zinc phosphate cements have been analyzed by optical emission spectrography for the purpose of characterizing elements in minor or trace quantities. The following elements were measured: bismuth, boron, cadmium, chromium, copper, iron, lead, silver and titanium. The content of any of these elements did not exceed the level of 0.1%. The amounts of such elements which might be transferred to the gastrointestinal tract associated with dissolution from unsuccessful restorations have been considered.


Acute non lymphoid leukaemia following Hodgkin's disease. Clinical, biological and cytogenetic aspects of 3 cases. In a groups of 254 patients treated for Hodgkin's disease with a follow up period of minimum 2 years, 3 cases of acute non lymphoid leukaemia (ANLL) were observed: erythroleukaemia, myelomonocytic and myeloblastic leukaemia, respectively. The crude incidence of leukaemia in all patients was 0.0128 and patient year risk was estimated to be 0.003652. All 3 patients had received radiation therapy and chemotherapy. In all cases of haemopoietic dysplasia preceded ANLL. Bone marrow chromosome investigations showed an abnormal karyotype in all patients: chromosomal changes were present in 100% of cells and revealed a non-random distribution, the most frequent involvement being clustered to chromosomes nos 11, 17 and 21. Hypodiploidy was prevalent and multiple structural rearrangements, such as markers, rings and minutes, were present in a high percentage of cells. Other changes involved chromosomes nos 5, 7 and 14. Our results are compared with other previously reported cases and possible pathogenetic implications are discussed.


Pulmonary blastoma. Preoperative cytologic and histologic findings. The preoperative positive cytologic and histologic findings in ten cases of pulmonary blastoma are presented and compared with the results from the literature. In eight of our ten cases a preoperative diagnosis of cancer was possible, and in six of them a review of the material disclosed a biphasic feature. A pulmonary blastoma may be suggested when the preoperative microscopic specimens show immature tumor cells of tumor tissue with biphasic differentiation.


Diagnostic significance of carcinoembryonic antigen levels in serous effusions. Correlation with cytology. Carcinoembryonic antigen (CEA) determinations were performed in 86 malignant and 103 benign serous fluids submitted for routine cytologic examination. Cytology alone identified 54 (63%) of the malignant fluids. The remaining 32 (37%) had elevated CEA levels but no detectable malignant cells. In nearly half of 67 effusions with CEA greater than 2.5 ng/ml and negative cytology, elevated CEA concentrations were confirmed to be associated with malignancy. Most (92.5%) cytologically positive serous fluids also had elevated levels of CEA. Elevated CEA assay may raise the suspicion of malignancy in serous fluids that are negative cytologically. Increased CEA concentrations alone, however, cannot be used for confirming malignancy because CEA levels greater than 2.5 ng/ ml (mean, 10.5 +/- 8.2) were found in 50% of the fluids proven to be nonmalignant. Fluid CEA was more consistently elevated in tumors of gastrointestinal tract (greater than 25 ng/ml), lung (11.2 +/- 8.9) and breast (11.6 +/- 7.7) than in lymphomas or sarcomas (3.6 +/- 1). Paired plasma and fluid CEA levels may be particularly helpful in confirming a clinical diagnosis of malignancy in cases with negative fluid and biopsy findings.


Cytologic changes of the respiratory tract as a consequence of air pollution and smoking. A comparison was made of cytologic abnormalities in sputum specimens from inhibitants of an urban environment with a high level of air pollution (Sarajevo) and from inhabitants of a rural area (Podvelezje). The subjects of this study were grouped according to their smoking habits and sex. At the time of the investigation, all the subjects were clinically healthy. The cytologic specimens were evaluated in reference to eosinophils, respiratory spirals, atypia of bronchial cells and squamous metaplasia. The abnormal findings were more frequent among urban inhabitants than among rural ones. In both groups the abnormalities were more pronounced in smokers than in nonsmokers and in men then in women. Atypical squamous metaplasia was observed in 56% of smokers from the urban environment. There were no significant differences in cytologic abnormalities between nonsmokers from the urban environment and smokers from the rural area.


Cytopathologic findings in pulmonary blastoma. The exfoliative cytologic description of a pulmonary blastoma is reported. The debated histogenesis of these tumors is briefly reviewed. A review of all case reports recording cytopathology findings indicates that these rare tumors yield diagnostic cells in only a minority of cases. In the present case, as in previous reports, only the epithelial component (carcinoma) was recognized prior to the histopathologic diagnosis. The stromal cells were less numerous and not as conspicuous as the epithelial cells. The diagnosis of pulmonary blastoma should be considered whenever nonsquamous carcinomatous cells plus a separate population of smaller malignant cells are seen in a pulmonary cytology specimen.


Cytologic diagnosis of giant cell tumor of bone metastatic to lung. A case report. An unusual case of giant cell tumor of bone metastasized to the right lung and was diagnosed by percutaneous transthoracic needle aspiration biopsy.


Cytologic diagnosis of amniotic fluid embolus. Report of a case. This paper reports a case of a primigravid woman with the presumptive diagnosis of amniotic fluid embolus who had a blood sample aspirated from the right heart. The blood specimen was sent to the cytology laboratory, processed and then examined for squames and lanugo. The laboratory procedure and results are described.


Percutaneous transperitoneal aspiration of renal adenocarcinoma guided by ultrasound. Morphologic appearance of normal and malignant cells. An aspiration guided by ultrasound of a clear cell renal adenocarcinoma provided abundant, well-preserved  material. Surgical specimens of the granular and sarcomatoid (spindle cell) varieties of renal adenocarcinoma were aspirated with the same gauge needle as that of the Chiba University. The cytomorphologic appearances of these entities are described.


Papillary and undifferentiated thyroid carcinoma presenting as a metastatic papillary serous effusion. A case report. Papillary carcinoma  of the thyroid pursues a long course of local nodal metastases and rarely leads to death. This case reports an occult thyroid tumor which presented as a serous effusion with pure papillary carcinoma. At autopsy, both papillary and undifferentiated carcinoma were found in the thyroid. Although the pleural component was papillary, the fulminant course was that of an undifferentiated carcinoma.


[Lysine metabolism in acute leukemia].

[Lysine metabolism in acute leukemia]. The metabolism of 14C-lysine by leukaemic cells in acute myeloblastic, myelomonocytic, lymphoblastic and chronic myeloid leukaemia with blast crisis was studied. The investigations included lysine metabolism to CO2, lipids, organic acids and nucleotides and its incorporation into cellular proteins. The obtained results were compared with determinations carried out in granulocytes and lymphocytes of healthy subjects. Cells in acute leukaemias metabolized 14C-lysine in a similar range. In relation to normal cells the range of lysine metabolism to lipids in the leukaemic cells was significantly higher (p less than 0.01), while that of organic acids was significantly lower (p less than 0.05). The activity of 14C-lysine metabolism depended on the number of blast cells in the sample and the type of acute leukaemia. Neoplastic cells in blast crisis and in acute myeloblastic leukaemia incorporated more actively 14C-lysine into proteins than cells in acute myelomonocytic and acute lymphoblastic leukaemia (p less than 0.05). Similar differences in lysine metabolism were observed between myelomonocytes and blast cells from acute lymphoblastic leukaemia (p less than 0.05).


The cytologic findings in two cases of stromal sarcoma of the uterus. The cytologic findings in two cases of stromal sarcoma of the uterus are presented. The morphologic features useful in the cytologic diagnosis of this neoplasm are discussed, including: (1) the presence of isolated tumor cells; (2) the uniform pattern of tumor cells in spite of marked nuclear variations; (3) the "comet" appearance of some tumor cells; and (4) the presence of bizarre, multinucleated, giant tumor cells.


Effects of exogenous androgen treatment on X-chromatin. In studying a possible hormonal influence on X-chromatin frequency, buccal smears from two groups of women, one on androgen therapy and one not on androgen therapy, were compared. Both groups were nonmenstruating, renal dialysis patients, 41 to 69 years of age. For each patient the X-chromatin frequency was determined from 100 analyzable and intact buccal mucosa cells. In determining X-chromatin frequency, stringent selection criteria were used, and a selection ratio was derived by dividing by 100 the total number of cells that were counted in order to discover 100 analyzable and intact cells. Using the Guard's staining technique, no significant difference could be demonstrated in either the X-chromatin frequency or the selection ratio between the women receiving androgens and those not receiving them.


Computed tomographic findings of the brain in children with acute lymphocytic leukemia after central nervous system prophylaxis without cranial irradiation. Nineteen children in primary remission of acute lymphocytic leukemia (ALL) were investigated by computed tomographic (CT) scans of the brain 2 to 64 (mean 19) months after the central nervous system (CNS) prophylaxis was finished. The CNS prophylaxis consisted of high dose Methotrexate (HDM) intravenously combined with 6--8 doses of Methotrexate intrathecally. Two children received only Methotrexate intrathecally as CNS prophylaxis. In addition three children with ALL who had CNS leukemia were investigated by CT scans of the brain. Only one abnormal CT scan was found among the nineteen asymptomatic children, and one of the three patients with CNS relapse had slightly dilatated subarachnoidal spaces. These results compared with other reports in literature in which the CNS prophylaxis has consisted of intrathecal Methotrexate and cranial irradiation, suggest that there are fewer abnormal CT findings of the brain in patients not receiving cranial irradiation as part of CNS prophylaxis.


Bronchial metaplasia as a benign or premalignant lesion. I. Cytologic and ultrastructural discrimination between acute carcinogen effects and toxin-induced changes. The respiratory tracts of hamsters were exposed to either of two different chemical compounds contained in cigarette smoke, the carcinogenic chemical benzo(a)pyrene or the noncarcinogenic chemical formaldehyde. At various times during or shortly after the exposure, the acute cytologic, histologic and ultrastructural responses to the two agents were compared. Both agents induced microscopically similar squamous metaplastic changes of the tracheobronchial epithelium. However, there were several cytologic and ultrastructural differences in the appearance of the  chromatin, nucleoli and cytoplasm that could be used to separate carcinogen-induced from noncarcinogen-induced acute metaplastic changes. Furthermore, after cessation of the exposures, squamous metaplastic changes induced by the noncarcinogenic agent formaldehyde regressed to normal, while the acute carcinogen-induced changes were replaced by other, more persistent metaplastic changes.


Kinetics of cell replication of the uterine cervix. I. Normal epithelium. The rate of cell production in the squamous cervical epithelium, as deduced from the number of arrested mitoses at various time intervals after a single injection of vincristine, was investigated in 83 C57B1 mice. In the basal cell layer several peaks of arrested mitoses were registered: the first major peak was found at 9 hours, the second at 12 hours, the third at 16 hours and the fourth at 20 hours. Distinct peaks of arrested mitosis were also found in the nonbasal (parabasal) cell layers. Each mitotic peak may correspond to a number of cells that had entered the proliferative pool from the "resting" compartment. The stathmokinetic effect of vincristine on the squamous cervical epithelium had ceased after 20 hours.


Correlation between virus-cell receptor properties of alphaviruses in vitro and virulence in vivo. Virulent and avirulent clones of Venezuelan, Western, and Eastern equine encephalitis viruses were examined for their in vitro attachment characteristics to the surface of cultured cell monolayers. These attachment characteristics were correlated with in vivo plasma clearance rates and virulence. For the clones investigated, avirulence correlated in vitro with attachment pH optima close to physiologic pH and in vivo with a rapid clearance from plasma. Conversely, virulent clones had lower in vitro attachment pH optima and low plasma clearances in vivo.


A water-insensitive ventilator alarm.

A water-insensitive ventilator alarm. Most of the low-pressure ventilator alarms available have the pressure registration unit connected to the patient circuit by a narrow bore plastic tube. Condensed water in this tube will stop the correct function of the alarm in a few hours if the tube is placed after a heated humidifier. The pressure registration should be as close to the patient's tracheal tube as possible to monitor the pressure of the airway and hence a ventilator alarm with the pressure sensing unit in the patient circuit is described. The alarm has proved to be reliable, insensitive to water and very easy to adjust to maximum sensitivity.


Effects of stannous fluoride and amine fluorides on caries incidence and enamel solubility in adults. Three groups of men aged 19 to 22 years were examined. Group A was regarded as control, group B was treated topically with stannous fluoride solution every 6 months, group C received a gel for brushing once a week. All the subjects were re-examined after 6, 12, 18, 24, 30 and 36 months and DMFS scores were analysed. In the end of the trial 639 teeth from 213 participants were evaluated in vivo for enamel solubility rates by the CRT test. After three years of treatment both examinations disclosed that the gel was more effective in dental caries inhibition and reduction of the enamel solubility in acids, than stannous fluoride solution.


Cultural barriers to preventitve dentistry. The concept of social class and its influence on health attitudes and behaviour has been reviewed. Some dental attitudes and behaviour characteristic of lower socio-economic culture have been described and possible implications for preventive dental instruction outlined.


A metallographic evaluation of porosity occurring in removable partial denture castings. Conveniently sized sections from six removable partial denture castings were examined metallographically for porosity. Abrupt changes in cross sectional areas were the site of porosity in some specimens; also seen were small generalized areas of porosity unlikely to be disclosed radiographically.


Personality disorder in transcultural perspective. Personality disorder constitutes one of the most controversial diagnostic categories within clinical psychiatry. Explosive and antisocial personality disorders in particular are central to this controversy. The difficulties for diagnosis encountered when clinician and patient belong to different socio-economic classes are seen to be magnified in the transcultural situation, when cultural and language variables are superimposed. The diagnosis of personality disorder among Australian Aborigines is reviewed, and the face validity of some prevalence rates is challenged. An examination of the terms for anger and aggression used by a Central Australian tribal Aboriginal group demonstrates that Aborigines differentiate them both quantitatively and qualitatively. This facility is seen as providing psychiatrists with a method for enhancing diagnosis of personality disorder in both clinical and epidemiological settings.


Suicide in Australia--a comparison with suicide in England and Wales. This study reports changes of suicide rate in Australia and in England and Wales in the twenty years up to 1976. Rates in both places reached a peak in 1963, related to increases in poisoning as a means of suicide. Decreases since then can be attributed partly to reduced likelihood of death after inhalation of domestic gas or after ingestion of poisons. There has been an increase in suicide deaths among younger people, but a decrease among older age groups. The two countries have patterns of suicide which are similar in many respects, the most striking difference being the frequency with which firearms are used by male suicides in Australia. There is good reason to believe that variation in availability of a means of suicide is the factor which has most effect on rates of suicide, though cultural attitude towards each method also is an important determinant of how much it will be used for suicide.


The supplementation of alcoholic beverages with thiamine--a necessary preventive measure in Queensland? The large and increasing number of cases of Korsakoff's psychosis in a Queensland mental hospital prompts an examination of the theoretical and practical issues concerning the supplementation of alcoholic beverages with thiamine. It is concluded that supplementation of alcoholic beverages in Queensland with thiamine (and in particular with one of the allithiamines) warrants urgent and unprejudiced consideration.


Repertoires of response to potential precipitants of depression. A study that would appear to overcome two weaknesses in previous investigations of what have been termed 'antidepressive behaviours' is reported, from patients routinely attending two general practices. Questionnaires were designed to measure such behaviours and their reported effectiveness in response to potential precipitants of depression. While the subjects revealed no sex differences on a trait depression measure, in previous recourse to professional help for depression, or in their appraisal of two given situations, a number of sex differences in their reported antidepressive responses were found. Females scored as less reckless, and they scored higher on help-seeking and self-consolation dimensions ; they were also less likely to regard reckless behaviours as being effective. Higher social class was associated with higher scores on the self-consolation behavioural dimension and in higher scores on socializing. Younger subjects scored higher on socializing and found reckless behaviours more effective than did the older subjects.


Social support and the social environment of depressed and normal women. A brief self-report measure of social support was administered initially to a student population, and then to a sample of hospitalized depressed women. Comparison of the responses of the 32 patients with 35 student women of similar age showed no differences between the groups in number of cohabitants or of casual friends, or in faith in the value of talking over one's problems. Patients were more likely than controls to report having no or few confidants, nobody confiding in them, and little confidence in being liked by others. Training in social skills specific to fostering intimacy is suggested as a therapeutic step, and modifications to the social support measure for future use discussed.


The psychiatrist's family--a comparative study. The results of a questionnaire survey of the partners of psychiatrists and general practitioners are presented. The questionnaire was designed to elicit feelings about the respective professions. Methodological issues are discussed, and the wisdom of comparing different medical groups is questioned. Although significantly fewer psychiatrists' partners initially had positive feelings towards their spouse's career, the majority of both groups reported currently positive feelings. Only a minority, and in equal proportions in the two groups, reported that their spouse's profession had interfered with their relationships with friends or had influenced their marital relationship. A significantly greater number of general practitioners' partners reported that their spouse's profession was more stressful than that of other professionals. The results also indicated that a significantly greater number of psychiatrists than general practitioners as perceived by their partners as using psychiatric interpretation and jargon in the family setting. Furthermore, the comments provided, although representative of only a minority of respondents, demonstrated that this could provide a unique stress for the families of some psychiatrists.


Chlormethiazole dependency--a case report. Although dependency is reported to be one of the side effects of chlormethiazole, very few cases of such dependency have been reported. A detailed report of a female patient with a previous history of other dependencies, and who subsequently became dependent on chlormethiazole, is offered.


Peer review--the West Australian experience. The West Australian Peer Review Sub-Committee. In view of the Department of Health's recommendations that Peer Review be accepted as an integral part of the medical system, local members of the college volunteered to take part in a pilot study. Those involved were divided into three groups and were left to devise their own system. Following subsequent discussion and assessment, a workable scheme evolved as described. This system employs a 'rolling' or an ongoing technique in which a group of four psychiatrists form the peer review group. Following each assessment a new member joins the team and the longest serving person is assessed before leaving. The problems and difficulties of peer review are discussed and the importance of the link between peer review and continuing education is stressed.


[Transfusion of leukocytes and platelets in the treatment of acute leukemia]. Supportive therapy of concentrated leukocytes and platelets has no obvious significance. In the paper authors presented the methods of separation of concentrated leukocytes and platelets, investigation of number and functional abilities of preserved leukocytes and platelets as well as the monitoring of the transfusion effect in the patients with acute myeloblastic leukemia. Special attention was paid to the separation of blood cells by the cell centrifuge with continuous flow. Side effects after leukocytes and platelet transfusion was monitored -- occurence of the sensibilization to the HL-A antigens. For the detection of HL-A antibodies two-stage microlymphocytotoxic test was used for the investigation of patient's serum; for the application of leukocyte and platelet transfusion we used cross-match test between donor's lymphocytes and patient's serum in progressive dilution. In the paper authors discussed the correlation between the appearance of HL-A antibodies and the number of given transfusions.


[Malignant histiocytosis and histiocytic leukemia in a boy treated for eosinophilic granuloma]. The paper presents a case of the acute histiocytic leukaemia and malignant histiocytosis in a boy treated of eosinophilic granuloma. We could not explain whether it was the question of the generalized basic disease or of a "secondary carcinoma" resulting from the applied radiotherapy.


[Familial leukemia].

[Familial leukemia]. Occurrence of familial leukaemia confirms the influence of genetic factors in the appearance of malignant diseases. Such cases were described in one generation, in distant relations of two and three generations and in monozygotic siblings. Either the same type of leukaemia was recorded or different types. This is thought to be caused by pathological gene transmission in interaction with environmental factors which increase the tendency to malignant diseases in these families. Two cases of familial type of leukaemia are presented in the paper; in one family the illness appeared among members of one generation, but in the other in two generations. In both families it was a question of acute lymphoblastic leukaemia. Other types of malignancy were not found, nor was any environmental factor confirmed to have influenced cancerogenesis. Cytogenetic studies of the patients did not show any deviation from the normal kariotype. The illness evolution was fatal. This is the second report of familial leukemia in Yugoslav literature.


Excretion pattern of 3 beta-hydroxysteroids in patients with adrenal tumor, Cushing's disease and 21-hydroxylase deficiency, and in pregnancy, using thin-layer chromatography and color development of 3 beta-hydroxysteroids with 3 beta-hydroxysteroid oxidase. The fractional assay is described of 3 beta-hydroxysteroids in various patients by thin-layer chromatography and color development using an enzyme that reacts specifically with some 3 beta-hydroxysteroids. Together with dehydroepiandrosterone, androst-5-ene-3 beta,17 beta-diol and 16 alpha-hydroxydehydroepiandrosterone can be detected, but their concentrations differ with each disease. An unknown fraction, a more polar 3 beta-hydroxysteroid than 16 alpha-hydroxydehydroepiandrosterone, is also detected in moderate amounts in patients with adrenal tumor (18.3 mg/day), 21-hydroxylase deficiency (3.2 to 1.2 mg/day), and Cushing's syndrome (0.9-2.3 mg/day, as pregn-5-ene-triol).


Juvenile periodontitis. Localization of bone loss in relation to age, sex, and teeth. The distribution of bone loss in 156 patients, 12-32 years old, with juvenile periodontitis was analyzed according to age, sex, and teeth affected. The criteria for bone loss were: vertical or horizontal bone loss involving more than one-third of the root as judged by radiographs. Three age groups were established: 12-18, 19-25, and 26-32 years old. Three types of bone loss localization were defined: I. First molars and/or incisors. II. First molars, incisors and some additional teeth (total less than 14 teeth). III. General involvement . There was a dominance of female patients. The ratio females: males decreased from 5.3:1 in the youngest age group to 1.5:1 in the oldest. The mean number of involved teeth increased with age from 5.3 teeth in the youngest group to 11.6 in the oldest. The frequency of type I bone loss decreased from 55% in the youngest group to 7% in the oldest. Type II occurred with the same frequency (55-58%) in all three age groups. Type III was not seen in the youngest group whereas it increased from 17% in the middle to 35% in the oldest group. Of the total number of involved teeth, the first molars were most frequently affected, followed by the incisors. Maxillary teeth were involved to a slightly higher degree than mandibular teeth, and there was a strong "mirror effect" between involved teeth of right and left jaw halves.


Gingival blood circulation after experimental wounds in man. Capillary blood circulation following experimental wounding was observed by fluorescein angiography. Contralateral punch wounds 1.5 mm in diameter were made in healthy mandibular labial attached gingiva of 31 volunteers. Areas of ischemia were clearly visible angiographically 6 hours after wounding and were significantly greater in area (P less than 0.05) and wider (P less than 0.01) for wounds in the long axis of mandibular incisors (N = 14) than those on the vertical midline of the gingival papillae (N = 17). The ischemic changes occurred exclusively cranial to the experimental wounds. By the third day the epithelium adjacent to the wound margin in the central part of the ischemic area had necrotized, thus extending the wound coronally. By the seventh day the axial wounds were significantly (P less than 0.001) larger than the papillary wounds. The data strongly suggest that the blood supply of mandibular labial attached gingiva is preferentially oriented in an apico-coronal direction and that the capacity for collateral circulation is dependent upon local differences in vascular structure. The findings are applicable to flap design in periodontal surgery.


Electron microscopic study of junctional and oral gingival epithelia in the juvenile and adult beagle dog. A previous study demonstrated structural differences in the junctional epithelium between juvenile and adult dogs. In juveniles the junctional epithelium showed some resemblances to the oral gingival epithelium, and a cuticular structure at the dento-gingival junction was of particular interest. The oral gingival epithelium is considered to be less permeable than the junctional epithelium. As cytoplasmic filaments are held to be the main component in the process of keratinization, and to have a stabilizing influence on the cells and tissues, the present investigation was designed to study the relative amounts of cytoplasmic filaments in the junctional and the oral epithelia of beagle dogs during juvenile and adult stages. In addition, the ultrastructure of the dento-gingival junction was characterized. Six beagle dogs were used. The material consisted of gingival biopsies sampled when the dogs were 3 and 12 months old, respectively. On these occasions the gingiva was in excellent health. The biopsies were prepared for electron microscopic analysis and three randomly selected fields were recorded photographically from each of the following epithelial strata: basal and granular cell layers of the oral epithelium and basal and superficial cell layers of the junctional epithelium. Morphometric analysis was performed in order to estimate the density of cytoplasmic filaments of the cells in these epithelial strata. The amount of cytoplasmic filaments was considerably lower in the cells of the junctional epithelium than in those of the oral epithelium. In the oral epithelium the amount increased from basal towards superficial cells, whereas no such increase was seen in the junctional epithelium. The pattern was the same in the juvenile and the adult stage. At the dento-gingival junction all dogs had a thick, laminated layer of dental cuticle material in the juvenile stage. In the adult stage a similar structure was seen only infrequently, and it never attained the thickness observed in the juvenile stage.


Free gingival graft and coronally repositioned flap. A 2-year follow-up report. Eleven cases are described in which the width of attached gingiva was increased by a free gingival graft, followed 2 months later by a coronally repositioned flap. This two-step operation was performed on 36 areas of recession in 11 patients. In all cases, the procedure has much improved the periodontium functionally as well esthetically. In two patients, a clinically stable reattachment has taken place within preexisting dentinal cavities. The relationship of the probe tip to periodontal tissues during probing and the reattachment of both epithelium and connective tissues are discussed.


Prevention of periodontal disease in the future. Existing knowledge about periodontal disease is sufficient to permit the interested individual to carry out a preventive program which can result in preventing the major forms of the disease from developing. It is likely that the sooner such a program is started in a person's lifetime, the likelier it is to succeed. With the additional knowledge obtained from current avenues of research, clinical microbiology and immunology will become applicable to the management of selected forms of periodontal disease, both for diagnostic and therapeutic purposes. Some of the information gained may help in fostering the establishment of a desirable microbial flora and in better control of potentially pathogenic strains. The implementation of an effective preventive program for periodontal and other dental diseases will vary on a regional basis depending on political, economic, social and ethical considerations.


The epidemiology of dental caries and periodontal disease. Dental caries and periodontal disease are common in industrialized countries and caries is increasing in non-industrialized countries. The predominant method of coping with the disease problem has been to treat rather than prevent the diseases, an approach which has obviously failed to cope with the problem as shown by the results of the International Collaborative Study of Dental Manpower Systems (58). Epidemiological evidence suggests that a food policy directed at lowering the refined sugar consumption level to about 10 kg per person per year in conjunction with fluoride supplementation of the diet would virtually eliminate dental caries in industrialized countries. Health education to improve the effectiveness of toothbrushing will reduce the progression of periodontal disease to a rate compatible with keeping teeth for a life-time.


Genetic recombination in fused spheroplasts of Providence alcalifaciens. Spheroplasts of Providence alcalifaciens strain P29 auxotrophs were prepared by combined treatment with glycine and lysozyme-EDTA. About 15% of spheroplasts had areas of cytoplasmic membrane exposed where cell wall was absent. The spheroplasts of different auxotrophs were mixed pairwise and fusion was attempted with polyethylene glycol or nascent calcium phosphate. After spheroplasts had regenerated to bacterial forms selection was made for recombinants. Recombinants arose at frequencies of 3.8 X 10(-6) to 1.7 X 10(-7) per spheroplast initially present, by both methods of fusion. The frequency was strongly dependent on the number of chromosomal loci used in selection. The possible order of five loci was determined and this corresponded to that on the closely related Proteus mirabilis chromosome. Control experiments excluded possibilities of auxotrophic reversion, conjugation, transformation, transfection or transduction as explanations of the results. Analysis of prototrophic clones yielded stable prototrophs or mixtures of stable prototrophs and stable recombinants. Parental types were not encountered. Unselected markers segregated among recombinants. It was concluded that the formation of recombinant bacteria was due to spheroplast fusion and that only stable products of the very temporary heteroploid state were haploid recombinants. The low frequency of recombination was ascribed to the limited number of spheroplasts with areas of exposed cytoplasmic membrane.


Quantitative scanning of osteogenic sarcoma with nitrogen-13-labeled L-glutamate. N-13 L-glutamate was used to image an osteogenic sarcoma in a 9-year-old patient. Serial quantitative measurements of the amount of N-13 taken up by the primary tumor showed a decrease of 40% after 10 wk of chemotherapy. Blood-clearance data obtained from normal subjects indicate that more than 90% of the N-13 activity had left the blood before scanning of the tumor was begun. It appears that the N-13 label concentrated in the soft-tissue portion of this osteogenic sarcoma, whereas Tc-99m diphosphonate uptake was greatest in the regions where calcification was occurring.


Variation of gene conversion and intragenic recombination frequencies in the genome of Ascobolus immersus. Eighty mutants in 17 ascospore character genes were studied for their conversion patterns. The correlation between conversion pattern and mutagenic origin, previously found in genes b1 and b2 was extended to all the genes studied. Aberrant 4:4 asci were found in most genes irrespective of their conversion frequency. From gene to gene, the conversion frequency showed an almost 100 times variation. The frequency of intragenic recombination also showed sharp variation from gene to gene. The mean conversion frequency and the maximal intragenic recombination frequency were shown to be highly correlated in 5 genes for which these 2 values are known. This correlation was extended to 12 other genes in other Ascomycetes: Saccharomyces cerevisiae, Schizosaccharomyces pombe, Neurospora, and Sordaria. From this study it is concluded that, 1) the probability of hybrid DNA formation undergoes considerable changes according to the region of the genome; 2) the intragenic recombination frequency primarily reflects the frequency of hybrid DNA formation rather than the physical length of the gene; 3) for a given physical distance on the DNA, a similar fraction of the gene conversion events lead to recombination in the 5 Ascomycetes.


Ant-mediated inactivation of Salmonella phage L-specified repression at OR of prophage L. Ant product of phage P22 inactivates repression of prophage L at the right-hand operator OR and allows for transactivation of prophage gene 12. The transactivation efficiency observed with a series of phage and prophage recombinants, using single superinfection of a lysogenic bacterium, is about the same as that recently observed at OL of prophage L. This finding is in contrast to the failure to demonstrate derepression at OR of prophage L in an experimental system employing double superinfection (Prell, 1978a). The reasons for the differing results are discussed and it is shown that derepression by the ant product in trans at OR of the prophage is not modified to any significant degree by the immunity specificity (L or p22) of the prophage or of the superinfecting phage.


Evidence for non-random spatial distribution of meiotic exchanges in Podospora anserina: comparison between linkage groups 1 and 6. In Podospora anserina, positive and very efficient chiasma interference is observed. However, its modalities are different for the two linkage groups 1 (LG1) and 6 (LG6) studied here. In the right arm of LG1, two zones exist in which always occurs only one crossing-over. They are formed independently each other. Moreover, the genetic map consists of clusters of genes located near the centromere and at the limit between the two interference zones. It is postulated that this structure of the map results from the localization of crossing-over in the middle of each zone. We suppose that the type of chiasma interference, in Podospora, is a typical one as it is in Drosophila. It seems that both these phenomena are under common genetical control. In the LG6, we observe a weaker positive chiasma interference without crossing-over localization.


[The statement of nuclear volume, DNA content and nuclear form in tissue sections (author's transl)]. 15 days after amputation of the forelimb of young postmethamorphic Triturus vulgaris DNA-content and volume of the nuclei of the mesodermal blastema cells have been investigated in longitudinal sections of 2 microns in thickness by Feulgen-photometric and electronic determination of area. Discrimination of the DNA-synthesis phase was carried out using microautoradiography after "in vivo" labeling with tritiated thymidine. Volume and DNA-content of the nuclear sections have been found to be positive correlated. The DNA-synthesising part of the population shows characteristic differences to the mean value of volume and DNA-content of the remaining population. The factor circumference 2/area is suitable to characterize the differentiation degree of cells.


[Quantitative image analysis in pulmonary pathology - digitalization of preneoplastic lesions in human bronchial epithelium (author's transl)]. The report concerns the first phase of a quantitative study of normal and abnormal bronchial epithelium with the objective of establishing the digitalization of histologic patterns. Preparative methods, data collecting and handling, and further mathematical analysis are described. In cluster and discriminatory analysis the digitalized histologic features can be used to separate and classify the individual cases into the respective diagnostic groups.


[On-line measurement of antibiotic concentrations (author's transl)]. A laboratory computer implementation of an inhibition zone antibiotic assay is described. It utilizes square plates with 49 or 64 wells containing standards and unknowns. Inhibition zone sizes are measured and, using parabolic regression, the unknown antibiotic concentrations are computed.


[Correlation of morphometric parameters with enzyme-activities in cases of liver diseases with fibrosis (author's transl)]. 50 liver specimens with fibrotic liver disease were taken from current autopsy material and, after preparation, subjected to automatized image analysis by QUANTIMET 720 for quantitation of the connective tissues and their cellularity. In cell-free supernatants of liver tissue homogenates we determined the activities of N-acetyl-beta-glucosaminidase (beta-NAG, E.C. 3.2.1.30), a lysosomal glycosidase that is involved in proteoglycane metabolism of connective tissue. Beta-NAG-isoenzymes were demonstrated by electrofocusing in thin layers of polyamide gel. The results showed statistically significant correlations between beta-NAG activity and morphometrically assessed quantities of connective tissue, and of mesenchymal cells found in the latter or in the whole specimen, respectively. Demonstration of tissue or serum levels of beta-NAG or its isoenzymes provides a readily practicable method for assessing mesenchymal activities of the liver.


[Cell activation and nuclear volume (author's transl)]. Freezing dried semithin sections (1 micron) coloured with nuclear fast red are suited for determination of volume and activation state of cells and nuclei by means of electronic image analysis. Additional investigations of the proteinsynthesis with help of autoradiographs after incorporation of tritiated amino acids affirm the informations. Magnification of the nucleus together with a simultaneous increase of the proteinsynthesis per unit volume characterize the Stratum basale near the amputation level as the most active area of the regeneration epidermis. The cell volume is correlated with the alterations of the nuclear volume. Determination of the mean relative volume of nuclei with aid of measurements of nuclei sections suffices to get informations about cell activity.


Pyomyositis in acute lymphocytic leukemia heralded by cutaneous vasculitis: brief communication. We have observed two cases of staphylococcal myositis in patients with acute lymphocytic leukemia which are distinguished from previously reported cases by a history of cutaneous vasculitis overlying the area of subsequent infection.


Unusual cytogenetics in a case of acute lymphoblastic leukemia. The cytogenetics in the study of a patient with acute lymphoblastic leukemia are presented. Initially, a large proportion of both unstimulated and phytohemagglutinin (PHA)-stimulated blood mitoses showed an abnormal karyotype with a 7;12 translocation and a trisomy 19. At the time of relapse, a PHA-stimulated culture showed the clonal abnormality as well as dicentric chromosomes in normal cells, the latter possibly resulting from treatment.


Oral aspects of osteopetrosis.

Oral aspects of osteopetrosis. The characteristic feature of osteopetrosis is a lack of osteoclastic activity, leading to a series of somatic problems for afflicted persons. The life span of osteopetrotic patients has increased in recent years, thereby making oral aspects of the disease more evident. Four children with malignant osteopetrosis, born between 1967 and 1975, were examined. In all patients the anterior teeth were of normal shape, and erupted on schedule. Primary molars and all permanent teeth were greatly distorted, and remained totally or partly embedded in basal bone. Vertical growth of alveolar ridge was very  limited. Where a fenestration of overlaying mucosa had occurred, a localized progressive osteitis developed, leading to soft tissue inflammation and, in two cases, extraoral mandibular fistulas. Peridontal attachment was very poor, spontaneous exfoliation had occurred in all patients. In two children tooth germs and necrotic bone were surgically removed. No beneficial effect of the treatment was observed. Large doses of antibiotics were needed to control recurring infections. No means of curing progressive osseous destruction of mandibular bone has been found. The general prognosis is poor.


Dental findings in patients with Aarskog syndrome. Dental manifestations of the Aarskog syndrome were studied in 10 individuals. There was retarded development and eruption of the permanent teeth in six boys. Dental age was less retarded than height age and bone age. The prevalence of hypodontia and the prevalence and degree of orthodontic anomalies were higher than in the general population. Caries prevalence was high.


Dentofacial development in long-lasting nasal stenosis. In 18 patients with congenital choanal atresia the connection between impeded nasal respiration and dentofacial development was studied by a combined radiocephalometric and biometric method. The results obtained showed that neither the dental occlusion nor the vertical facial growth diverged from normal. The sagittal growth, however, was significantly reduced. Consequently, nasal stenosis remaining during the growth period contributes not only to transitory discomfort but seems to induce permanent morphologic alterations as well.


Tooth stain during 2 years' use of chlorhexidine- and fluoride-containing dentifrices. The purpose of the present study was to evaluate the effect of fluoride upon the stain-inducing capacity of chlorhexidine. Ninety-one children, 13 years of age, volunteered for the experiment. Three test dentifrices were used, containing 0.1% NaF, 0.1% NaF + 2% chlorhexidine, and 2% chlorhexidine respectively. The experiment was carried out as a double-blind test, and the degree of staining was recorded after 1 and 2 years. Four methods were used for stain scoring. The results after 1 year showed that chlorhexidine induced less stain when applied together with fluoride than when applied alone. After 2 years this difference disappeared, indicating that fluoride only retarded chlorhexidine-induced staining of teeth.


Effect of mechanical plaque control on development of subgingival plaque and initial gingivitis in neutropenic dogs. Histologic, histometric and morphometric investigations were performed on the gingival tissues of three neutropenic dogs. Over a period of 4 d the animals had been subjected to daily toothcleaning of the left side of both jaws, whereas plaque accumulation and subsequent gingivitis occurred on the uncleaned teeth of the right side of both jaws. Observations and data revealed that subgingival plaque had formed in both sides and extended further apically (max. 0.6 mm) on the cleaned than on the uncleaned sides. In the responding gingival tissues, leukocytes of the junctional epithelium were more numerous and blood vessels of the marginal connective tissue occupied a greater volume on the cleaned sides when compared with the uncleaned sides. It is concluded that neutrophilic granulocytes normally help to prevent bacterial invasion into the dentogingival region, and that, in the presence of subgingival plaque, toothcleaning may aggravate the inflammatory response of the gingiva.


Effect of chlorhexidine on the relative proportions of Streptococcus mutans and Streptococcus sanguis in hamster plaque. The effect of chlorhexidine on the proportions of Streptococcus mutans and Streptococcus sanguis in plaque was studied in hamsters fed a diet containing 28% sucrose. In animals given chlorhexidine in their drinking water for 10 d a decrease in the population of S. mutans and an increase of S. sanguis occurred in the plaque. Following the removal of chlorhexidine the population of S. mutans increased again in the presence of sucrose and the number of S. sanguis returned to initial values. When animals were given a sucrose-free diet the low proportion of S. mutans observed following the short-term chlorhexidine period persisted. These data indicate that there is an inverse relationship between the number of S. sanguis and S. mutans in plaque and that the sensitivity in vivo of S. mutans to chlorheximide can be used to suppress the population of S. mutans with a concomitant rise in the proportion of S. sanguis.


Effects of bactericidal treatments on bacterial adherence and dental plaque formation. In vivo plaque formation was significantly reduced when tooth surfaces were subjected to topical applications of iodine (0.2% I2 in 2.0% KI) twice daily for 3 d. Similarly, in vivo plaque formation was significantly reduced on enamel surfaces that were subjected to ultraviolet irradiation. Control experiments indicated that neither ultraviolet irradiation nor iodine treatment interfered with mechanisms for bacterial apposition to dental plaque. The results are  interpreted to suggest that plaque grows in mass primarily by the division and multiplication in situ by plaque bacteria, not by a continued apposition of salivary microbes.


Possible origin of sulfated glycosaminoglycans in human dental calculus. The sulfated glycosaminoglycans present in human dental calculus have been shown to be dermatan sulfate and chondroitin-4-sulfate. The composition suggests that the glycosaminoglycans present in calculus, particularly subgingival material, could originate as a result of associated periodontal disease since closely similar compounds have previously been identified in normal and inflamed human gingiva.


Retention of fissure sealant in primary second molars after 6 months. Low retention of fissure sealant in primary teeth could be due to insufficient moisture-control in young children. In the present study 10 primary maxillary second molars and 29 primary mandibular molars were sealed using rubber dam while their contralateral teeth were sealed using cotton rolls. No difference in the retention of the sealant could be demonstrated.


Gastrin and enteroglucagon cells in human antra, with special reference to intestinal metaplasia. In a consecutive material consisting of 24 stomachs resected due to adenocarcinoma, intestinal metaplasia occurred in 21. Gastrin-producing cells (G-cells) were found to be distributed in a sporadic manner in antra with intestinal metaplasia. Not a single G-cell could be demonstrated in areas with metaplasia, while in the nonmetaplastic areas the distribution of the G-cells corresponded to that of the middle part of the mucosa. This means, that an error can occur when determining the quantity of G-cells, and can explain the previous controversial results regarding the density of G-cells. Enteroglucagon containing cells (GLI-cells) on the contrary were demonstrated in areas with intestinal metaplasia in antra of 19 of the stomachs showing intestinal metaplasia but never in the nonmetaplastic mucosa. This indicated that metaplasia also includes the endocrine cells. The identification of the G-cells and the GLI-cells was carried out by means of indirect immunoperoxidase technique combined with alcian blue pH 2,6-PAS staining.


Benign idiopathic recurrent rectal ulceration (BIRRU). New clinical aspects of the condition currently known as solitary ulcer of the rectum are presented and various histological phases in its development are described. Benign idiopathic recurrent rectal ulceration, shortened as BIRRU, is suggested, as a new more appropriate nomenclature.


The endoscopic and histological features of peptic duodenitis. This study attempts to compare the endoscopic features of duodenitis with the histological characteristics. During a 12 month period, 98 patients undergoing fibreoptic oesophago-gastro-duodenoscopy had the endoscopic appearances of the duodenum classified on a three point scale of increasing severity of duodenitis. Multiple duodenal biopsies were then taken and the histological features of the severity of duodenitis graded from 0 to 4 plus by an independent observer. The histological criteria included an assessment of neutrophil infiltration, villous bluting, gastric metaplasia and chronic inflammation. Routine endoscopic assessment alone was unsatisfactory for diagnosing and grading the severity of duodenitis and multiple target biopsies are required for histological examinations.


Electron microscopic appearances of chronic nonspecific duodenitis (bulbitis). The diagnosis of CND cannot be improved by electron microscopy. The normal duodenal cap and CND have similar ultrastructural appearances on guided endoscopic biopsy.


A study of occupational status, responsibility and authority in patients with duodenal ulcers, other gastrointestinal diseases and controls. Five hundred and twenty-two African and Indian patients were studied, including 206 with duodenal ulcers, 25 with irritable colon, 51 with oesophagitis, 31 with pancreatitis, 14 with ulcerative colitis or Crohn's disease, 71 miscellaneous gastrointestinal diagnoses and 124 controls. The mean ages were similar in each group. Every patient underwent endoscopy and a detailed psychosocial questionnaire was applied. Comparison of occupations of patients and their patients was investigated on 3 scales, for Status/Prestige (9 levels), Responsibility (5 levels) and Control over Others (10 levels). Significantly more patients with duodenal ulcers were in the lowest group in terms of occupational authority compared to other diagnoses and controls. Similar number of all groups had been urban for their entire life. Stress was present in the 10 days preceding an attack in significantly more Indian males with duodenal ulcers compared to controls. Upward shifts in prestige had not occurred in African male patients with duodenal ulcers when compared to their parents but had occurred among Indian men. More duodenal ulcer patients were in the very lowest occupational authority category compared to other groups. It may thus not be occupational prestige as such that is important, but factors associated with it, such as lack of control over others and, among Indian men, stresses associated with social disruption following upon occupation mobility.


Role of ulcer morphology in evaluating prognosis and therapeutic outcome in duodenal ulcer. Endoscopic morphology of duodenal ulcer (DU) have been studied in 188 patients repeatedly observed in the course of medical therapy (120 with conventional therapy and 68 with Cimetidine alone). The evolutive behaviour under treatment reveals a clear speeding up effect of Cimetidine on the healing time with a smaller number of failed and delayed recoveries and a lower frequency of relapses than after conventional therapy. Endoscopic morphology allows a limited but significant forecast of therapeutic outcome of DU. The shape, the number and partly the location of ulcer in the bulb appear to be the most significant parameters with prognostic influence both on the healing time and on the frequency and early development of relapses.


Parietal cell mass after short and long term cimetidine treatment of duodenal ulcer. The parietal cell mass (PCM) was evaluated on endoscopically obtained biopsy specimens of fundus mucosa from 20 duodenal ulcer patients before and after cimetidine treatment. Patients were given cimetidine, 1 g/day, for 28 days. Six out of the 18 cases which healed after short-term therapy went on taking 400 mg/day of cimetidine for 9 months. The PCM was expressed by means of an index (PI) obtained by multiplying the mean cell number per mm of section surface by the mean parenchymal thickness. The analysis of the obtained data failed to demonstrate any significant difference between the PI observed before and after 28 days treatment with cimetidine, while after long term treatment for 9 months, a significant increase of the PI was achieved.


Does the duodenal cell ever return to normal? A comparison between treatment with cimetidine and denol. After six weeks therapy with the bismuth-containing substance Denol, the ultrastructure of the duodenal cell is normal in most cases. Following therapy with the histamine-2 receptor antagonist (cimetidine), for the same period and even after one year continuous therapy, the denodenal cell remains abnormal in most instances. This may explain the frequent relapse of duodenal ulcers after cimetidine treatment.


Brush cytology of the papilla of Vater.

Brush cytology of the papilla of Vater. In every case of duodenal endoscopy we collect cell material from the papilla of Vater by means of a guided brush technique. The microscopic techniques used include phase contrast study of unfixed material and Papanicolaou stained smears. Normal epithelial cells of the papillary region differ from those of the duodenal epithelium and the epithelial cells of the common bile or pancreatic ducts collected by retrograde cannulation. A striking feature in the cytology of the papilla is the marked tendency for cellular atypias. Mostly these atypias have no correlation to histologic biopsy specimens although they persist in such cases during repeated examinations. Tumour cells from carcinoma of the papilla are found very regularly and consequently the cytodiagnosis of these tumours became of great practical value. Polypoid lesions of the papilla give also, a characteristic cell picture. From a cytological point of view the papillary region, where different kinds of epithelia come together, is of special pathogenetic importance.


Pyloric reflux: a duodenal functional problem? A manometric study of duodenal motor activity was performed in 8 duodeno-gastric (D.G.) reflux patients and in 5 healthy volunteers. The examination was done by an open-tip probe containing three catheters which was positioned in the descending portion of the duodenum. The evaluation of manometric data evidenced in D.G. reflux patients a Motility Index (M.I.) significantly higher than that of control subjects in all the three duodenal recording points both in basal conditions and after prostigmine stimulation. Evaluation of the percentage of coordinated waves showed that in D.G. reflex patients the waves had a frequency lower than that in normals. On the basis of these results we can conclude that the duodenum of patients with D.G. reflux exhibits hyperkinetic-dyskinetic disturbances suggesting an important role of the duodenum in determing D.G. reflux.


A model for duodeno-gastric reflux.

A model for duodeno-gastric reflux. Electric stimulation of the duodenum can produce duodeno-gastric reflux. The functionability of this model was examined by intraluminal manometry, bromsulphtaline reflux and duodenal electrogram.


Histochemistry of the human duodenal mucosa with special reference to the gradient of activities of the brush border enzymes. Histochemical examination of aspiration biopsy specimens of the duodenum in 8 healthy volunteers and 23 patients with various gastrointestinal disorders revealed no characteristic abnormality except for a rather frequent absence of the activity of disacharidases especially of lactase. A distinct difference of disacharidase was established between the duodenum and the jejunum in some individuals. A systematic study of different levels of the upper gastrointestinal tract established the fact that the activity of brush border enzymes of enterocytes starts to appear in individually different parts of the duodenum and sometimes even as low as in the jejunum. The distribution of lysosomal enzymes and the activity of dehydrogenases display differences as well. Consequently specimens from different parts of the duodenal and jejunal mucosa are not equivalent and cannot be used alternatively for diagnostic purposes. Biopsies of duodenal mucosa are not adequate for the diagnosis of the malabsorption syndrome.


Prolonged endoscopic and manometric observations of the pylorus. Functional aspects of the antral-pyloric segment were evaluated in 30 patients without gastroduodenal disorders by means of prolonged endoscopic observations. Patients were examined in standardized conditions. Pressure measurements of the antrum, pylorus and duodenal bulb were assessed by means of water-perfused polyvinyl tubes in 7 patients of the same group a few days after the endoscopy. The pylorus appeared open in above 80% of the total endoscopic observation time. Pyloric closure was observed only for few seconds at the end of 30-40% of antral peristaltic waves. The antrum and pylorus appeared to contract in sequence. Antral peristaltic waves moved at a mean rate of 2.4 per minute and duodenal reflux was observed at a mean rate of 0.96 per minute usually in the form of bubbles. The manometric measurements by means of pull through in 7 patients and immediately after by means of prolonged registration carried out in a fixed position in 4 patients failed to show a high pressure zone in the gastroduodenal junction. In some cases it was possible to observe a peculiar phasic activity in the pyloric tract. The endoscopic and manometric observations suggest that human pylorus does not act as a true physiological sphincter. These findings confirm the functional aspects described by radiology and manometry in other studies. In this way, endoscopy appears to be a useful procedure to evaluate some functional aspect of the gastroduodenal tract.


A preliminary study of scanning electron microscopic changes of the duodenum during healing of duodenal ulcers. Using the scanning electron microscope, changes in the rat duodenum have been studied during the healing of gastric secretagogue-induced duodenal ulcers on the 1st, 3rd, 7th and 10th days post-infustion. A montage technique with fine resolution has allowed both the entire area of the duodenum and the cellular organization in individual villi in proximity to the ulcers to be investigated. There was a considerable range of appearances noted at any one time point due to the variations in the size and depth of the original area of ulceration. On day 1, there was acute destruction of the mucosal surface with distortion of the villi at the ulcer margin. By the 3rd day, some specimens already showed full epithelialization over the defects whereas others up to day 10 revealed persistent areas of ulceration. Occasional specimens showed areas suggestive of gastric surface metaplasia on the villous surface adjacent to these ulcers.


Studies on duodenal gastrin concentrations in dogs following antrectomy and total gastrectomy. In extracts of the normal duodenum from dog minute amounts (2%) of gastrin are present compared to those extracted from the pyloric antrum (4). Despite that, basal levels of gastrin in plasma are not lowered when the antrum is surgically removed and test meal stimulation still significantly elevates the concentrations of plasma gastrin. When also the duodenal bulb is surgically removed basal gastrin levels decrease considerably and stimulation by a meal no longer raises the gastrin concentration in plasma (5). The related results suggest that extra-antral release of gastrin may take place under basal and stimulated conditions in dogs and that this release essentially occurs from the proximal portion of the duodenum, i.e. the duodenal bulb. Considering the low amounts of gastrin normally present in the duodenum of dog we found that levels of gastrin in plasma under basal and stimulated conditions after antrectomy surprisingly high and have therefore put forward the hypothesis that a compensatory increase in duodenal gastrin content takes place when the antrum is surgically removed (3). In the present study the relation between time following antrectomy and duodenal concentration of gastrin has been studied. In addition we also investigated how total gastrectomy influences the gastrin content of duodenum in dogs.


"In vitro" duodenal muscle in the pharmacological study on natural compounds. In vitro duodenal muscle was found to be a useful tool in the study of natural compounds. In the field of polypeptides rat duodenum was found to be of definite importance to differentiate the bradykinins (which induce relaxation) from the tachykinins (which evoke contractions). Human duodenum both "in vitro" and "in vivo" is relaxed by peptides of the gastrin and cholecystokinin family (like caerulein), whereas it is contracted by bombesin. Dog and cat duodenum is contracted by all the different types of peptides though in various degrees. Guinea pig duodenum is contracted by many peptides and also by histamine and related substances. In this case another differentiation seems to be possible as contraction induced by stimulation of H1 receptors concerns essentially the longitudinal muscle layer whereas stimulation of H2 receptors seems to inhibit the longitudinal contraction because of a contraction of the circular muscle or because of true relaxation of the longitudinal muscle. All the above considerations suggest that a comparative study performed on duodenal muscle of different animals might give useful information in the screening of new natural active compounds of synthetic analogues.


Mucin histochemistry and questions in gastroenterology. A group of modern mucosubstance histochemical techniques was employed on normal and pathological specimens obtained from the gastrointestinal tract of 2212 individuals. In the light of the results, five main problems in the filed of gastroenterology are discussed; namely: 1) The nature of intestinal metaplasia and histogenesis of adenocarcinoma of the stomach, 2) Early diagnosis of small intestinal carcinoma, 3) The so called transitional colonic mucosa, 4) The diagnosis of ulcerative colitis and Crohn's disease and 5) Differential diagnosis of other carcinomas growing into the large bowel.


A new type of tube for guided small bowel biopsy. A new instrument for duodenal and jejunal guided biopsies is described. The instrument is made of a tube, whith a steerable tip, which permits three-dimensional movements, and has a suction capsule. It is constructed by Medi-Tech Cooper Scientific Corporation (USA), and has been used in our department for three months. The technical aspects of this instrument, the procedure and the results achieved are described.


The pharmacokinetic profile of pirenzepine. This paper gives a brief review of the pharmacokinetic studies performed on pirenzepine (L S 519 Cl2, Gastrozepin hitherto. Particular attention will be paid thereby to the clinical significance of the pharmacokinetic parameters.


Sampling gastro-enterologists' opinions--an OMGE study. This study describes a pilot project to sample gastroenterologists' opinions on a variety of interesting and controversial topics. At the Madrid World Congress, a sample of delegates were asked to respond to a questionnaire distributed at the meeting itself. A total of 224, representative of those attending by discipline and by geographical area, did so. The results were analysed in two days and presented to the Congress within 72 hours. Amongst the findings were several of interest. Vagotomy is now the most common operation for (elective) duodenal ulcer surgery. Three-quarters of those responding prescribe high-fibre diet for chronic diverticular disease. Over 80% routinely prescribe sulphazalazine for patients with ulcerative colitis--even in remission. The most useful mode of detection of gastro-intestinal cancer is now felt to be endoscopy, even ahead of double contrast radiology. The results should be interpreted with caution, although the survey represents findings in over 200 hospitals. The principle of an on-the-spot rapid attitude survey has been established as feasible. It is proposed to repeat the exercise on a wider scale at the next World Congress in Stockholm in 1982.


The efficacy of amidantel, a new anthelmintic, on hookworms and ascarids in dogs. Amidantel is a new anthelmintic from a new chemical class with an interesting anthelmintic spectrum. In dogs amidantel is highly effective in a single oral dose of 25 mg/kg against both hookworm species, Ancylostoma caninum and Unicinaria stenocephala. In Toxascaris leonina infected dogs a complete cure rate was achieved with a single oral dose of 50 mg/kg. Similar results were obtained with 8 mg/kg administered three times per day. The most sensitive parasite to amidantel was found to be Toxocara canis  with a 100 per cent cure rate after a single oral treatment with 10 mg/kg. In preliminary trials amidantel was also effective against hookworms and ascarids after subcutaneous administration. All hookworms and almost all of the ascarids were eliminated with the faeces within 2 days after treatment. Amidantel was tolerated in all dosages tested by all the dogs without any symptoms.


[Albumin requirements of the aged].

[Albumin requirements of the aged]. In German speaking countries the opinion that old people require more protein than younger adults is still widely held. However, in its latest bulletin (1975) even the German Society for Nutrition recommends the same amount of protein for all adults over 21 years of age; this corresponds to the International Allowances. The physiological data on which allowances are based is summarized, and epidemiological evidence is given to show that in western countries the protein intake of the elderly corresponds to the recommendations.


Neuropsychological study in treated thyroid dysgenesis. Neuropsychological assessment was carried out in 57 patients aged 3.0 to 17.5 years (mean 8.5) with thyroid dysgenesis under adequate long-term therapy. Starting age of hypothyroidism as estimated by bone age at diagnosis was prenatal in 32 cases, close to birth in 13 cases and postnatal of 1-12 months in 12 cases. Hypothyroidism of prenatal onset results in severe neuropsychological disorders and mental retardation if not treated early. Only some signs of "minimal brain dysfunction" which compensate with advancing age and normal IQ are found in these children if therapy is started before one month of age. Hypothyroidism starting at birth does not result in mental retardation but neuropsychological disorders are found. They are more frequent if treatment is started after 6 months of age. Children who become hypothyroid between 1 and 12 months of age are usually not mentally retarded and show minor neuropsychological disorders.


Leakage of fluorescein: first sign of juvenile diabetic retinopathy. Role of diabetic control and of duration of diabetes. In order to ascertain the first vascular lesions responsible for juvenile diabetic retinopathy, 408 fluorescein angiographies were performed in 114 diabetic children and adolescents whose diabetes became clinically apparent before the age of 14 years. Compared with regular ophthalmoscopy, fluorescein angiography doubles the frequency of the diagnosis of incipient retinopathy. In addition to the classical diabetic lesions, fluorescein leakages are demonstrated in 50% of diabetic eyes with initial retinopathy. They probably reflect early changes in capillary permeability. They appear often before microaneurysms. Duration of diabetes as well as insufficient and poor metabolic control considerably increase the frequency of retinopathy.


Breast milk thyroxine and not cow's milk may mitigate and delay the clinical picture of neonatal hypothyroidism. Thyroxine concentration was measured in human milk and Cow's milk products by a specific radioimmunoassay. The mean (+/- S.E.M.) milk T4 concentration during the first 5 days postpartum was 0.7 +/- 0.3 microgram/dl (n = 11). The mean T4 concentration between 6-49 days postpartum rose to 3.1 +/- 0.2 microgram/dl (n = 108), falling after 50 days to a mean of 1.4 +/- 0.2 microgram/dl (n = 39). The mean (+/- S.E.M.) T3 concentration in breast milk in the first 50 days postpartum was 386 +/- 17 ng/dl (n = 56). T4 concentration in cow's milk products was less than 0.3 microgram/dl. Thyroxine concentration in 24 hours breast milk collection ranged from 0.7 to 7.7 microgram/dl and the total T4 in this milk ranged from 0.7 to 28 microgram/day. These data suggest that milk of human but not bovine origin may provide a significant exogenous source of T4 to the premature infant. This amount of exogenous T4 which is insufficient in preventing the proceeding of neonatal hypothyroidism, may delay the clinical recognition of this disorder. This once again emphasized the importance of early screening for neonatal hypothyroidism.


Diabetes insipidus in children. I. Arginine-vasopressin determination in plasma during short dehydration test. Plasma vasopressin as well as plasma and urinary osmolality are measured during an overnight dehydration test in vasopressin is undetectable. It is present in plasma from patients with partial diabetes insipidus but the level is not appropriate for plasma osmolality. In patients with polyuria of renal origin plasma vasopressin was significantly higher than in patients with neurogenic diabetes insipidus. Plasma vasopressin measurement is of diagnostic values in partial neurogenic diabetes insipidus and may be of considerable help to distinguish this group of patients from children with polyuria of renal origin.


Linear growth in hypopituitary patients treated with hGH after age fifteen. Two groups of hHG deficient adolescents (isolated growth hormone deficiency: 11 patients and multiple pituitary hormone deficiency: 20 patients) receiving hGH therapy were analyzed for their linear growth response. It was found that even at a chronological age of 15 years or more, growth can be markedly enhanced, depending upon the bone age and pubertal stage in the IGHD patients and upon optimal balance between hGH and sex hormones in the MPHD patients.


L-asparaginase-induced hypocomplementemia in acute lymphocytic leukemia (ALL) of childhood. Serum complement studies were carried out in five children with acute lymphocytic leukemia. During therapy with L-asparaginase, prednisone and vincristine, hypocomplementemia developed in all patients, and disappeared within 2 weeks after the discontinuation of L-asparaginase. Complement breakdown products were not present in plasma. The changes of serum complement levels paralleled those of plasma fibrinogen. These findings suggest that the hypocomplementemia observed in these patients may be related to impaired protein synthesis induced by L-asparaginase.


Evaluation of intramuscular versus intravenous administration of L-asparaginase in childhood leukemia. A study was done to evaluate intramuscular versus intravenous administration of L-asparaginase in childhood leukemia. The results of this study demonstrate that the intramuscular method of administering L-asparaginase is as effective, but less toxic, than the intravenous method for children with advanced leukemia. The utilization of L-asparaginase in the initial induction of children with lymphoblastic and undifferentiated leukemia should be investigated. Its addition to the standard inducing agents may increase the percentage and ease of remission without significantly increasing toxicity.


Correlation of the FAB morphologic criteria and prognosis in acute lymphocytic leukemia of childhood. The bone marrows at the time of initial diagnosis of 101 children with acute lymphocytic leukemia diagnosed from April 1969 to December 1974 were evaluated employing the FAB morphologic classification. The group with L1 morphology and a significantly improved duration of first remission and survival when compared to the L2--L3 morphologic groups. Both groups were similar in age and initial level of WBC, indicating that the morphologic classification has prognostic significance in childhood ALL when age and initial WBC were considered together as prognostic risk factors. The L1 morphologic groups survival for the low- and moderate-risk groups was significantly better than for the L1 high-risk group and for the L2--L3 groups.


Acute lymphoblastic leukemia with eosinophilia and basophilia. A boy with acute lymphoblastic leukemia showed cerebrospinal fluid and blood eosinophilia and basophilia. No cause for the eosinophilia or basophilia was identified, but they preceded the appearance of leukemic lymphoblasts in  both CSF and blood. The first appearance of basophils and eosinophils in the CSF was associated with acute symptomatology and responded completely to antileukemic therapy. Though treatment with intrathecal drugs reversed major neurological signs, there was evidence of generalized cerebral cortical atrophy. The possible mechanisms responsible for this unusual cellular reaction include: 1) reaction to antileukemic therapy; 2) immunological reaction to the lymphoblasts; 3) ectopic hormone production; 4) common stem cell origin of lymphoblasts, basophils, and eosinophils. The last explanation seems the most likely.


[Non-Hodgkin's lymphomas of high-grade malignancy. Pathological and differential diagnosis (author's transl)]. The non-Hodgkin's lymphomas of high-grade malignancy (NHL-hM) occur in patients of every age. There are two peaks of frequency: the first one between the 3rd and the 14th and the second one between the 50th and the 80th years of age. The NHL-hM may arise de novo or they develop more frequenctly in the course of a low-grade malignant lymphoma or in immune-deficiency states. They grow very fast and metastasise very early. However an early diagnosis allows to detect them in patients with the clinical stages I-II. By a radical operative removal of these tumours and by a thorough subsequent treatment a persistent remission or cure may be achieved. The most frequent types of NHL-hM are the lymphoblastic leukemias of childhood, the centroblastoma, and the immunoblastoma. In typical cases the histological diagnosis is easy. The immature, anaplastic types are difficult to diagnose and different methods (demonstration of surface and cytoplasmic immunoglobulins, cytochemistry, electron microscopy) most be applied. The most important differential diagnoses are the acute myeloblastic and myelomonocytic leukemias (naphthol-AS-D-chloroacetatesterase) immature epithelial tumours (lymphoepithelioma), and reactive processes (e.g. infectious monocleosis).


Parity and pre-eclampsia.

Parity and pre-eclampsia. In a series of 26,209 patiens, the incidence of pre-eclampsia was 9.3%, being significantly higher in primiparae (14.1%) than multiparae (5.7%) (P less than 0.001). In patients with early-onset pre-eclampsia there were highly significant (P less than 0.001) increases in the incidences of proteinuria, severe hypertension, placental abruption, fetal growth retardation, neonatal asphyxia and perinatal mortality. There were no significant differences between the incidences of these complications in primiparae and multiparae. The incidence of subnormal oestriol excretion was increased before the emergence of early-onset pre-eclampsia with equal to significance (P less than 0.001) in primiparae and multiparae. Eclampsia was more common in patients with late-onset pre-eclampsia, but not significantly so.


Perinatal death: audit and classification. Two hundred and thirteen perinatal deaths occurred in a population of 10,539 deliveries over a 4-year period. The associated obstetric complications and circumstances were analysed. The majority of perinatal deaths occurred in fetuses in whom there was a serious malformation, or whose birth weight was less than 800 g. Of the 110 deaths which occurred in normal babies weighing 800 g or more, 54 were antepartum, 5 were intrapartum, and 51 were neonatal. The clinical features surrounding these deaths were classified, and their implications discussed.


Mechanical dilatation of the cervix during labour. An instrument designed to produce vibrations to the cervix was assessed as a method of shortening the active phase of labour in 138 patients with abnormal labour. Results showed that it shortened labour in multiparous but not in nulliparous women. The cervilator's obvious benefit in certain patients and lack of apparent complications suggest that it can be a valuable addition to labour ward equipment. Further work is required to establish in which patients the instrument is likely to have the greatest value.


Duration of menstruation.

Duration of menstruation. Menstrual length was analysed in 2,342 women attending the Shepherd Foundation. Prolonged menses were more common in Australian and New Zealand born, in women with irregular, short or long menstrual cycles, menstrual pain, high parity, and an intrauterine device. In contrast to women with premenstrual tension and menstrual pain, psychological factors, smoking and drinking were not more common in women with increased menstrual length. It is concluded that somatic factors alone control menstrual length, and results in the present study support the hypotheses that both the hypothalamic-pituitary system and prostaglandins may be involved in this control. Evidence was found that the use of the contraceptive pill reduces the incidence of premenstrual tension when menstrual length is also reduced.


Infertility--a flow chart approach.

Infertility--a flow chart approach. A logical approach to the diagnosis and treatment of infertility using a "flow-chart" is outlined. Its application in the treatment of 100 patients in a peripheral gynaecology unit is presented. The distribution of the aetiological factors is also discussed.


Simplified antibiotic prophylaxis for vaginal hysterectomy. Single dose administration of antibiotics prior to vaginal hysterectomy was found to be an efficient and safe way of providing prophylaxis against infection. Metronidazole was as efficient as ampicillin in achieving a significant reduction in major morbidity, pelvic sepsis, and the "quantity" of postoperative fever. Antibiotic prophylaxis reduced hospital stay by an average of 3 days.


Prophylactic anticoagulation in the management of recurrent pre-eclampsia and fetal death. The case is described of a patient whose third pregnancy ended successfully, after 2 perinatal deaths caused by severe pre-eclampsia in the second trimester of her previous pregnancies. Anticoagulant therapy with warfarin was given in the third pregnancy.


A patient with pure gonadal dysgenesis, gonadal tumour and virilisation. A phenotypic female, karyotype XY presented with virilisation and amenorrhoea. The gonads showed evidence of oestrogen and testosterone production and, in view of the risk of malignancy, a laparotomy was performed. A streak gonad was present on one side with a streak gonad containing discrete tumours on the other. The uterus and Fallopian tubes were present. Removal of the gonads and uterus and subsequent oestrogen replacement therapy have produced a satisfactory clinical result.


Uterus didelphys associated with unilateral cervical atresia and renal agenesis. A case is reported of uterus didelphys associated with unilateral cervical atresia and renal agenesis on the same side. Two successful pregnancies occurred in the affected side after surgical correction.


Volvulus of the small bowel complicating mid-trimester pregnancy. A case of volvulus of the small bowel with gangrene extending from the duodeno-jejunal flexure to 15 cm from the ileocaecal junction is reported. The complication arose during the second trimester and was successfully treated by resection and end-to-end anastomosis.


Multicentric, pigmented carcinoma in situ of the vulva in association with vulval condyloma acuminata. A case report is presented of a 22-year-old woman with carcinoma in situ of the vulva in a multicentric pigmented form in association with vulval condyloma acuminata. The aetiology of the disease, varied appearances, malignant potential, and mode of treatment are discussed.


Macrophage-like cell transformation and CFU(c) fluctuations in normal and leukemic human marrow cultures treated by phorbol diester. Bone marrow from normal and chronic myeloid leukemia donors was grown in liquid cultures without feeder layers and with and without 12-u-tetradecanoyl-phorbol-13-acetate (TPA). In 24-96 hours most of the cells (60-70%) cultured with 10(-7) M and 10(-8) M TPA stuck to the bottom of the flasks and had a peculiar shape resembling macrophages possessing strong phagocytizing activity and surface markers of monocyte-macrophage lineage of differentiation. 10(-7) M and 10(-8) M TPA fully inhibited CFU(c) in cultures of normal marrow as well as of chronic myeloid leukemia (CML) patients; 10(-9) M and 10(-10) M exhibited individually varied partial suppression. Cultivation of bone marrow with 10(-11) M to 10(-13) M TPA led in some cases to statistically significant increase of CFU(c) on day 4 and day 7.


Effect of fluoride varnish (Duraphat) in preschool children. The caries-preventive effect of semiannual applications of a fluoride varnish (Duraphat) was tested for 2 years in 225 3-year-old children; 113 children served as a control group. At the baseline examination, 69% of the children in the test group and 75% in the control group were caries-free. The results after 2 years showed an average caries increment of 2.1 surfaces in the test group and 3.7 in the control group. The difference is statistically significant. Thirty-eight percent of the children in the test group and 27% in the control group were still caries-free. The caries reduction was 44%.


Effectiveness of combined preventive methods on erupting teeth in children in a fluoridated community. Several preventive methods were used in combination to reduce dental caries in children residing in a fluoridated area. The method included dental health education, prophylaxis, pit and fissure sealants, topical fluoride and restorative care. Prophylaxis, sealant and fluoride procedures were repeated every 6 months. Sealant was applied to all fully erupted caries free posterior teeth in the mouth. This report compares results obtained for teeth that erupted after the study began with those teeth that were already present at the time treatment procedures were applied. Percent reductions in caries increment for newly erupted teeth at the end of 3 years for treated 6th graders was 77.5% in DMFT and 79.2% DMFS as compared to 71% and 58.3% for previously erupted teeth. Results for children in 1st grade did not how such beneficial results. Permanent first molars in younger children appear to be highly susceptible to caries. Sealant retention for newly erupted teeth follows the same pattern as for teeth previously erupted.


Effect of dental health care instruction and prophylaxis on knowledge, attitude and behavior in Dutch military personnel. A study was conducted to evaluate the effect of a single dental health care instruction and prophylaxis on knowledge, attitude and behavior. Ninety-six army recruits from two military camps were randomly allocated to four groups: a control group, a group that received an oral prophylaxis, a group that received a single dental health care instruction, and a group that had both prophylaxis and dental health care instruction. Treatment effects were measured by a questionnaire 1 month and 3 months after the instruction. A single dental health care instruction improved knowledge, and some areas of behavior. The improvement in attitude was not clear. The improvements were small and showed a tendency to diminish after 1 month.


Relationship between age, dental status and regular dental care in Norway illustrated by a model. The purpose of this paper was to describe the relationship between age, dental status, and patterns of dental visits. Data from a national health survey of 11,014 persons in Norway 1975 were used. The model shows that though the absolute number of regular attenders decreased with increasing age their relative number among dentate persons increased with increasing age. Different examples of how the model may be used are described. Finally three explanations are given of the dental attendance pattern among Norwegian adults.


Factors influencing the local planning of dental services. Findings from a survey of 796 high school children in four districts constituting a health administrative area were examined to ascertain the factors influencing their dental disease experience, treatment received and attendance pattern. In three of the four districts, over 60% of the children were regular attenders, enjoying the benefit of less active caries than irregular attenders. However, in the remaining district, much of which consisted of depressed, inner city areas undergoing re-development, only one third were regular attenders. Several local factors, such as availability and accessibility of services, probably influenced the numbers seeking regular care, but one of the most important appeared to be the level of provision in the salaried Community Dental Service. The implications of the findings for planning improvements in local services are discussed.


Dentists and dental technicians as competing suppliers of complete dentures in Southwest Finland. In Finland, not only dentists but also dental technicians with special training have the right to supply clients with complete dentures. The present study investigated how the demand for their services is distributed between these two professional groups, and what are the factors affecting the distribution. The material consisted of 220 randomly selected subjects who had lost all their teeth in one or both jaws. Of the full dentures worn, 50% had been made by a dentist and 41% by a dental technician, while in 10% one denture, either maxillary or mandibular, was made by a dentist and the other by a dental technician. 56% of the subjects said they would choose a dental technician the next time health center services become more general and patients are more able to get treatment by dentists at a reduced cost, it seems probable that the majority of the edentulous will again resort to the dentists. However, judging by the current attitudes, a considerable number of the edentulous will continue to resort directly to the dental technician for the supply of dentures.